Honesty as good policy: Evaluating Maryland's Medicaid managed care program

State policymakers have been at the center of many important health care reform initiatives in the past decade. Launching large-scale, innovative programs presents many challenges for state agencies in design, implementation, and management. Conducting credible evaluations of these initiatives also is a crucial activity that may be overlooked or neglected because of resource constraints or competing demands on key staff. The experience gained in Maryland's HealthChoice evaluation reveals how a strong commitment to an open and participatory process combined with a rigorous focus on the need for quantitative and qualitative data contributed to both a better understanding of the program's effects and greater support for its future development.