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.
Dr. Al Dobson delivered a presentation entitled “Improvements to Medicare Disproportionate Share Hospital (DSH) Payments: National Provider Call” during a CMS National Provider Call. The purpose of the Call was to solicit public comment to inform the implementation of Section 3133 of the Affordable Care Act (ACA) as it relates to definitions and measures of the uninsured and uncompensated care. Approximately 1,300 stakeholders joined the call.
To view the presentation, click here.
The Missouri Hospital Association and Missouri Foundation for Health released a report on November 28th entitled “The Enrollment and Economic Impacts of Medicaid Expansion on Missouri.”
Dobson | DaVanzo was commissioned, along with the Department of Health Management and Informatics (HMI) at the University of Missouri School of Medicine, to determine the potential economic impacts if the state participates in Medicaid expansion under the Affordable Care Act. Two simulation models were developed based on the Impact Analysis for Planning (IMPLAN) model building software to estimate: (1) increased enrollment in and direct federal and state expenditures on Medicaid, and (2) the value-added economic and tax impact on the state’s economy, as well as private employer health insurance premiums.To view the full report, click here. To view the executive summary, click here.
At the 1st National Dual Eligibles Summit, Dr. Al Dobson delivered a presentation entitled “Can Medicare Acute and Post-Acute Care Payment Bundles Improve Care for Dual Eligibles?” In the presentation, Dr. Dobson argued that Medicare acute and post-acute care payment bundling is a sensible, near-term policy approach to payment reform for dual eligibles. Payment bundling could address misaligned provider incentives under siloed prospective payment systems and the lack of care coordination faced by the vast majority of dual eligibles in fee-for-service. The presentation was based on a research study funded by The Commonwealth Fund.For more information about the National Dual Eligibles Summit, click here.
The American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) released a report written by Dobson | DaVanzo analyzing a series of episode-based payment bundles. Using beneficiary-level Medicare claims files for a five percent sample of beneficiaries over a three-year span, Dobson | DaVanzo identified a number of important considerations for hospitals for bundled payment policy based on descriptive statistics and multivariate regression analyses.
The report concluded that in order to promote Medicare payment bundling as a nationwide, population-based model, policymakers will need to design a complete framework that carefully considers the options for defining and pricing bundles, with adequate safeguards to protect the quality of patient care and the financial stability of providers. It will likely be necessary to determine the cost to providers of delivering care within an episode, rather than use the current Medicare payment levels to predict payment.To view the issue brief and full report, click here.
Dr. Dobson addressed the Maine Primary Care Association on October 25th at the Annual Conference entitled “Health Reform Ready: Community Health Centers as Assets, Allies & Innovators.” Dr. Dobson presented on “The Potential Role of Health Centers in CMS Payment Bundling Systems of the Future.”
Dr. Dobson remarked that community health centers could have an impact on bundle expenditures if they can improve the continuity of care and become part of the “deal flow.” He emphasized the need to work with hospitals and physicians to ensure care is minimized for high risk patient populations during a bundle time frame.
To view the full presentation, click here.