This study uses two studies about the role of managed-care programs in serving Medicaid long-term care clients in Florida to illustrate how different research designs can reach divergent conclusions. Two reports from different groups using essentially the same database to assess the impact of managed care on a group of older Medicaid clients served by a Nursing Home Diversion Program reached different conclusions. The report from Florida's Office of Program Policy Analysis and Government Accountability concluded that the Diversion program saved money, whereas the report from the Florida Policy Exchange Center on Aging at the University of South Florida reached basically the opposite conclusion. Both agreed that the capitation rate was too high. How the policy questions are framed and analyzed can affect the conclusions reached. A variety of factors can influence the apparent effects of programmatic interventions. Evaluations must take relevant confounding variables into account.
Bibliographical noteFunding Information:
This work was supported in part by a Task Order (#CMS-04-0014) under a Centers for Medicare & Medicaid Services (CMS) Master Contract between CMS and the CNA Corporation (Master Contract #500-00-0035), Arlington, Virginia, with a subcontract to the University of Minnesota. The statements and opinions in the report are those of the writers and do not necessarily reflect the views of CMS or any of its staff or the state liaisons to the project. The authors would like to thank Glenn Mitchell and Larry Polivka from the Florida Policy Exchange Center on Aging at the University of South Florida and Steve Harkreader from Florida’s Office of Program Policy Analysis and Government Accountability for so generously sharing their analyses and providing insights. However, the responsibility for the final product rests solely with the authors. It reflects neither these institutions nor CMS.
- Home-and community-based care
- Long-term care
- Policy analysis