The RAND Evaluation

When The Robert Wood Johnson Foundation authorized Improving Chronic Illness Care, it mandated that a rigorous independent evaluation of the collaborative improvement process and the implementation of the Chronic Care Model (CCM) by health systems be included. In 1999 a multidisciplinary research team from RAND and the University of California at Berkeley, in cooperation with ICIC, undertook the evaluation work.

 

During the following four years, the evaluation team conducted in-depth assessments across 51 participating sites in four collaboratives involving almost 4,000 patients with diabetes, congestive heart failure (CHF), asthma and depression.  More than fifteen papers have been published detailing what was learned from the evaluation, and a summary of each can be found at RAND's web site. Highlights of the findings include:

  • Organizations were able to improve, making an average of 48 changes in 5.8 out of the 6 CCM areas;
  • Patients with diabetes had significant decreases to their risk of cardiovascular disease;
  • CHF pilot patients more knowledgeable and more often on recommended therapy, had 35% fewer hospital days;
  • Asthma and diabetes pilot patients were more likely to receive appropriate therapy.

When contacted a year later, the care teams reported that involvement in the collaboratives was rewarding.  Over that year, 82% of sites had sustained the changes and 79% of sites had spread change to other places or diseases.