Ensuring the Consumer Voice in Coverage and Quality in Massachusetts

The Program Being Evaluated

A Robert Wood Johnson Foundation (RWJF) initiative titled Ensuring the Consumer Voice in Coverage and Quality in Massachusetts, originally titled Massachusetts Quality Coverage and Quality Care (QCQC), aims to ensure that consumers have an effective voice in efforts to achieve quality coverage and care as the details of implementing Massachusetts’ health reform are hammered out. RWJF is supporting the initiative with a three-year, $1.5-million grant to a Boston-based consumer advocacy organization, Health Care For All (HCFA). Both the Foundation and the grantee organization see Ensuring the Consumer Voice (ECV) as a rare opportunity to combine an unusually fluid policy context with substantial funding support in order to learn more about building effective consumer voice in health system change.

About The Evaluation

Carolyn Needleman, Ph.D., of Social Research Associates, was contracted by the Foundation to assess the project’s progress. Because the project itself is reactive to an unpredictable and rapidly shifting policy context, the evaluation’s design is by necessity formative, descriptive and mainly qualitative. Its purpose is not to assess Massachusetts’ health reform as a policy approach, but rather to learn from HCFA’s efforts to engage consumers actively and strengthen consumer voice in health policy decision-making.

Major Evaluative Topics and Questions

The evaluation has focused on qualitative description and interpretation of HCFA’s evolving consumer advocacy activities in three areas:

  1. expanding affordable quality coverage (implementation of Massachusetts’ health reform law, known as Chapter 58);
  2. improving quality of care, especially patient safety; and
  3. planning for increased use of information technology in health care (e-Health).

In all three areas, the emphasis is on lessons being learned about the process and potentials of consumer engagement.

Summary of Methods

The evaluator gathered information from ongoing review of electronic and print commentary, six site visits, and ongoing telephone interviews with HCFA staff and participating consumers. For analysis, information from all of the above sources was first converted to narrative text consisting of abstracted notes from electronic and print sources, field notes from the site visits, and content summaries of the telephone interviews. This text material was combined and analyzed qualitatively to yield a description of Year 1 project activities and a compilation of lessons learned. The research approach in Year 2 remains essentially unchanged, except that the scope and volume of data-gathering has expanded to explore the consumer engagement activities and strategies; differences in approach from Year 1; and new insights into consumer engagement gained.

Products and Dissemination

The evaluation of Ensuring the Consumer Voice began May 2007 and will run for three years. The first interim report describes ECV’s initial year of operation, roughly from March of 2007 through March of 2008. The second year interim report describes the second year of operation, roughly from April of 2008 through April of 2009.