TITLE: Evaluation of Drug Use Review Demonstration Projects Final Report

ABSTRACT: The purpose of this project was to test the effectiveness of the drug use review (DUR) demonstration projects in improving drug use and reducing the negative consequences of drug misuse. Since 1990, the Medicaid program has been mandated to operate prospective and retrospective drug use review programs. In 1992, the Health Care Financing Administration (HCFA) funded two experiments managed by Iowa and Washington State Medicaid agencies. Project C.A.R.E., a joint effort between Washington's Department of Social and Human Services and the University of Washington School of Pharmacy, was evaluated to test the effects of paying pharmacists to provide cognitive services (CS). The Iowa Medicaid OPDUR Demonstration Project, involving Iowa's Department of Human Resources, together with researchers from the University of Iowa, Drake University and the Iowa Pharmacists Association, tested online prospective drug use review (OPDUR). Maryland and Georgia were included for experimental and comparative purposes. Both evaluations sought to improve drug prescription by influencing pharmacists' behavior. Findings indicate that prospective drug use review had no measurable effects on the frequency of drug problems, the utilization and expenditures on prescription drugs and other medical services. Further analysis revealed no behavioral changes in pharmacists who received OPDUR messages. Instead, the cognitive services most often provided by pharmacists involved counseling and educating patients, rather than interactions with prescribers or other pharmacists. Pharmacists who received payment for cognitive services provided more of this service than those who did not receive payment. These findings will be used to assess current DUR requirements for possible changes.

AGENCY SPONSOR: Office of Strategic Planning


PHONE NUMBER: 410-786-6591

PIC ID: 6296

PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA

TITLE: Examination of the Medicaid Expansions for Children

ABSTRACT: This project looked at changes in Medicaid legislation as a result of the Omnibus Budget Reconciliation Acts of 1989 and 1990. Analyses on the impact of the expansions included: (1) examination of enrollment and expenditure trends from 1988 to 1992; (2) assessment of the extent to which the expansions penetrated the target population; and (3) multivariate analysis to examine the impact of State policies and the eligibility group on enrollment, expenditures, and utilization of services. The examination of access to care and utilization of services included the development of a theoretical model, an analysis plan and items that could be incorporated into an established national survey.

AGENCY SPONSOR: Center for Beneficiary Services

FEDERAL CONTACT: Suzanne Rotwein, Ph.D.

PHONE NUMBER: 410-786-6621

PIC ID: 6300

PERFORMER ORGANIZATION: Urban Institute Washington, D.C.

TITLE: Service Utilization Patterns for Preventive Care for Undocumented Alien Children Under California's Medi-Cal Program

ABSTRACT: This project provides an analysis of service utilization and expenditure patterns for preventive and illness-related care for undocumented alien children under California's Medi-Cal program. The contractor initially developed a database of undocumented alien children covered by Medi-Cal. The analysis was conducted using State-specific eligibility codes for the years 1989-1992. They will then provide descriptive analyses of enrollees, utilization and payments, the proportions of total Medicaid child enrollees, utilization and payments that these children represent, and a descriptive analysis of the classification of services, including emergency, preventive and non-emergency, and service sites were examined. Also examined were the magnitude of expenditures for this group of undocumented alien children and the average expenditures per child and per person for month of eligibility.

AGENCY SPONSOR: Office of Strategic Planning


PHONE NUMBER: 410-786-6691

PIC ID: 7167

PERFORMER ORGANIZATION: Medstat Group Washington, DC

TITLE: The Evolution of the Oregon Health Plan: First Interim Report

ABSTRACT: Implemented in February 1994, the Oregon Health Plan (OHP) extends health insurance coverage (Medicaid eligibility) to uninsured State residents below the poverty level. The costs of expanded insurance coverage are financed through the use of a prioritized list of health care services (to determine the benefit package), increased enrollment in capitated managed care organizations (MCOs) and revenues generated by a cigarette tax earmarked for OHP. The program evaluation addresses both the implementation process and program impacts, using qualitative and quantitative approaches. Additionally, the evaluation focuses on the evolution of the OHP, its problems and challenges, and is based on State data and three site visits conducted in November 1994, October 1995 and June 1996. (final report is 226 pages)

AGENCY SPONSOR: Office of Strategic Planning


PHONE NUMBER: 410-786-6629

PIC ID: 6991

PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA