Table 1 Characteristics of case examples for evidence-based practice financing strategies
From: Translating economic evaluations into financing strategies for implementing evidence-based practices
Characteristic | Case 1 | Case 2 | Case 3 |
|---|---|---|---|
Financing strategies used | Pay-for-Success | Alternative payment models: case management payment, pay-for-performance | Fiscal mapping process (i.e., tailoring of strategies) |
Service sector | Behavioral health | Medical/hospital | Primary care |
Clinical problem | Serious behavior problems (e.g., conduct disorder) | Cancer | Opioid use disorder |
Evidence-based practice(s) | Multisystemic therapy (MST) | 24/7 clinician access, patient navigation, comprehensive care plan, guideline-consistent treatment | Integrating Support Persons In Recovery (adapted Community Reinforcement and Family Training) |
Service modality | Family- and community-based psychotherapy | Bundle of care coordination and treatment services | Group intervention for support persons; in-person and telehealth versions |
Other implementation strategies used | Required readiness, training/consultation, and quality assurance activities | Audit-and-feedback, continuous quality improvement, updated health record systems | Training and ongoing supervision |
Evidence base | Extensive clinical and economic effectiveness data | Extensive clinical data and more limited (but still promising) economic data | Original intervention has shown clinical efficacy; adaptation is being evaluated in a pragmatic trial |
Stakeholders involved in financing decisions | Colorado Governor’s office; social impact investor companies; MST intermediary | Center for Medicare & Medicaid Services, based on diverse stakeholder input | Bottom-up decision-making: intervention developer conducts fiscal mapping with input from health system and funding agency partners |
Role of economic evaluation in financing decisions | Projected cost-savings were the basis of selecting MST for implementation | A simulation budget impact analysis was conducted for the new payment models based on prior studies | Cost data are being collected and evaluated during the pragmatic trial |