Dobson | DaVanzo is pleased to announce that we recently co-authored a publication in Health Affairs with the Federation of American Hospitals titled: "CMS Hospital Value-Based Programs: Refinements Are Needed to Reduce Health Disparities and Improve Outcomes." In this research article, we assessed how both patient and community-level health equity risk factors affected hospital penalties under several CMS value-based programs. We found a statistically significant positive relationship between hospital penalties and medical complexity, uncompensated care, and the proportion of catchment area populations living alone - all factors not under hospitals' control. 

CMS has focused on value-based programs in an attempt to link provider payments to the quality of care provided. Our research indicates that adjustments may be required to existing value-based programs to account for community level health equity factors. Dobson | DaVanzo is glad to contribute to the ongoing discussions regarding value-based programs and we hope that our contribution will result in improved and more effective payments for providers. The full study can be found here.

Dobson | DaVanzo is pleased to announce that we have crossed another milestone in the history of our company. May of 2023 marks 15 years since our corporate inception, and we would like to take this occasion to thank each and every one of our clients, colleagues, and companions for being an enthusiastic part of Dobson | DaVanzo, LLC, meeting its founders' vision of a firm that would use claims data and econometrics to improve public policy.

What began as a small firm with just three members housed in a kitchen has risen up to stand tall amongst leading businesses in the field. Our company has earned countless achievements and accomplishments, and our work ethic mixed with a small business family culture has proven to be exceptionally inclusive and productive.

Throughout the years, we have provided testimony to the Centers for Medicare & Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC), as well as members of Congress, State legislatures, and numerous stakeholder groups. Our company has provided litigation support at the highest levels to aid courts, plaintiffs, and defendants in understanding the economic value of various health care issues. Our team is at the forefront of using administrative data sets to explore payment bundling and other CMS initiatives. We have applied decades of experience, access to a broad range of policymakers and subject matter experts, and innovative research techniques in order to best meet our clients’ needs. Our analyses are rigorous, objective, and make use of a variety of public and private-sector data sources. 

We are grateful to our clients who have trusted us and will continue to trust us to help them tackle difficult policy questions and challenges. Their feedback has pushed us to grow, improve, and become preeminent in our field. Our success story remains incomplete without the support of our clients and customers.

If it were not for the support and dedication of our team, our accomplishments would have never been possible. Every team member plays a very important role in the development of our company. Their enthusiasm, support, and dedication have brought us to this height.

We plan to keep our business and relations growing; we will continue to provide our clients with nothing less than the best, and with their support, we wish to explore new heights in the coming years.

Summer Arnold joined Dobson | Davanzo in March as a Research Analyst. She holds a B.A. in Psychology with a minor in Music from Indiana University of Pennsylvania, as well as an MPH with a concentration in health policy, administration, and management from New Mexico State University. Summer has also taken graduate-level coursework in Experimental Psychology.

Summer has experience in numerous sectors of public health including clinical research, healthcare administration, non-profit community work, and project management. She interned with the New Mexico Department of Health, working on a statewide vaccine equity grant. Summer has several years of experience in research design and methodology as well as unique experience with public health issues in the US-Mexico border region. 

Dobson | DaVanzo welcomed Collin McGuire as a Research Analyst in December. Collin has earned a Master of Health Science degree from the Johns Hopkins Bloomberg School of Public Health, as well as a Bachelor of Arts in Global Health and Bachelor of Science in Biochemistry from Arizona State University. Mr. McGuire brings considerable experience to the firm as he has worked with infectious disease research and education, especially human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Mr. McGuire worked as an HIV and AIDS educator for HEAL International, in Tempe Arizona and on the ground in Arusha, Tanzania. Mr. McGuire is proficient in the use of STATA and R for quantitative analysis and used qualitative analysis extensively during his time as a student and in HIV AIDS prevention. His manuscript, “Characterizing the impact of the Key Populations Investment Fund (KPIF) on HIV prevention and treatment programs for key populations in Malawi”, was presented at the International AIDS Conference 2022.

We are pleased to announce that Dobson | DaVanzo was recently awarded a contract to evaluate the baseline and first performance year results of the Episode Quality Improvement Program (EQIP)—an episode-based payment program for non-hospital providers designed to help the State of Maryland meet the financial targets of Total Cost of Care (TCOC) model.

Under this project, we will support Chesapeake Regional Information System for Our Patients, Inc. (CRISP) in evaluating the impact of EQIP on healthcare spending and outcomes in Maryland using Medicare FFS Claims data. Our team will also compare program results, key elements and strategies under EQIP to those of other successful bundled payment and value-based care models to identify opportunities for improvement.

Dobson | DaVanzo looks forward to supporting CRISP in this important work through qualitative and quantitative analyses that will be published in a final report.

Want to learn more about our claims data expertise or collaborate on a project? Get in touch with us.

Dobson DaVanzo & Associates, LLC is pleased to announce that the Interim Report to Congress (RTC), an evaluation of the Medicare Patient Intravenous Immunoglobulin (IVIG) Demonstration prepared by Dobson | DaVanzo, has been published by the Centers for Medicare & Medicaid Services (CMS). The report can be found here.

The Medicare IVIG Access Act of 2012 mandated the implementation of the IVIG Demonstration in 2014. Under the Demonstration, Medicare provides a bundled payment for the services and items involved with in-home IVIG therapy for the treatment of beneficiaries with primary immune deficiency disorders (PIDD). The Demonstration was extended by Congress in 2017 under the Disaster Tax Relief and Airport and Airway Extension Act, and again in 2020 under the Consolidated Appropriations Act.

Analyses found that access to in-home IVIG therapy improved under the Demonstration, evidenced by: 1) beneficiaries’ receipt on average of two additional IVIG therapies each year, 2) reduced likelihood of missing or postponing IVIG therapies, and 3) a reduction in infection-related services due to a more regular and predictable IVIG therapy regimen. Consequently, Medicare expenditures increased by $8,082 per beneficiary per year due to the increased use of IVIG, despite Demonstration beneficiaries experiencing fewer infections and reduced expenditures for hospital outpatient and physician services. Overall, CMS paid over $20M for items and services involved with the in-home administration of IVIG under the Demonstration for the 2,682 beneficiaries who utilized the Demonstration benefit at least once as of December 28, 2020

Dr. Al Dobson, President of Dobson DaVanzo and Associates, LLC, was invited to speak at the recent Institute on Rehabilitation Payment Models: Innovation, and Research and Policy, hosted by the Center on Health Services Training and Research (CoHSTAR) and the Learning Health Systems Rehabilitation Research Network (LeaRRn).

The two-day institute was held virtually on June 21 and 23, 2022. Distinguished speakers discussed a variety of topics including: continued provider adjustment to two significant payment system changes (the Skilled Nursing Facility Patient Driven Payment Model (PDPM) and the Home Health Patient-Driven Groupings Model (PDGM)), Quality Measure Development and Reporting, Health Equity, Alternative Payment Models, and an uncertain future given continued COVID-19-driven volatility, and a forthcoming Unified Post-Acute Care (UPAC) Prospective Payment System.

Leading the Opening Session for Day 2 of the Institute, Dr. Dobson provided a brief history of Post-Acute Care (PAC), synthesized key themes and lessons learned from Day 1 of the conference, and highlighted key issues within the PAC landscape including the role of therapy provision and the challenges of developing and operating within a UPAC Prospective Payment System.

Dobson | DaVanzo staff are pleased to announce a recently accepted study in Respiratory Medicine, titled, "Early Initiation of non-invasive ventilation at home improves survival and reduces healthcare costs in COPD patients with chronic hypercapnic respiratory failure: A retrospective cohort study".

Some highlights include:

• Multi-year retrospective cohort study of patients with COPD-CRF receiving Non-invasive Ventilation at Home (NIVH) using 100% Medicare claims
• Econometric IPTW matching methodology – Cox proportional hazard models for time-to-event outcomes and generalized least square model for Medicare expenditure outcomes.
• Findings are that hypercapnic patients benefited in reduced mortality risk from NIVH applied within the first week after index; hypoxic patients did not reduce their risk of mortality.
• Medicare expenditures for hypercapnic patients were lower in the 12 months after treatment than expenditures for either hypoxic or unspecified phenotypes.

 We are pleased to announce that Dobson | DaVanzo was recently awarded the State Data Resource Center (SDRC) contract with the Centers for Medicare and Medicaid Services (CMS) under our General Services Administration (GSA) Multiple Award Schedule (MAS).

 A key aim of this work is to support states as they obtain and use Medicare data for their dually eligible beneficiaries. These data, combined with the states' Medicaid data, allow the states and territories to gain a full picture of the care provided to this population, including beneficiaries' access to care, and the areas for care coordination.

Dobson | DaVanzo, together with our subcontractor, Acumen, LLC, look forward to supporting CMS and states in this important work through hands-on data assistance, webinar content creation and facilitation, and data validation tasks.

Want to learn more about our claims data expertise or collaborate on a project? Get in touch with us.

Dobson | DaVanzo welcomed Michael Beins as an Associate in June. Michael has earned an M.S. in Global and International Education from Drexel University, and a B.A. in both Secondary Education and English from the University of Maryland. He previously served as an English Language Development coordinator at Denver Public Schools and occupied positions in Istanbul, Turkey and Ukraine. Throughout his career in education, he focused on using research-backed approaches to modernize educational teaching methods, contributing to critical theory methodologies, student-centered practices, and restorative approaches in the field. With over a decade of academic editing experience and expertise in qualitative research methods, Mr. Beins uses his knowledge to diversify the research capabilities of Dobson | DaVanzo.

Dobson | DaVanzo welcomed Gage Grispino as a Research Assistant in June. Gage holds a B.S. in Biochemistry and Political Science with a certificate in American Constitutional Democracy from the University of Missouri. He has previously interned at the Cancer Support Community's DC Headquarters and was also selected as a Kinder Scholar from the Kinder Institute on Constitutional Democracy. Gage brings experience in financial analysis, project management, and producing policy proposals and budgets.

Dobson | DaVanzo welcomed Sky Gonzalez as a Research Assistant this month. Sky holds a B.S. in Public Health and Health Administration with a Certificate in Public Health Management from the Edward J. Bloustein School of Planning and Public Policy at Rutgers University. She is currently pursuing an MPH degree with a concentration in health policy from George Washington University. Her previous experience includes managing and serving as a medical assistant at a healthcare practice. Sky views healthcare from both clinical and public health perspectives. She has experience producing research in healthcare, specializing in reproductive health, insurance programs, and healthcare disparities.

Dobson | DaVanzo attended the Wound Care Evidence Summit from May 19^th - May 20^th 2022, organized by the Alliance of Wound Care Stakeholders.

The summit convened a multi-disciplinary group of wound care stakeholders including payers, federal regulators such as the FDA, researchers, clinicians, and manufacturers to collaboratively discuss the challenges in wound care research, clinical care, and coverage. Specifically, stakeholder discussions focused on understanding the quantity and type of evidence payers need to make a coverage determination for wound care products and services, and how that evidence fulfills the requirements of federal regulators concerning safety and efficacy.

During the two-day meeting, attendees reflected on the drawbacks of evidence from clinical trials that are often designed with stringent inclusion criteria - limiting the generalizability of these studies to the actual patients with wound seen in a clinical practice in a hospital or a clinic. Panelists and attendees also discussed the opportunities for using Real World Evidence (RWE) obtained from Real World Data (RWD), including Electronic Health Records (EHRs), administrative claims, registries, and patient-generated data, to support Federal regulatory approvals and payer coverage decisions.

Over the next few weeks, Dobson | DaVanzo will prepare and publish conference proceedings that will include key lessons learned as well as actionable next steps that wound care stakeholders can take to address the challenges discussed.

Dobson | DaVanzo has extensive experience applying rigorous statistical and econometric methodologies to Medicare FFS Claims to infer causal relationships between interventions (such as drugs or services) and outcomes. For instance, in a recently published journal article, we used a two-stage inverse probability treatment weighting model to compare the outcomes for Medicare patients with diabetic foot ulcer(s) (DFU) receiving cryopreserved placental membrane containing viable cells (vCPM) to other Cellular- and Tissue-Based Products (CTPs).

Want to learn more about our claims data expertise or collaborate on a project? Get in touch with us.

Dobson | DaVanzo welcomed Enaas Ahmad as a Research Assistant this month. Enaas holds a Bachelor of Arts in Medical Anthropology from the University of Virginia. Her previous experience includes introducing technology to ease the patient care system in a small-scale healthcare facility in urban Pakistan. She is skilled in clinical comprehension and has experience producing research in healthcare, specializing in indigenous health and biopolitics.

Dobson | DaVanzo staff are pleased to announce a recently accepted study in Advances in Wound Care, titled, "Cryopreserved placental membrane allograft reduces the likelihood of developing a new or recurring foot ulcer and all-cause mortality in diabetic patients, when compared to other cellular- and tissue-based products". This study examines differences in ulcer occurrence and mortality for Medicare Diabetic Foot Ulcer (DFU) patients receiving cryopreserved placental membrane containing viable cells and other cellular and tissue-based products. The study's strict DFU definition which excludes beneficiaries without foot ulcer with demonstrated diabetes etiology makes it an innovative study. Suggested citation: DaVanzo J, Hartzman A, Surfield C, Dobson A. Cryopreserved placental membrane allograft reduces the likelihood of developing a new or recurring foot ulcer and all-cause mortality in diabetic patients, when compared to other cellular- and tissue-based products. Adv Wound Care (New Rochelle). 2022 Mar 9. doi: 10.1089/wound.2021.0123. Epub ahead of print. PMID: 35262428.