Our experience with payment reform grants helped to change our way of thinking about grantmaking and evaluation because of the innovative and complex nature of projects that experiment with options for health reform.
In a series of interviews with grantees we conducted in late fall 2014, grantees shared the stories of their journey from the beginning of their funding to the conclusion of their work. Nearly every grantee found that their journey took them in a different direction than they anticipated. This posed a challenge to the structured evaluation process we had planned.
Though we started our grant program with a traditional evaluation plan and process, we came to understand that the complexity of payment reform and the dynamic environment in which health care innovations percolate make these projects better suited to developmental evaluation. Michael Quinn Patton described this type of evaluation, which is characterized by rapid learning rather than accountability for specific results, and grantee involvement in evaluation rather than outside objectivity. It measures adherence to values and big goals rather than delivery of expected outcomes. It is more about adaptation than rigorous follow-through.
To see more about what we learned and video clips of the grantees’ thoughts about participating in this initiative, go to the full blog post in the the Tools and Materials section of the MeHAF website. You can also find the three Issue Briefs and the final evaluation report from the University of Southern Maine on the Reports and Research page.
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