What do we know about rate-setting?

State regulation of hospital revenue is one approach to cost containment on which there is voluminous evaluative data from the "laboratory of the states"; yet these data are sufficiently complex and ambiguous that they are claimed by both proponents and opponents of rate-setting as support for their respective cases. This paper summarizes the evidence, concluding that mandatory rate-setting has generally constrained hospital costs where it has been implemented. However, were rate-setting established in additional states, it is not clear that comparable results would be realized. It is still less clear that rate-setting would constrain health care costs more than would increased competition and selective contracting.

Evaluation readiness: improved evaluation planning using a data inventory framework.

Factors intrinsic to many programs, such as ambiguously stated objectives, inadequately defined performance measures, and incomplete or unreliable databases, often conspire to limit the evaluability of these programs. Current evaluation planning approaches are somewhat constrained in their ability to overcome these obstacles and to achieve full preparedness for evaluation. In this paper, the concept of evaluation readiness is introduced as a complement to other evaluation planning approaches, most notably that of evaluability assessment. The basic products of evaluation readiness--the formal program definition and the data inventory framework--are described, along with a guide for assuring more timely and appropriate evaluation response capability to support the decision making needs of program managers. The utility of evaluation readiness for program planning, as well as for effective management, is also discussed.