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Quantitative Data Analysis Projects

Quantitative Data Analysis Projects

Featured Project:
Recovery – Comparative Effectiveness Research (CER) Public Use Data Pilot Project

Client: Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services
 
CMS has contracted with IMPAQ International, and partners including NORC and Buccaneer Computer Systems & Services, to pioneer the creation, dissemination, and support of Medicare claims public use file (PUF) to conduct comparative effectiveness research. The final data products for this project include Basic, Enhanced, and Linked PUF for a 5% sample of Medicare beneficiaries across 3 years of data using all nine Medicare claims limited data sets (Denominator, Inpatient, Outpatient, PDE, Carrier, Skilled Nursing Facility, Durable Medical Equipment, Hospice, and Home Health Agency). To guarantee the confidentiality of Medicare beneficiaries’ Protected Health Information (PHI) and assure an overall low risk of disclosure, sophisticated de-identification methods (e.g., GRLS-PC, GenMASSC) and rigorous re-identification analysis will be employed. In addition to the creation of the public use file, a large component of this project is the establishment of a Technical Expert Panel/Data User’s Group, the development of data access solutions, the creation of user support documentation, and the initiation of outreach/marketing activities. Other tasks to be performed under this contract include: Environmental Scan, Needs Assessment, CMS Research Data On-Demand, and Ad Hoc Program and Policy Analysis. 
 
IMPAQ is pleased to announce the completion and delivery of the CMS 2008 Chronic Conditions PUF and eight Basic Stand Alone (BSA) PUFs including the CMS 2008 BSA Inpatient Claims PUF. All PUFs are available on the CMS website. 
 

Analysis of Case-Mix Growth for Hospitals Paid Under the Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System

Client: Centers for Medicare & Medicaid Services,U.S. Department of Health and Human Services
 
In FY 2008, the Centers for Medicare & Medicaid Services (CMS) made changes to its Medicare severity diagnosis related group (MS-DRG) system for the inpatient prospective payment system (IPPS) and the Medicare severity long-term care hospital diagnosis related group (MS–LTC–DRG) system.
 
The purpose of this project is to estimate the observed change in national average case-mix between FY 2007 and FY 2008 and between FY 2008 and FY 2009 under the MS-DRG system, and determine what portion of that change is the result of documentation and coding improvements rather than a real increase in patient severity of illness. An additional objective of the study is to perform a separate analysis for Sole Community Hospitals (SCHs), Medicare Dependent Hospitals (MDHs), and Puerto Rico hospitals to see whether these hospitals, which are not fully subject to the documentation and coding adjustment, are experiencing significant increases in case-mix under the MS-DRG system.  For long-term care hospitals (LTCHs), the goal is to develop an estimate of annual real case-mix growth, to estimate the observed change in case-mix in FY 2008 based on LTCH claims data, and to estimate the proportion that is a real increase versus an apparent increase.
 

Analysis of Case-Mix Growth for Hospitals Paid Under the Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System: 2010 Follow-On

Client:  Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services

In an effort to more fully account for the severity of Medicare patients and its prospective payments to facilities, CMS replaced its Diagnosis Related Group (DRG) System with the Medicare Severity Diagnosis Related Group (MS-DRG) System in FY 2008.  In addition to more accurately compensating hospitals, the MS-DRG system was also expected to encourage hospitals to more fully document and code their patients’ conditions.  The MS-DRG weights were designed to produce a budget neutral transition from the DRG system to the MS-DRG system.  However, changes in coding and documentation behavior threatened this budget neutrality.  The purpose of this project is to continue the evaluation of the impact of documentation and coding changes on the increase in the case-mix index for hospitals paid under the inpatient prospective payment system and of long-term care hospitals paid under the prospective payment system.  These estimates will be used to inform CMS on how to set payment rates for FY2012 and FY2013 in order to ensure the overall budget neutrality of the implementation of the MS-DRG system. In addition to the analysis, IMPAQ will also contribute to the documents that are submitted to the Federal Registrar and assist with responses generated during this process.

Part C and Part D Payment Error Analysis / Payment Validation / MARx Payment Error Rates Support

Client:  Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services

IMPAQ is working for the fourth consecutive year with CMS to provide support in estimating components of payment error and improper payments in Medicare Part C and Part D; support payment validation and data integrity issues related to payments in these programs; and provide consultation and additional analyses regarding Part C and Part D payment error, including BPV and/or MARx payment error.

Analysis of the Impact of Electronic Medical Records on Risk Adjustment

Client: Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services

In this project, IMPAQ International and the National Opinion Research Center are conducting research to evaluate the potential impact of electronic medical record systems on risk adjustment in payments to Medicare Advantage plans. Using diagnostic information from medical encounters and the CMS-Hierarchical Condition Category (HCC) risk adjustment methodology, CMS determines annual risk scores for Medicare Advantage enrollees and uses these scores to adjust the monthly payments to Medicare Advantage organizations.  Accurate risk adjustment depends upon the accuracy of the supporting diagnosis data.  Thus, our evaluation  focuses on the impact of electronic medical record systems and other health information technologies on the quality and quantity of diagnosis data provided to CMS for the purpose of Medicare Advantage risk adjustment.  Project activities include:

  1. Analysis of data from various sources, including the CMS’ Risk Adjustment Data Validation (RADV) system and the Risk Adjustment System (RAS) to determine differences in diagnosis data generated from electronic medical record systems and diagnosis data generated from paper-based medical records.
  2. A review of the implementation of the American Recovery and Reinvestment Act provisions related to health information technologies, and their potential impact on Medicare Advantage risk adjustment.
  3. An environmental scan including literature review and key stakeholder interviews to gain an understanding of how available software generate diagnoses.
  4. The development of recommendations for CMS regarding the collection of diagnosis data generated from electronic medical record systems for the purposes of conducting Medicare Advantage risk adjustment.

Examining the Relationship Between Alcohol Policies and Violence (CDC)

Client:  Division of Violence Prevention, Centers for Disease Control and Prevention

Few public health issues have proved as challenging as the quest to determine whether government policies aimed at reducing alcohol consumption in the US would in turn reduce various types of violence that may result in injury or death.  While there is strong documented association between alcohol use and violence, there is no strong evidence of a causal link between alcohol consumption and violence.  Prior related studies have faced substantial challenges in compiling complete, valid, and reliable measures of the full range of policies and regulatory initiatives that may be implemented by States and other jurisdictions to reduce alcohol related violence and its costs.  IMPAQ has contracted with the Division of Violence Prevention, Centers for Disease Control and Prevention to develop an improved statistical approach for estimating this relationship, examining policies from multiple levels of government and multiple types of violence. 

Evaluation of the Federal Contractor Selection System

Client:  Center for Program Planning and Results of the Office of the Assistant Secretary for Administration and Management (OASAM), U.S. Department of Labor

The scope of this project is to evaluate the Federal Contractor Selection System (FCSS) used by the Office of Federal Contract Compliance Programs (OFCCP) to identify federal contractors who do not comply with federal laws related to employee discrimination.  There are four general goals under this project:

  • Evaluate the quality of the FCSS data used to identify non-compliant federal contractors
  • Identify employer characteristics and other factors available in the FCSS data that are strong indicators of non-compliance.
  • Evaluate the effectiveness of statistical models currently used to predict non-compliance.
  • Suggest improvements in the OFCCP contractor selection process.

To conduct this evaluation, IMPAQ will review the FCCS data and all documentation relevant to the data and the OFCCP selection process.  IMPAQ will also conduct interviews with key OFCCP staff to assess the data collection practices, data quality, and OFCCP selection process.  Using this information, IMPAQ will examine the quality of the FCSS data and identify factors that predict non-compliance among federal contractors.  IMPAQ will also use rigorous quantitative techniques to evaluate the effectiveness of current statistical models to predict contractor non-compliance.  The final deliverable will describe the findings of the evaluation, including suggestions for improving the OFCCP selection process.

Development of Medicare Part C, D, and Retirement Drug Subsidy (RDS) Error Rates

Client: Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services
 
A risk assessment of Medicare Advantage (MA) payments conducted by the Centers for Medicare & Medicaid Services (CMS) found that the MA program was susceptible to improper payments exceeding $10 billion, with a 2.5 percent error rate.  As a result, CMS contracted with IMPAQ to help identify the systems and processes that were causing these errors.
 
IMPAQ’s work on this project included two phases.  In Phase I, IMPAQ developed a Medicare Part C, D and RDS Risk Assessment which included a payment system overview, a comprehensive identification of risks, a ranking of the risks identified, and a definition of a Part C Payment Errors.  Phase II includes the development of a Measurement Methodology for selected Part C, D and Retirement Drug Subsidy (RDS) High Risk Areas. 
 

Data Quality Review

Client:  Millennium Challenge Fund – Georgia
 
The Millennium Challenge Corporation of the United States Government awarded a total of $395 million in grant funding to the Republic of Georgia between 2005 and 2008 to stimulate economic growth in the country.  The objective of the Data Quality Review (DQR) project is to ensure that data collected for program monitoring and evaluation are of acceptable quality, reliability, and consistency.  As part of the DQR, the IMPAQ team will assess the quality and
consistency of data across different Implementing Entities and other institutions engaged in survey data collection efforts. The IMPAQ team will report on key issues or problematic areas regarding data quality, as well as identify mitigation measures to correct the problems. This review will help to improve the overall effectiveness and efficiency of both the data collection and data analysis efforts for the development projects managed by the Millennium Challenge Fund team in Georgia. 
 

Medicare Part C and Part D Payment Error Analysis: Logical Follow-On

Client:  Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services
 
In accordance with the Improper Payments Information Act (IPIA) of 2002, the Centers for Medicare & Medicaid Services (CMS) has undertaken an initiative to develop methodologies for estimating components of payment error and improper payments in Medicare Part C, Part D, and the Retiree Drug Subsidy (RDS) programs. IMPAQ is supporting this effort through: 1) the development of payment error rates for Medicare Part C and Part D prospective payment systems; 2) the identification of the error rates associated with erroneous external data, such as Low Income Subsidy status; 3) the development of a composite error rate; and 4) the provision of support for the monthly Beneficiary Payment Validation analyses and reports prepared by CMS. 
 

Beneficiary Payment Validation

Client:  Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services
 
Effective Federal spending requires identification of potential improper payments and development of strategies to reduce payment error . The Improper Payments Elimination and Recovery Act of 2010 (IPERA) requires Federal agencies to review programs which may be susceptible to improper payments.  With this new contract award IMPAQ is proud to continue its support of CMS’ initiative to develop and implement methodologies to estimate payment errors and improper payments in Medicare Part C and Part D.  CMS reports Part C & Part D payment error rates to the Office of Management and Budget (OMB) each year. IMPAQ continues to support this important CMS initiative by (1) calculating the MARx Payment Error (MPE) Rate for Part C and Part D prospective payments; (2) providing monthly support for the Beneficiary Payment Validation (BPV) process; (3) conducting additional BPV analyses and producing reports; (4) developing and implementing processes for ensuring the integrity of data used in the monthly BPV process and monitoring these activities on a regular basis; and, (5) providing, as needed, consultation and analysis on additional payment error issues to respond to requests by CMS and OMB.
 

Medicare Prescription Drug Benefit (Part D) Final Payment Process

Client: Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services 
 
As a subcontractor to StrategicHealthSolutions, IMPAQ provided a full range of statistical, analytical, audit, financial, formulary, and professional services to the Centers for Medicare & Medicaid Services to assist them in analyzing the Part D Payment Reconciliation results as determined by the Payment Reconciliation System (PRS).  IMPAQ also supported the establishment and implementation of a process for determining final Medicare Part D Payments.