Incorporating Comparative Effectiveness Research Tools to Examine the Effect of a Reimbursement Policy Change on Local Public Health Service Outcomes

This supplement proposes to enhance the methodological capabilities of the currently RWJ funded North Carolina Practice-based Research Network project examining the consequences of a recent dramatic reduction of Medicaid reimbursement funding for a program that since the late 1980s has provided evidence-based case management, maternity outreach and postpartum services to low-income women and their children, and contributed to improved birth outcomes in these at-risk populations.

The present application for an administrative supplement for methodological work in public health systems and services research augments the current research with two Aims. The first Aim is to enhance the current propensity score matched analysis examining the effects of the funding reductions through further methodological extensions such as coarsened-exact matching methods and other propensity score techniques in order to refine control groups of pregnant women and children who are as similar to women and children receiving care coordination services as possible. The second Aim is to use tools developed in the comparative effectiveness research literature to examine the range of effects the funding cuts may have had on diverse groups of women and children. While conducting subgroup analysis by age or race is straightforward and feasible where sample size permits, current tools allow researchers to better estimate the range of effects of funding cuts on a vulnerable group of women and children.

The methodological supplement will leverage the currently funded project in NC by taking advantage of the data and resources already available to the NC PBRN, while expanding the size and capabilities of the research team.

Marisa Domino, PhD, Principal Investigator

Dorothy Cilenti, DrPh, MPH, MSW, Co-Principal Investigator