Back to Evaluating Value-Based Care

Module 2

Comparison Groups

The heart of causal evaluation: why before-and-after misleads, how to build a valid comparison, and why value-based models rarely randomize.

3 lessons About 14 min

By the end of this module, you will be able to:

  • Explain why before-and-after comparisons cannot isolate a program's effect
  • Apply difference-in-differences to separate a program effect from background trend
  • Judge how much weight a study deserves based on how its participants were selected
  1. Why Pre-Post Comparisons Mislead Comparing a program's population before and after seems obvious and is usually wrong. This lesson shows why you need a comparison group. About 4 min
  2. Building a Valid Comparison A comparison group only works if it is truly comparable. This lesson covers matching and difference-in-differences in plain language. About 5 min
  3. Randomized vs Observational Randomization solves the comparison problem cleanly, and value-based models almost never use it. This lesson explains the trade-off you are always reading around. About 5 min

Module quiz

Answer all questions to see your score.

1. Why is a before-and-after comparison with no comparison group unreliable?

2. What does difference-in-differences measure?

3. Why is randomization the strongest evaluation design?