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MES Certification Repository

Writing a good outcome statement

To meet the standards of recent CMS guidance, all enhanced funding requests should include written outcomes statements and metrics. A great outcome statement should provide clear answers to the following questions:

1. What is the benefit to Medicaid?

Technology should enable better program outcomes. How does the project align with the goals of the state’s Medicaid program and therefore provide a benefit beyond technical specifics?

Questions that may help include:

  • How does this support the Medicaid State plan?
  • How does it improve efficiency of the Medicaid State Plan?
  • How does it improve the effectiveness of the Medicaid State Plan?
  • How does it improve the economics of the Medicaid State Plan?

Examples:

  • Growing the provider directory
  • Improving care coordination

2. What are the intended Outcome(s)?

The Outcome statement is more specific to the project and should describe the desired results and benefits once the system or project is implemented.

Questions that may help include:

  • What will be better after this project is completed?
  • How will the project demonstrate added value to operations?
  • How will it leverage the ongoing investment to support operations?

Examples:

  • Simplifying the referral process to reduce wait times for follow up appointments
  • Reducing Emergency Room and hospital readmissions by improving care coordination with more timely patient engagement by their community care team

3. What Metrics (data) provide evidence that Outcomes are being met?

Once an Outcome statement is clearly identified, supporting Metrics must be documented to identify how the intended Outcome will be measured. Metrics are data/ evidence that the Outcomes are being met on an ongoing basis. In addition, Metrics enhance transparency/accountability of IT, as well as provide insight into program evaluation and opportunities for continuous improvement.

Questions that may help include:

  • What metrics would demonstrate whether a system is meeting the Outcome?
  • What method is used to measure the results?
  • What is the current baseline?

Examples:

  • The number of providers listed in the directory that are searchable either by a structured search or a free text search
  • The number of Emergency Room and hospital readmissions
  • The timeliness of patient engagement by their community care team after discharge