Ms. Justine Wagner

Ms. Justine Wagner (B.A., Economics, University of Maryland, Baltimore County) is a Research Associate at IMPAQ International, LLC specializing in healthcare provider performance measurement, in addition to implementation, monitoring, and evaluation of Medicare programs. Ms. Wagner is the Program Director for the Centers for Medicare & Medicaid Services (CMS) Qualified Entity Certification Program (QECP), a program mandated by Section 10332 of the Affordable Care Act. In this role, she is responsible for the successful implementation of the QECP on behalf of CMS. Since January 2012, the QECP has certified 13 “qualified entities” to receive Medicare claims and prescription drug event data for the purposes of publicly reporting on the cost and quality of healthcare.

As part of the CMS Monitoring Methods project series (2009 to 2014), Ms. Wagner served as Project Manager, Task Lead for the Medication Therapy Management (MTM) task, Co-Task Lead for the Special Needs Plan (SNP) Enrollment task, Task Lead for the Administrative Function task, Lead Analyst for the Part D Rejected Point-of-Sale (POS) Claims task, and Lead Analyst for the Voluntary Disenrollment task. For these Medicare program monitoring tasks, Ms. Wagner was responsible for understanding the intricacies of Medicare Part C and Part D program policies and developing data collection and analysis tools (including performance measures) to ensure Medicare Advantage Organizations and Part D sponsors are in compliance with program requirements.

As part of the CMS Payment Error Analysis project series (2008 to 2013), Ms. Wagner served as the Task Lead for the MARx Payment Error (MPE) task, and Task Coordinator and Analyst for the Beneficiary Payment Validation (BPV) Data Integrity, Enhancement, and Trending Analysis tasks. For these Medicare payment error analysis tasks, Ms. Wagner was responsible for synthesizing monthly Part C and Part D payment error data and calculating Medicare Advantage Prescription Drug System (MARx) Payment Error (MPE) estimates to assist CMS with its annual reporting responsibilities under the Improper Payments Information Act (IPIA).

As part of the CMS Senior Risk Reduction Demonstration evaluation project (2010 – 2011), Ms. Wagner served as quantitative analyst and data manager. She assisted in the development of experimental and quasi-experimental evaluation designs and methodologies, and used SAS to import and analyze health risk appraisals and Medicare claims data received from vendors and CMS.

IMPAQ Papers and Presentations

Warth, M. & Wagner, J. (2015, November). Completing the Quality Puzzle: The Impact of Medicare FFS Data on Provider Performance Results in Oregon and Central New Mexico. Presentation at the APHA Annual Meeting & Exposition, Chicago, IL.

Wagner, J. (2015, June). Impact of Medicare FFS Data on Provider Performance in Oregon and Central New Mexico. Presentation at the AcademyHealth Annual Research Meeting, Minneapolis, MN.

Turbyville, S., DeMar, S., Peters, B. & Wagner, J. (2014, June). The Qualified Entity Certification Program: A Change Agent for Healthcare. Presentation at the AcademyHealth Annual Research Meeting, San Diego, CA.