Successful health system transformation requires alignment of incentives to promote high-value, patient-centered care.
Increasingly, public and private sector payers are requiring health care providers to measure and report quality of care and using financial incentives to encourage them to prevent illness and improve quality while reducing the cost of care.
To respond to these requirements and incentives, health care providers need new tools for measuring quality, identifying and managing high-risk individuals, and exchanging information and coordinating care across settings. At the same time, both public and private payers need analytic and methodological support in implementing and monitoring the impact of new incentives on cost and quality and detecting unintended consequences.
IMPAQ is helping to make our health system more effective and efficient. IMPAQ is helping CMS and other federal agencies to implement new payment models; tailor quality measures for clinically defined patient populations; evaluate new workforce training models; improve quality by reducing healthcare-associated infections and other adverse events; and evaluate the success and sustainability of care delivery redesign or payment methods. IMPAQ is also helping states to evaluate the cost and quality impacts of new care delivery and payment models.
Customizing Solutions for Your Particular Challenges
IMPAQ can help you incentivize continuous quality improvement and cost reduction by providing the necessary information to make data-driven decisions.
Our health care experts collaborate with government, nonprofit, and private sector clients to evaluate, design and implement health care delivery policies, programs, and systems.
IMPAQ can bring industry veterans with significant experience in payment, policy, and delivery systems to address your challenges. Our teams of health executives, statisticians, social scientists, clinicians, survey experts, programmers, and project managers, approach problems from diverse viewpoints to craft holistic solutions.
IMPAQ’s in-house survey data collection and information technology expertise sets IMPAQ apart by allowing us be seamlessly responsive, listening and adjusting to your needs, while uncovering new challenges and opportunities.
View all of our services here, or read about a few of our health care projects below.
The successful implementation of new programs requires the ability to work flexibly on a tight timeline. Through experience, IMPAQ knows to expect and be prepared for the unexpected. In doing so, IMPAQ has demonstrated its flexibility and adaptability, as well as its capacity to quickly re-align staffing and project resources as projects’ needs and priorities evolve over time.
For example, IMPAQ is implementing for CMMI all aspects of the Comprehensive ESRD Care (CEC) Model, which is the nation’s first condition-specific ACO program. In doing so, IMPAQ’s health economists and data analysts are identifying eligible beneficiaries and attributing them to participating dialysis facilities, establishing expenditure targets, conducting payment reconciliation to determine shared savings payments, adjusting those payments for performance on quality measures, developing condition-specific quality measures and a quality monitoring and scoring approach, and assisting provider organizations to submit performance data electronically.
In addition, IMPAQ supports the Center for Consumer Information and Insurance Oversight in a variety of activities and programs relating to the implementation of health insurance-related provisions of the Patient Protection and Affordable Care Act. IMPAQ conducts qualified health plan (QHP) certification, recertification, and post certification assessment (PCA) reviews across a range of QHP certification standards. IMPAQ also plays a critical role in developing standard operating procedures, conducting data quality assurance activities, providing help desk support for multiple stakeholder community inquiries, supporting issuer outreach communications, triaging and tracking various outreach communications, and providing technical assistance to states participating in the Health Insurance Marketplace.
Developing Data to Inform Research and Policy
Timely, accurate information is the basis of useful, credible research and effective policy decisions. IMPAQ has combined our substantive expertise on the health care system, understanding of researchers’ and policy makers’ data needs, and technical expertise to develop data resources to inform health-related research and policy.
For example, IMPAQ is assisting the National Institutes of Health to develop a database of state statutes to inform clinical, health economic, and technology diffusion-related research. The State Health Practices Database for Research will include information that is critical to advancing the knowledgebase on efficiency and quality in the financing and delivery of health care services, and particularly the use and impact of new health care technologies.
IMPAQ also developed the Environmental Scanning and Program Characteristics Database on behalf of the Centers for Medicare and Medicaid Services. This database is a fully documented repository of Medicaid program characteristics that may influence beneficiary outcomes, such as eligibility requirements, benefit design, and provider characteristics. Information from the database can be linked to other data, such as the Medicaid Analytic eXtract files, to support comparative effectiveness research and other program and policy studies.
In addition, IMPAQ developed public-use and restricted-use datasets for the US Department of Health and Human Services that are intended to strengthen comparative effectiveness research. In doing so, IMPAQ staff securely obtained, processed, and stored claims records for more than six million Medicare beneficiaries.
Health Policy Analysis
IMPAQ has undertaken a variety of activities to inform the development of health policies and the decisions to adopt and implement them. These activities include conducting literature reviews and environmental scans, convening expert panels, developing and fielding surveys, conducting key-informant interviews, and writing white papers and decision memos.
For example, IMPAQ conducted two environmental scans on two major areas of concern to policymakers. The first was the increasing use of second-generation antipsychotic drugs, also known as atypical antipsychotics, among children over the past 15 to 20 years. The second area was the large racial and ethnic disparities observed in antipsychotic drug utilization. Based on this information, we developed an empirical approach and an analytic data set to explore these questions.
Using the results, IMPAQ investigated antipsychotic drug utilization rates and explored how utilization differs across states, over time, and by child characteristics such as age, gender, race and ethnicity, and eligibility group. IMPAQ concluded that plateauing rates of antipsychotic drug use in 2009 was likely the result of changes in the Medicaid population rather than a change in providers’ propensity to prescribe antipsychotic drugs.
An industry leader in program evaluations, IMPAQ has designed, developed, and implemented state-of-the-art techniques and approaches to evaluating health programs. Our research staff includes experts in economics, statistics, psychology, sociology, and anthropology who bring together diverse viewpoints, subject area knowledge, and real world experience to collect reliable, valid data to measure the impact of programs from both quantitative and qualitative perspectives.
For example, we are working with the Centers for Medicare & Medicaid Innovation to conduct several evaluations of innovative CMMI programs. Our evaluation of the Graduate Nurse Education Demonstration program will help CMMI to determine whether reimbursing hospitals for the cost of providing clinical training can increase the number of Advanced Practice Registered Nurses. The evaluation of Bundled Payments for Care Improvement Model 1 will determine whether a bundled payment approach for inpatient episodes, combined with gainsharing between hospitals and physicians, produces savings for the Medicare program and improvements in patient outcomes. IMPAQ is also testing whether the Community-based Care Transitions Program, which focuses on improving transitions from inpatient to other care settings, reduces readmissions and produces savings.
IMPAQ is also working in partnership with the Health Research & Educational Trust to evaluate the Agency for Healthcare Research and Quality’s TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) program. The evaluation effort is gathering information about training participants’ reactions to and learning immediately after course completion and then following-up at least six months later to assess the transfer of training content to their organizational settings.
In addition, IMPAQ assisting the Agency for Healthcare Research and Quality to evaluate comprehensively the National Action Plan to Prevent Healthcare-Associated Infections. In doing so, IMPAQ is examining the effort’s leadership and strategy, knowledge development, infrastructure development, HAI prevention practice adoption, and the effects on stakeholders. So far, IMPAQ has conducted more than 100 key informant interviews with the leadership of the Department of Health and Human Services, leaders of exemplar quality improvement efforts, and state and regional public health officials. IMPAQ has also conducted literature reviews and analyzed national healthcare-associated infection rates.
Improving the Lives of Older Adults and People with Disabilities
With experts in aging, disability and long-term services and supports policy, IMPAQ has experience at the local, state and federal levels conducting research that brings together expertise in education, human services, health care, and labor.
For example, for the Centers for Medicare and Medicaid Services, IMPAQ developed a set of National Balancing Indicators that help federal and state agencies assess state efforts to implement long-term services and supports that reduce dependence on institutional care and expand home and community-based services. We are also working closely with partners to conduct national evaluations of the Accessibility of American Job Centers for People with Disabilities and the Community-based Care Transitions Program.
IMPAQ is also assisting in the design and implementation of the Long Term Services and Supports Information and Tracking System for the Mississippi Division of Medicaid. This work is focused on helping Mississippi to conduct in-person beneficiary experience and satisfaction surveys; conduct a mailed family caregiver survey; and strengthen Medicaid provider qualification requirements.
In addition, IMPAQ designed and conducted the National Evaluation of Aging and Disability Resource Centers, including quantitative process and outcome studies to examine whether and how the program met the needs of aging and disability populations and whether consumers who access Center resources have more positive experiences than who do not.
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