A recent Academy Health blog post explored the relationship between the number of physicians accepting Medicaid patients and the number of children who were able to access care without being turned away or having their care delayed. The author deduced a simple, yet important point: More doctors=better access for kids; better reimbursement=more doctors.
As researchers continue to explore these and other issues in Medicaid policy, it is vital that research findings are timely, relevant, and presented in ways that are useful for policymakers. It comes as no surprise that an important first step in making research relevant is understanding the priorities and evidence needs of the intended research user. This is the premise underlying a recent AcademyHealth report highlighting the research and data gaps that policymakers and analysts identify as key to informing Medicaid policymaking over the next several years. The report, “Improving the Evidence Base for Medicaid Policymaking,” is the second in AcademyHealth’s Listening Project series, which seeks to identify areas where new or better evidence could help inform timely issues in health policy and health care delivery. The Medicaid-focused report is informed by interviews with more than 50 Medicaid policymakers, researchers, and other stakeholders from across the country. Across the interviews, respondents consistently noted several areas where new or better evidence could help inform their decision-making or that of their colleagues. For example, respondents saw a role for the research community in helping them:
- Understand the health and budgetary implications of Medicaid expansion versus non-expansion;
- Implement strategies for driving quality and value through payment and delivery system reform;
- Develop targeted strategies for serving high-cost, high-need enrollees, such as dual eligibles and individuals with mental health and substance use disorders;
- Identify opportunities for better coordination among Medicaid programs and social services agencies, public health departments, and the criminal justice system;
- Determine what benefits and services best match the needs of specific groups of enrollees; and
- Explore the role of community health workers, peer support specialists, and other alternative health care providers in serving Medicaid enrollees.
In addition to outlining high-priority research needs, the report offers advice from the policymaking community for researchers seeking to produce more policy relevant work. Some of this advice we’ve heard many times before, such as the importance of communicating research results in clear, concise language and disseminating findings in multiple formats, such as a peer-reviewed publication accompanied by a shorter brief. In addition, many respondents noted the importance of understanding states’ unique political environments, budget constraints, and other contextual factors that can affect the production and use of research – a point that is not unique to Medicaid. In another piece of advice, several respondents encouraged researchers to put study findings in the context of existing literature as a way of helping policymakers and other audiences understand the study’s contribution to the current evidence base.
A product of Academy Health’s Translation and Dissemination Institute, the report is supported by the Robert Wood Johnson Foundation and the Medicaid and CHIP Payment and Access Commission. It follows an earlier Listening Project report focused on the evidence needs of Medicare policymakers, and precedes a 2016 report that will highlight opportunities for researchers to help inform pressing issues in safety net care.
In response to these needs, AcademyHealth today released the first in a series of Evidence Roadmaps that take a closer look at the evidence needs identified in the Medicaid report. The Roadmap explores how best to integrate physical and behavioral health services for Medicaid enrollees, especially for those with serious mental illness. Medicaid enrollees with both types of needs are often among the program’s most costly and medically complex.The Roadmaps are intended to help policy analysts and other research users better understand whether a perceived research gap represents an actual lack of evidence, or failure to effectively disseminate existing evidence to the policy arena. Nine Roadmaps created in response to findings from the Medicare-focused Listening Project were released earlier this year.
View complete findings from the Medicaid Listening Project here, and stay tuned for additional Roadmaps resulting from this work.