Assessing care integration for dual-eligible beneficiaries: a review of quality measures chosen by states in the financial alignment initiative.

Caring for the 9 million low-income elderly or disabled adults who are eligible for full benefits under both Medicare and Medicaid can be extremely costly. As part of the federal Financial Alignment Initiative, states have the opportunity to test care models for dual-eligibles that integrate acute care, behavioral health and mental health services, and long-term services and supports, with the goals of enhancing access to services, improving care quality, containing costs, and reducing administrative barriers. One of the challenges in designing these demonstrations is choosing and applying measures that accurately track changes in quality over time­essential for the rapid identification of effective innovations. This brief reviews the quality measures chosen by eight demonstration states as of December 2013. The authors find that while some quality domains are well represented, others are not. Quality-of-life measures are notably lacking, as are informative, standardized measures of long-term services and supports.

Engaging patients and stakeholders in preresearch: findings from the Pipeline to Proposal Awards Initiative.

Aim: The Patient-Centered Outcomes Research Institute Pipeline to Proposal (P2P) Awards Initiative funded 177 awardees to engage patients and stakeholder partners in preresearch. Based on P2P, we described engagement strategies; outcomes; facilitators; and challenges to inform research funders and stakeholders participating in preresearch. Materials & methods: We used a qualitative approach based on content analysis of program data and interviews with P2P awardees and partners. Results: Awardees developed partnership infrastructure by recruiting patients and stakeholders, establishing clear roles, and providing training. Building trust was key to engaging patients and stakeholders in preresearch. Awardees reported partners were more likely to engage in PCOR in the future. Conclusion: P2P awardees increased capacity of patient and stakeholder partnerships to conduct PCOR.