Applied Research Studies Projects

Development of a Medicare Advantage and Prescription Drug Plan Monitoring Methods

The goal of this project is to develop methods and measures for monitoring Medicare Advantage Organizations’ (MAOs) and Prescription Drug Plan sponsors’ (Part D sponsors) performance for a variety of Medicare Part C and D program requirements. To accomplish these goals the IMPAQ team engages in the following tasks:

• Conducting more than 100 interviews with CMS Subject Matter Experts
• Extracting and analyzing data from CMS’ Health Plan Management System (HPMS) and other large administrative data sources (e.g., Prescription Drug Events, Transaction Reply Reports)
• Calculating hundreds of parent organization/contract/PBP-level measures of MAO and Part D sponsor performance for CMS internal use
• Developing secure web-based surveys and data collection portals for MAO and Part D sponsor to upload required data
• Requesting and analyzing large datasets that CMS requires plans to maintain but does not require them to submit to CMS (e.g., rejected point-of-sale prescription claims, telephonic enrollment audio files, etc.)
• Reporting recommendations for increasing MAO and Part D sponsors’ compliance with Medicare Parts C and D regulation.

Additional efforts include conducting gap analyses and developing measures of Part C and Part D sponsors’ administrative function using CMS administrative data.

Job Corps Evaluation

The purpose of this project is to determine the factors that contribute to or impede the successful operation of the U.S. Department of Labor’s Job Corps program.  Through an examination of Office of Job Corps structures and Job Corps Center characteristics and practices that have not previously been evaluated the IMPAQ team will analyze how particular Office of Job Corps structures (such as participant selection criteria, performance-based fees, staffing, and the current Performance Measurement System) affect Job Corps success. We will also evaluate Job Corps Center characteristics, including program components and organizational capacity, and practices that influence the success of the centers to achieve positive effects on their participants. Once factors, practices, and processes that contribute to the success of Job Corps have been identified recommendations for alternative approaches to measuring Job Corps Center performance will be presented.

Specific tasks being performed include:

• Conducting interviews with Job Corps Management
• Developing performance measures and ranking systems
• Conducting site visits to Job Corps Centers
• Analyzing administrative data
• Administering a survey to directors of Job Corps Centers.

The final deliverable for this project is a Final Report summarizing the results of the analysis and providing appropriate recommendations to DOL.

Development of a Medicaid/CHIP Environmental Scanning and Program Characteristics (ESPC) Database

For the Centers for Medicare & Medicaid Services (CMS), IMPAQ is developing a Medicaid and Children’s Health Insurance Program (CHIP) database containing program characteristics and State-specific environmental factors (i.e., population demographics, and health, environmental-air, water, etc., political, economic, and provider factors). Since these programs are State and Federal partnerships, there are many options open to States, which results in various program structures.  Therefore, the factors that impact enrollment, utilization, and spending vary by State.

Funded through the American Recovery and Reinvestment Act (ARRA) of 2009, under this project the IMPAQ Team will develop a single database to support comparative effectiveness research (CER), and design the structure and reporting mechanisms so that it will be available to the research community in a format(s) that they can easily use.  Potential users of the database include researchers assessing CER and disseminating evidence based information and analysis to: 1) policy and decision makers in Federal and State agencies, 2) clinicians, 3) patients, 4) academia, and 5) consultants and contractors. 

No single source of data contains State/local variations containing program and environmental factors, particularly contextual variables to use for multivariate analysis.  This database will serve as a vital tool in understanding Medicaid and CHIP trends within a State, as well as allowing comparisons across States. It will also provide an opportunity to continue developing, enhancing, and complementing the current Medicaid Analytic eXtract (MAX) data for CER research.

Development of Medicare Advantage and Prescription Drug Plan Performance Measures   

IMPAQ is collaborating with CMS on a broad effort to review and analyze the CMS’ Medicare Advantage (Part C) and Prescription Drug (Part D) programs for approaches to monitor sponsors and to develop monitoring methods for selected approaches.  The methods and measures selected within this contract will monitor the administration of more than 630 contracts with MA-PD/Cost Plan sponsors and 89 contracts with PDP sponsors for CY2010.  There are several primary tasks/areas for analysis in the project which include:

• Providing a Part C and Part D monitoring gap analysis
• Developing a sustainable monitoring method and measures of administrative function for Part C and Part D Sponsors
• Developing a sustainable monitoring method and measures that ensure that marketing materials and beneficiary communications are available to beneficiaries in the required languages consistent with the CMS Marketing Guidelines
• Developing a sustainable monitoring method and measures to help ensure beneficiary provider access in the Part C program
• Developing a sustainable monitoring method and measures of benefits and out of pocket coverage for Part C benefits.

A critical component of each task is “knowledge transfer” regarding all datasets and documented procedures and programs.

Part C and D Complaints Resolution Performance Measure

Following on previous work developed by IMPAQ for CMS, we will develop and support implementation of a performance measurement for the Medicare Advantage (Part C) and Prescription Drug (Part D) program that validates plan resolution of beneficiary complaints closed by plans from the unique perspective of the beneficiaries themselves. CMS expects to publish a performance metrics using this data in November 2011. Key activities include analysis of administrative data, a beneficiary survey, and measure development.

Evaluation of Performance of Medicare Part D Organizations' Business Logic for Performance Metrics and Composite Scoring Report Card

National Balancing Indicator Contractor (NBIC) To Conduct Research, Development, amd Technical Assistance on Long-Term Support System Balancing Indicators

Design, Development, and Implementation Support for the Demonstration Project In Community Health Integration Models in Certain Rural Counties

During this contract IMPAQ and its subcontractors, NORC and Eide Bailly, will assist CMS in its exploration of new models for the delivery of health services to improve access to care and to better integrate the delivery of acute care, extended care, and other essential health care services in frontier counties.  The initial phase of this contract will include coordination with the HRSA grantee, Montana Health Education and Research Foundation, to identify problems that contribute to the low level of health care in frontier counties.  This problem assessment task will include a literature review, secondary data analysis, and structured interviews.  After identifying the key problems, IMPAQ will identify solutions to the problems. After CMS reviews the problems and solutions, IMPAQ will design and implement a demonstration based upon the solutions selected by CMS.  During the implementation of the demonstration, IMPAQ will assist CMS with the solicitation efforts, the review of applicants, and the estimation of the waiver costs and will provide implementation technical assistance to the demonstration participants.

Data Review and Guidance Development for Medicare Special Needs Plans and a Quality Improvement Program for Medicare Advantage

In this task order, IMPAQ is reviewing and evaluating data currently collected by CMS through its oversight activities for the Medicare Advantage (MA) and Special Needs Plans (SNPs) and is helping CMS develop policy guidance on quality oversight and improvement for these programs.  The task order will increase CMS’s ability to understand quality improvement and care coordination strategies currently being undertaken by MA plans, particularly the Quality Improvement Program (QIP) and Chronic Care Improvement Program (CCIP), and to provide guidance to plans on best practices. Among the set of deliverables is a framework upon which CMS guidance under the MA QIP and CCIP authority will be updated.  The specific tasks include:

• Evaluation and review of audit data to assure appropriate enrollment in Chronic Condition SNPs (C-SNPs);
• Review and analyze SNP audit data and performance data (e.g. member satisfaction, health status, clinical outcomes);
• Assist with the development of manual chapters on SNP issues and SNP specific Standard Operating Procedures (SOP); and
• Data analysis, reporting, trending, and identifying quality improvement processes across the Medicare Advantage program.

In the task order, we will also establish and test a pilot project using beneficiary encounter data for MA and SNP program evaluation and monitoring and identify Value Based Purchasing best practices and strategy recommendations for MA plans.

Evaluation of the Unemployment Insurance Benefits Program

National Business Group on Health’s Purchaser's Guide Evaluation: 

Feasibility and Methodology Study

• Refinement of an existing conceptual framework on the impact and effects of the use of the Guide on health and productivity outcomes
• The development of research questions and the identification of potential data sources to address them§          Development of an evaluation design and methodology.
• The conduct of a pilot test for data acquisition and analysis to address selected research questions.

Autism Spectrum Disorders (ASD) Services

• Conducting a comprehensive environmental scan of the research literature related to evidence-based services and supports available to individuals with ASDs
• Performing an assessment of the services currently being provided by nine states to individuals with ASDs
• Designing model programs of services and supports for children, transitioning youth, and adults with ASDs, including methods for measuring related processes and outcomes
• Developing and implementing a web-based ASDs information portal.