Al Dobson participated in a “roundtable discussion on emerging policy issues” at a Brandeis University Health Industry Forum held in Washington, D.C. earlier this week. The panel discussed a range of issues, including the evolution of bundled payment policy under Medicare, the implications of new preferred networks of post-acute services on patient care and on providers outside of those networks, and the impact of other likely Medicare policy changes.
Dobson | DaVanzo presented results of their study at AMRPA Spring Executive Leadership Forum today, in Washington, DC. The study, "Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Facilities and After Discharge", shows that when patients are matched on demographic and clinical characteristics, rehabilitation in IRFs leads to lower mortatlity, fewer readmissions and ER visits, and more days at home than rehabilitation in SNFs for the same condition.
For more information, please access the AMRPA website here.
Dr. Allen Dobson and Audrey El-Gamil joined the Alliance for Home Health Quality and Innovation (AHHQI) in a webinar presentation entitled "Bundling and Coordinating Post-Acute Care (BACPAC) Toolkit". The toolkit outlined new approaches for post-acute care bundled payments with the ability to improve delivery of care for patients, providers, and the entire U.S. health care system. The analysis elucidates issues related to the structure, components, and attributes of post-acute care payment bundles (excluding the initial acute care hospitalization) and models the financial impact of various design parameters.
Al Dobson participated on a technical expert panel on Valuing Physician Work under the Medicare RB-RVS at RAND on November 25, 2013. The main purpose of the meeting was to review and comment on RAND's draft work plan for this study.
She presented the results of a study recently published in Seminars in Dialysis entitled "Clinical and Economic Value of Performing Dialysis Vascular Access Procedures in a Freestanding Office-Based Center as Compared with the Hospital Outpatient Department among Medicare ESRD Beneficiaries." This study found that ESRD patients who receive vascular access maintenance and placement services in a dedicated vascular access center have better outcomes and lower Medicare payments than patients treated in the hospital outpatient department.
To access the article, click here.
The Amputee Coalition, with support from the American Orthotic and Prosthetic Association, released a report prepared by Dobson | DaVanzo that compares the clinical outcomes and Medicare payments for patients who received orthotic and prosthetic services to similar matched patients who do not receive the services. Using a custom cohort database of Medicare claims, the report presents findings from a series of retrospective cohort studies focusing on lower extremity orthoses, spinal orthoses, and lower extremity prostheses. The results of this study are based on the largest known sample of Medicare orthotic and prosthetic users and provide national results as opposed to the small regional studies currently available in the literature.
The study found that patients who received orthotic or prosthetic services have lower or comparable Medicare payments than those who did not receive these services. The orthotic and prosthetic services are associated with higher rates of physical therapy and rehabilitation, which allow patients to remain in the community and avoid costly facility-based care, including hospital admissions.
To access the full report, please click here.
Dobson | DaVanzo published an article in Seminars in Dialysis (Early View) that compares the cost-effectiveness of receiving dialysis vascular access services in a freestanding office-based center (FOC) as opposed to the hospital outpatient department. The article found that patients treated in the FOC had significantly better outcomes, including fewer related or unrelated hospitalizations, fewer vascular access-related infections, and fewer septicemia-related hospitalizations than patients treated in the hospital outpatient department. Furthermore, FOC care was associated with lower mortality rates and reduced Medicare payments.
To access the article, click here.
Washington Post and Politico report on recent Dobson | DaVanzo study, entitled, “Structural Changes Drive Health Care Spending Slowdown: Implications for Medicare Policy and Deficit Reduction” produced for the Federation of American Hospitals (FAH).
Read the Washington Post article.
Click here to view the full study.
Dr. Dobson recently gave a presentation to the Kentucky Hospital Association on Medicaid managed care alternatives, entitled, "Developing Provider-Based Proposals to Reform the Kentucky Medicaid Program."
Dobson | DaVanzo is proud to announce that we recently celebrated our sixth anniversary. Over the past six years the firm has expanded to a seasoned staff of ten full-time employees, and continues to grow. We have also had the opportunity to develop relationships with wonderful new clients, and have deepened our relationships with existing clients.
We look forward to continued interesting and challenging projects as health reform evolves over the next six years.
Audrey El-Gamil participated in a panel and presented the findings of the Clinically Appropriate and Cost-Effective Placement Project at the Pennsylvania Homecare Association Annual Conference. The session, entitled "Research on Home Health Use & Impact on Readmission" summarized the importance of patient pathways and readmissions on Medicare spending.
Dr. Dobson gave a webinar presentation entitled, “Managing the ‘Spend’ and Quality in Post-Acute Care and Beyond.” This presentation highlights the findings of several large, data-driven studies by Dobson | DaVanzo of Medicare bundled payments for acute and post-acute care episodes, in order to assist Pioneer ACOs in managing Medicare beneficiaries throughout the care continuum.
Dobson | DaVanzo and KNG Health Consulting LLC were commissioned to provide technical assistance to the Centers for Medicare & Medicaid Services (CMS) as it implements a revised Medicare Inpatient Prospective Payment System (IPPS) disproportionate share hospital (DSH) payment policy as called for in Section 3133 of the Affordable Care Act of 2010 (ACA). In doing so, the Team prepared summary analytic reports and data analyses to inform the development of the FY 2014 Notice of Proposed Rulemaking (NPRM).
Click on the following links to access the reports used to inform CMS’ Proposed Rule and to assist with public comment.
Dr. Dobson presented to the Kentucky chapter of Healthcare Financial Management Association (HFMA) at the Winter Institute held in Louisville, Kentucky. Dr. Dobson presented findings from the American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) commissioned study to conduct quantitative analyses of a set of episode-based payment bundles. The purpose of this study was to highlight considerations for policymakers and providers using descriptive statistics and multivariate regression analyses. Dr. Dobson also discussed key issues for bundling in practice and showed supporting Medicare claims data illustrating how to appropriately define, price, and manage the bundle.