Today Dobson | DaVanzo released a study that estimates the potential Medicare savings for deferring provider payments for RAC appeals until after Administrative Law Judge (ALJ) hearing determination (Level 3). Due to significant delays in the ALJ process, requests for hearings often take around 30 months until review and determination is received, resulting in significant interest payments for CMS when reimbursing providers for successful appeals. The study analyzed data from the Office of Medicare Hearing and Appeals (OMHA) and testimony from a Chief ALJ Judge to estimate the Medicare savings for avoided interest payments under this policy. This study focuses on the savings for RAC audits for O&P services, as well as all Medicare Part B services associated with RAC Level 3 audits.
Click here to read the report.
National Association of Psychiatric Health Systems (NAPHS) commissioned Dobson | DaVanzo to define the substance use disorder population and to appraise existing policies regarding the coverage, funding, and delivery of addiction treatment. The report, "Addiction Treatment Today and Tomorrow: Implications and Policy Recommendations" notes that transformative policies (namely, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA) have sought to improve patient access to treatment by reforming prior insurance coverage restrictions. Yet significant coverage gaps persist. The full report, along with the Dobson | DaVanzo two-page Executive Summary, is available at www.naphs.org.
On March 4, 2015, Al Dobson gave a presentation at the Select Medical CEO and Medical Director Conference in Coral Gables, Florida. His presenatation, "Market Place Considerations for Inpatient Rehabilitation Facilities Under Medicare Bundled Payment for Care Improvement (BPCI)", can be viewed by clicking here.
Al Dobson and Joan DaVanzo gave a presentation today at the Health Dimension Group (HDG) National Summit: The Pursuit of Value, in Orlando, Florida. The presentation, entitled, "Market Place Considerations For Post Acute Care Providers Under Medicare Bundled Payment for Care Improvement (BPCI) Initiative" can be viewed by clicking here.
Al Dobson recently briefed Senate staff on the findings of the Dobson | DaVanzo study on the impact of complex medical rehabilitation on patient outcomes. This study, entitled “Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge" can be found on the American Medical Rehabilitation Providers Association (AMRPA) website, or by clicking here.
Analyses of data from 262 psychiatric care facilities surveyed by Dobson | DaVanzo were released Wednesday in this year’s National Association of Psychiatric Health Systems (NAPHS) Annual Report. Findings from Dobson | DaVanzo’s analyses show a growing need for psychiatric services in inpatient hospitals based on 2011 and 2012 utilization data. The report provides trend analysis, looking at changes from year to year in NAPHS-member hospitals and residential treatment centers, as well as national averages to give a snapshot of members’ experiences in the reporting year. The report can be purchased from: https://naphs.org/resources/home.aspx?product-tab=1
Al Dobson and Joan DaVanzo co-presented at a AAMC BPCI Facilitator Convener Group Webinar, Friday, June 6, 2014. Al discussed risk of readmissions, and Joan presented case studies on current risk assessment strategies.
Al Dobson and Joan DaVanzo jointly participated in the NAACOS 2014 Spring Conference, on a panel entitled, “Managing Post-Acute Care and Risk Assessment”. Al’s presentation was on considerations for ACOs based on a payment bundling framework, while Joan’s presentation was on considerations for patient assessment in an ACO environment.
Dr. Allen Dobson and Audrey El-Gamil, along with the Alliance for Home Health Quality and Innovation (AHHQI), joined the Visiting Nurse Associations of America (VNAA) 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 explains 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. The webinar also summarized key findings from the Clinically Appropriate and Cost‐Effective Placement (CACEP) project, which examined how the Medicare home health benefit is currently serving Medicare beneficiaries, and how Medicare’s use of home health could better meet beneficiary needs and improve the quality and efficiency of care.
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.