Dr. Ajayi: We "must do better" at evaluating complex care programs

Commonwealth Care Alliance (CCA) in Massachusetts is regarded as one of the top complex care organizations in the country. Dr. Toyin Ajayi, CCA's Chief Medical Officer, called for more rigorous evaluation of care models for people with complex health and social needs in a May 15 article on the New England Journal of Medicine's Catalyst blog:

Large sums of money have been devoted to developing interventions focused on “bending the cost curve” by attenuating the rapidly rising costs of caring for these populations. Whether such programs actually save health care dollars remains an open question because rigorous evaluation data are limited.

Three Critical Principles

Dr. Ajayi, in partnership with Iyah Romm of Google's Sidewalk Labs and Dr. Maria Raven at UCSF, identified three critical principles for measuring comprehensive medical and non-medical impact of new models designed for high-needs populations:

  1. Use the right time frame for evaluation. To properly evaluate the impact of a complex care intervention, you likely need at least 24 months of data.
  2. Don't just track dollars spent. Quality of life and other non-utilization measures can provide a more comprehensive view of a program's impact.
  3. Connect data across sectors. Sharing data across sectors can help to "form a more person-centered view" of an individual's needs, their total impact on the system, and the program's impact on each person.
The full article: Evaluating Complex Care Programs: Is It a Zero-Sum Game?

Topics: Outcomes & Evidence