Overview of Selected Projects
The Center on Health Care Effectiveness works in a wide range of areas to inform decision makers of the best evidence surrounding difficult health care issues. For more information on related projects, click on one of the following research topics:
Comparative Effectiveness Research
(Projects are listed alphabetically by client.)
| Project Name |
Evaluation of Aetna's Care Coordination Program |
| Client |
Aetna |
| Description |
This was a retrospective study of the effects of Aetna’s Medicare managed care (Medicare Advantage) program on enrollees in the northeastern United States (New York, New Jersey, Pennsylvania, and Maryland). Aetna’s nurses provided a case management intervention to approximately 18 percent of its enrolled population, and other, less intense interventions to additional members. The study compared all plan enrollees to a non-experimentally matched comparison group in fee-for-service Medicare in the same market areas. Outcomes of interest included hospital admissions and days, emergency room admissions, skilled nursing facility admissions and days, and mortality. |
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| Project Name |
Establishing Federal Resources to Support the Patient-Centered Medical Home Concept
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| Client |
Agency for Healthcare Research and Quality (AHRQ)
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| Description |
This project supports the efforts of AHRQ and the federal government to build and reinforce primary care using the patient-centered medical home (PCMH) model. Mathematica is conducting an environmental scan of PCMH demonstration projects, activities, and research; preparing a series of five white papers and accompanying policy briefs; facilitating expert meetings; helping AHRQ with a website on the medical home; and working with AHRQ to convene a federal working group on primary care transformation and to develop strategic plans. |
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| Project Name |
Federal Facilitation of the Primary Care Medical Home Model |
| Client |
Agency for Healthcare Research and Quality |
| Description |
This project supports the efforts of AHRQ and the federal government to develop the evidence base on the patient-centered medical home (PCMH) for researchers and policymakers and to convene an expert working group on practice facilitation for primary care transformation. This project continues and expands the work of a project that began in September 2009. |
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| Project Name |
Evaluation of the Medicaid Value Program (MVP): Health Supports for Consumers with Chronic Conditions |
| Client |
Center for Health Care Strategies, Inc. |
| Description |
The Medicaid Value Program sought to test interventions seeking to improve care for adult Medicaid beneficiaries with multiple chronic conditions. The program was funded by a grant from Kaiser Permanente, with additional funding from the Robert Wood Johnson Foundation. Ten teams all sought to improve care for Medicaid beneficiaries, but they did so in a variety of ways and focused on different populations. Seven targeted their interventions to patients, all but one of them using a case management and coordination model to improve care. The exception augmented a pre-existing disease management program with in-person patient education. Others targeted providers to improve the quality of patient care. Mathematica’s evaluation identified factors that contributed to successful implementation of grantee interventions and lessons learned that would contribute to replicability and sustainability of their programs. |
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| Project Name |
Community-Based Care Transitions Program (CCTP) Implementation and Monitoring |
| Client |
Centers for Medicare & Medicaid Services (CMS) |
| Description |
The Community-Based Care Transitions Program, a major component of the Partnership for Patients Pledge created by the Affordable Care Act, will provide $500 million in funding over the next five years to test models for improving care transitions from the hospital to the community for Medicare beneficiaries at high risk of readmission. As the implementation and monitoring contractor, we are (1) developing and implementing an electronic system for collecting, validating, and paying invoices from community-based organizations (CBOs), and (2) monitoring CBOs' progress toward meeting their performance targets, as well as the program's impact on federal expenditures. Specifically, we are using Medicare claims and information collected through a participant experience survey to calculate 30-day hospital readmission rates, primary care provider follow-up visit rates, patient activation scores, and adverse event measures, such as 30-day emergency department visit, observation stay, and mortality rates. CMS will use the results to provide real-time performance feedback to CBOs and their hospital partners and to determine whether CBO contracts will be renewed after an initial two-year performance period. |
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| Project Name |
Demonstration to Maintain Independence and Employment (DMIE) Data Analysis |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica conducted a national evaluation of how the DMIE impacted participants' health status, employment outcomes and independence from federal disability programs. The projects were funded to encourage states to design, implement, and evaluate interventions for workers with potentially disabling health conditions. Read more. |
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| Project Name |
Evaluation of Disease Management Programs |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mandated by the Benefits Improvement & Protection Act (BIPA), this demonstration was designed to improve the health care and outcomes of Medicare beneficiaries with severe congestive heart failure, coronary artery disease, or diabetes. The program was expected to accomplish these goals while reducing total Medicare costs for enrollees by providing coverage for prescription drugs and by using disease management techniques to improve care and adherence to recommended medication, diet, and exercise regimens. Mathematica randomly assigned Medicare beneficiaries who agreed to participate in the 4 demonstration programs to a treatment or control group. The evaluation relied on Medicare claims data and a patient survey. We also conducted a telephone survey of 50 physicians from two of the programs to provide information on physicians’ acceptance of these DM programs and on how the programs have affected the physicians’ practice of medicine for chronically ill patients. The evaluation included an implementation analysis that examined the design and operational experience of programs through site visits, site documents, site data, and patient intake data. It also included case studies of each program, a report to Congress, and a final evaluation report on the LifeMasters disease management program. |
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| Project Name |
Evaluation of the Electronic Health Records Demonstration (MRAD) |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
This study is evaluating the effectiveness of the Electronic Health Records Demonstration, which aims to promote high-quality care through the adoption and use of certified electronic health records by primary care physicians in small-to medium-size practices who serve Medicare beneficiaries with chronic illnesses. Mathematica is examining whether financial incentives influenced the adoption and use of electronic health records, whether the demonstration improved quality of care for fee-for-service Medicare beneficiaries with chronic illnesses, and whether the pay-for-performance model tested should be implemented on a larger scale. Read more. |
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| Project Name |
Evaluation of the Extended Medicare Coordinated Care Demonstration |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica is conducting an ongoing evaluation of the CMS Medicare Coordinated Care Demonstration (MCCD), which was designed to test the use of various disease management interventions to improve care coordination, patient adherence to treatment and self-care regimens, and physician adherence to treatment guidelines for targeted chronically ill fee-for-service Medicare beneficiaries. This evaluation looks at those programs that were extended beyond the initial four-year period of operation. |
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| Project Name |
Evaluation of the LifeMasters Disease Management Demonstration Program for Dual Eligible Beneficiaries |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica conducted an evaluation of the LifeMasters Disease Management Demonstration Program for Dual Eligible Beneficiaries that targeted chronically ill dual eligible beneficiaries. Mathematica randomly assigned beneficiaries eligible for the program into treatment and control groups and reviewed Medicare administrative claims data to determine if the primarily telephonic program could reduce health care costs and improve quality of care. |
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| Project Name |
Evaluation of the Medicare Care Management Performance Demonstration |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica is evaluating a congressionally mandated demonstration on inducements for small- and medium-size physician practices to adopt health information technology and improve quality of care. The initiative is examining whether use of the technology results in better adherence to care standards, improved patient outcomes, and savings to the Medicare program. The demonstration operated in four states. Read more. |
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| Project Name |
Evaluation of Programs of Coordinated Care and Disease Management |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica evaluated 16 independent demonstration sites that provide coordinated care interventions to Medicare beneficiaries with chronic illnesses. The demonstration sites offered programs designed to improve both the care that patients received and patients’ knowledge of, and compliance with, recommended self-care and behavior. The study estimated the effects of each site on patients’ well-being and satisfaction, in addition to the site’s effects on the use and cost of Medicare-covered services. Read more. |
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| Project Name |
Evaluation of Project Access: Improving Access to Care for Children and Youth with Epilepsy |
| Client |
Epilepsy Foundation |
| Description |
Mathematica is evaluating Project Access, an initiative sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration to develop and enhance coordinated and comprehensive service systems for children and adolescents with epilepsy. This evaluation covers the second phase of the project, in which four grantees oversee the development and implementation of nine state demonstration projects. The primary data collection methods include review of grantee documents and semi-structured interviews with the project director from each grantee, staff, and stakeholders. Read more. |
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| Project Name |
Comparative Effectiveness of Generic and Branded Antidepressants |
| Client |
Forest Laboratories, Inc. |
| Description |
Mathematica used an observational (cohort) design to determine antidepressant use patterns from a large administrative claims dataset for commercially insured patients who had new episodes of treatment and assessed the costs of care associated with alternative antidepressants and use patterns. Multivariate regression with adjustment for selection bias was used to determine differences between a branded selective serotonin reuptake inhibitor and several generically available antidepressants. This information was supplemented by chart reviews to obtain clinical information regarding the underlying reasons for the use patterns observed in claims data. |
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| Project Name |
Rx for Health Reform Initiative: Chapter on Care Coordination and Disease Management for the NGA State-Based Health Delivery System Improvements Report |
| Client |
National Governors Association (NGA) |
| Description |
The NGA health reform initiative produced a state-based health delivery system improvements report to highlight the strategies that governors and state policy leaders can pursue to improve health care delivery effectiveness and efficiency. Mathematica wrote the chapter on care coordination and disease management. The chapter reviews the evidence on program effectiveness; describes the role of state purchasing in implementing care coordination and disease management programs for Medicaid enrollees and state employees; and discusses other state policy levers for promoting greater care coordination and use of disease management for all populations, particularly those with chronic conditions. |
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| Project Name |
Rehabilitation Research and Training Centers (RRTCs): Employment Policy and Measurement |
| Client |
National Institute on Disability and Rehabilitation Research |
| Description |
This project includes several research studies to support the University of New Hampshire’s Employment Policy and Measurement RRTC in improving the effectiveness of services authorized under the Rehabilitation Act of 1973 through advanced research, training, technical assistance, and dissemination activities. We are leading seven studies to expand knowledge of the effects of program incentives on employment outcomes of people with disabilities. We are also conducting a comparative assessment of employment measures across surveys and administrative records. A unique feature of the project is that it includes data from several restricted access administrative data sources, including the Social Security Administration, Centers for Medicare & Medicaid Services, and Rehabilitation Services Administration. |
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| Project Name |
Analysis of Overuse of Percutaneous Coronary Interventions |
| Client |
United Health Foundation |
| Description |
Mathematica conducted analyses for the American Medical Association Foundation in support of the development of performance measures to improve care in a clinical area with known high levels of variation in care and cost. The focus was the overuse of percutaneous coronary intervention (PCI) for coronary artery disease. Mathematica analyzed available data on resource use (cost) and utilization of procedures, treatments, and tests related to PCI and identified variation and growth in resource use and utilization by geographical area and patient demographic characteristics. |
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| Project Name |
Evaluation of the Head Start Oral Health Initiative |
| Client |
U.S. Department of Health and Human Services, Administration for Children and Families |
| Description |
Mathematica designed and implemented an evaluation of the Head Start Oral Health Initiative, which was designed to improve oral health services to young children and pregnant women. Mathematica monitored the first two years of implementation, documented grantees’ implementation experiences and challenges, identified promising program models and service delivery strategies, assessed the feasibility of replication or expansion of the models in other programs and communities, and disseminated information about lessons learned to the broader Head Start community. Read more. |
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| Project Name |
Center of Excellence in Research on Disability Services and Care Coordination and Integration |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation |
| Description |
The American Recovery and Reinvestment Act of 2009 allocated funds to DHHS for the development of comparative effectiveness research for persons with disabilities. To date, this three-year project has conducted a systematic review of the evidence on which care coordination models work best for persons with disabilities and identified criteria for assessing the effectiveness of services and models in this area. Pending approval of the contract modification currently under consideration at ASPE, the remainder of the project will focus on conducting comparative effectiveness research and supporting studies on new initiatives and innovative systems of care designed to improve health outcomes and quality of life for persons with disabilities, as well as disseminating findings to policymakers, consumers, providers, and researchers. Findings from the studies will be presented at a national conference in March 2013. |
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| Project Name |
Developing Quality Measures for Schizophrenia in Medicaid |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation |
| Description |
This project is developing, field testing, and submitting for endorsement at least three quality measures to assess the quality and appropriateness of outpatient care for Medicaid beneficiaries diagnosed with schizophrenia. Mathematica is conducting a targeted literature review to identify potential measure concepts and topics and present findings from the review to our technical advisory group and project consultants. We are examining the feasibility of draft measure specifications using Medicaid Analytic eXtract (MAX) data and field testing the measure specifications using focus groups with stakeholders. Once input from stakeholders has been incorporated, measure specifications will be pilot tested using the MAX data including an assessment of the measures’ psychometric properties. |
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| Project Name |
Evaluation of the Medicare Personal Health Records Choice Pilot |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation |
| Description |
Mathematica evaluated the Personal Health Records Choice Pilot, which offered a choice of personal health records to fee-for-service Medicare beneficiaries in Arizona and Utah. Personal health records are designed for health care consumers and are intended to provide an online portal for people to view and manage their health information and transactions electronically. Mathematica analyzed Medicare claims and personal-health-record-use data to report on how pilot participants differed from nonparticipants in key demographic and other characteristics, including health care utilization, costs, and quality of care. The analysis is helping to develop an evidence base for understanding the role of personalized health information technology tools, such as personal health records, in improving the value of services for Medicare beneficiaries. Read more. |
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| Project Name |
Research Evaluation and Impact Assessment of ARRA Comparative Effectiveness Research Portfolio |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation |
| Description |
This evaluation of our nation's comparative effectiveness research (CER) portfolio, funded under the American Recovery and Reinvestment Act of 2009, is identifying gaps and barriers to achieving long-term CER goals. The study is also developing metrics needed to assess long-term impacts and provide immediate feedback on short-term effects. Our approach incorporates primary and secondary data and multiple data collection methods to evaluate the array of relevant federal programs and community perspectives. |
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| Project Name |
Assessment of Medicaid Psychotropic Drug Management |
| Client |
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration |
| Description |
Mathematica evaluated the effectiveness of a behavioral pharmacy management system that seeks to reduce Medicaid prescription drug costs by using physician education to encourage more appropriate psychotropic drug prescribing and beneficiary utilization. The project evaluated the impact of the system in one state to help state Medicaid and mental health agencies and other stakeholders determine whether this kind of educational intervention is an effective way of encouraging more appropriate use of psychotropic drugs. Although prescriber education through a series of letters and alerts appeared to have had some positive impacts on prescriber behavior, these impacts were generally small, not statistically significant, and not measurably different from fluctuations in prescriber behavior in periods prior to the intervention. |
| Project Name |
Medicare Quality Measurement Support, Mortality Implementation, and Measures Development and Monitoring |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica provided support for the Medicare Quality Measurement Support project, an ongoing effort by CMS to improve the quality of care provided to Medicare beneficiaries. Mathematica worked with the Colorado Foundation for Medical Care, a Medicare Quality Improvement Organization that holds the prime contract to advance quality measure reporting and development, primarily for hospital care. |
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| Project Name |
Transparency in Public Reporting: Consumer Testing and Enhancements to CMS's Compare Tools |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
In response to a growing public mandate and federal legislation to publicly report health plan- and health provider-specific quality indicators, CMS currently reports comparative information on health plans, nursing homes, home health agencies, renal dialysis facilities, and hospitals through the use of interactive tools on its website. CMS will continue to expand the number and types of measures reported. Mathematica is assisting in incorporating additional quality measures, testing language and data displays with consumer and professional audiences, and improving the organization and navigation of the sites. |
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| Project Name |
Healthy Indiana Plan Evaluation |
| Client |
Indiana Office of Medicaid Policy and Planning |
| Description |
Mathematica is conducting an evaluation of the State of Indiana's Healthy Indiana Plan (HIP). The evaluation includes three major components: annual reports for CMS, a survey of HIP participants and a technical report based on the survey, and white papers on areas of focus within the evaluation. |
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| Project Name |
Study of Informed or Shared Decision Making |
| Client |
Medicare Payment Advisory Commission (MedPAC) |
| Description |
MedPAC sought to learn more about how to convey information on the cost and quality of health care services to consumers in a way that can inform their behavior. Mathematica examined programs of shared decision making and the factors that affect their ability to provide actionable support to patients who must decide among various options, with a particular focus on program implementation. The project included a literature review, interviews with researchers and staff from active shared decision-making programs, and site visits. |
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| Project Name |
Study of Public Health Consumer Education Programs |
| Client |
Medicare Payment Advisory Commission (MedPAC) |
| Description |
MedPAC recognizes the importance of engaging consumers in the movement to promote greater quality and efficiency in the health care system. In this project, Mathematica explored what can be learned from public health campaigns in other arenas about strategies for engaging consumers and influencing their behavior. Drawing on a limited review of the literature and key informant interviews, as well as focusing on selected campaigns that have demonstrated an effect on consumer behavior, Mathematica identified strategies associated with success, highlighted challenges common to public health consumer education programs, and explored the implications for programs or campaigns targeting Medicare beneficiaries. |
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| Project Name |
Health Care Survey of DoD Beneficiaries: Data Analysis and Presentation Support |
| Client |
Office of TRICARE Management Activity |
| Description |
Mathematica assisted the U.S. Department of Defense (DoD) in sampling, analyzing, and reporting for the annual Health Care Survey of DoD Beneficiaries, a mail survey of adults eligible for military health care. The survey measures beneficiaries’ perceptions of their health status;, use of health services and insurance; access to health care; satisfaction with care; and attitudes toward and enrollment in TRICARE, the military health system. Mathematica assists with ongoing research that makes use of the data sets, including analysis to help with briefings to policymakers and research projects addressing selected topics of interest to military health system leadership and the scholarly community. Mathematica also supplements survey analysis with other data collection and analysis and uses focus groups to follow up on survey findings. |
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| Project Name |
Analysis of the Medicare Advantage Marketplace |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE) |
| Description |
Mathematica supported ASPE on Medicare Advantage (MA) policy options. Specifically, Mathematica tested the underlying assumptions about competition among MA health plans and the ability of consumers to navigate the market by examining the link between enrollment and disenrollment patterns and plan characteristics and explored potential options for enhancing value-driven health incentives in the MA marketplace. |
| Project Name |
Develop Strategies for Validation Methodology, Cost Estimates, and Impact on Underserved Areas |
| Client |
Centers for Medicare & Medicaid Services (CMS) |
| Description |
Mathematica assessed the new Physician Voluntary Reporting Program (the pre-cursor to the Physician Quality Reporting System) under which physicians began reporting additional quality-related data drawn from patients' medical records on their claim forms. CMS has been using these data to compute new quality measures for physicians. Mathematica also developed a method for validating the physician-supplied data, estimated the cost to physicians of supplying medical record data through this mechanism, and assessed how the program is likely to affect physicians serving minority populations. |
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| Project Name |
Development of Physician Quality and Resource Use Reports Using Medicare Fee-for-Service Beneficiary Data |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica supports CMS in understanding analytic and policy issues related to measuring and reporting physician-driven costs of care, in relation to the quality of clinical care received by beneficiaries, and the beneficiary health outcomes that result. Mathematica continues to assist CMS with identifying fair, actionable, and meaningful measures of resource use and quality for individual physicians and physician practices, with the ultimate goal of using composite scores of resource use and quality to implement the value-based payment modifier required by the 2010 Patient Protection and Affordable Care Act. Additionally, Mathematica is producing and disseminating confidential reports to physician practices that compare patterns of resource use and quality to provide feedback and education to encourage more efficient medical practices. |
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| Project Name |
Development of Physician Quality Measures |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
These projects assisted CMS in the development of new physician quality measures in support of the Physician Quality Reporting System. Key partners included the American Medical Association and the National Committee for Quality Assurance. Tasks included identifying clinical or other topic areas in which quality measures were needed, identifying and specifying measures in conjunction with expert working groups, and providing the literature and supporting evidence for development of the measures. Formative testing of selected measures with practicing clinicians was also conducted. Read more. |
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| Project Name |
Development of Resource Use Reports for Medicare Fee-for-Service Claims |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica worked with CMS on developing meaningful, actionable, and fair measures of resource use for individual physicians and physician practices treating Medicare beneficiaries. The ultimate goal is to use the measures in future CMS value-based purchasing initiatives for physicians, as well as to provide confidential feedback reports on their relative performance to assist them with identifying opportunities for improvement to encourage efficiency in physician practices. Read more. |
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| Project Name |
Evaluation of the Medicare Care Management Performance Demonstration |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica is evaluating the Medicare Care Management Performance Demonstration, a congressionally mandated test of pay-for-performance incentives to encourage physicians to improve the quality of care they provide to eligible fee-for-service Medicare beneficiaries and foster the implementation and use of health information technology. The demonstration, which started in July 2007, is aimed at physicians in solo or small- to medium-size practices. Read more. |
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| Project Name |
Medicare Quality Measurement Support, Mortality Implementation and Measures Development and Monitoring |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica provided support for the Medicare Quality Measurement Support project, an ongoing effort by CMS to improve the quality of care provided to Medicare beneficiaries. Mathematica worked with the Colorado Foundation for Medical Care, a Medicare Quality Improvement Organization that holds the prime contract to advance quality measure reporting and development, primarily for hospital care. |
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| Project Name |
Production and Implementation of the CMS Hospital Outcomes and Efficiency Measures II |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
Mathematica supported CMS Medicare hospital quality reporting initiatives by producing and implementing the reporting of
risk-adjusted hospital 30-day mortality and readmissions measures for acute myocardial infarction, heart failure, and pneumonia. Mathematica produced the mortality and readmission measures using Medicare claims and enrollment data for all hospitals in the country. |
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| Project Name |
Public Reporting of Provider Quality: Research and Testing |
| Client |
Centers for Medicare & Medicaid Services |
| Description |
In response to a mandate to publicly report health plan- and health provider-specific quality indicators, CMS currently reports comparative information on health plans, nursing homes, home health agencies, renal dialysis facilities, and hospitals through the use of interactive tools on its website. CMS will continue to expand the number and types of measures reported. Mathematica is assisting CMS in incorporating additional quality measures, testing language and data displays with consumer and professional audiences, and improving the organization and navigation of the sites. |
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| Project Name |
Transparency in Public Reporting: Consumer Testing and Enhancements to CMS's Compare Tools
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| Client |
Centers for Medicare & Medicaid Services
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| Description |
In response to a growing public mandate and federal legislation to publicly report health plan- and health provider-specific quality indicators, CMS currently reports comparative information on health plans, nursing homes, home health agencies, renal dialysis facilities, and hospitals through the use of interactive tools on its website. CMS will continue to expand the number and types of measures reported. Mathematica is assisting in incorporating additional quality measures, testing language and data displays with consumer and professional audiences, and improving the organization and navigation of the sites. |
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| Project Name |
Assessing Business Plan Options for Financing Clinical Pharmacy Services in HRSA-Supported Programs |
| Client |
Health Resources and Services Administration, Office of Pharmacy Affairs |
| Description |
Mathematica assisted in responding to a congressional mandate to provide information on how clinical pharmacy services might be extended nationally among health centers and other safety net providers. We developed an internet-based business model tool that health centers can use to plan for adding or expanding services; convened a meeting of national organizations concerned with the safety net and pharmaceuticals; conducted case studies of health centers, safety net hospitals, and HIV/AIDS clinics that have managed to sustain these services to find out how they did it; and prepared a report to Congress. |
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| Project Name |
Site Visit Study of Resource Use and Quality Measurements in Private Health Plans |
| Client |
Medicare Payment Advisory Commission (MedPAC) |
| Description |
Mathematica assisted MedPAC with collecting detailed information on how different health plans have implemented resource use and quality measurement and what episode groupers and methodologies were used. In addition, the study looked at how plans linked the results of episode-grouping analysis to physician payment and network development, and how physicians and beneficiaries responded to the introduction of such programs. |
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| Project Name |
Minnesota’s Health Reform Initiative: Provider Peer Grouping |
| Client |
Minnesota Department of Health |
| Description |
This project is producing, testing, and disseminating a system of measures for the relative cost and quality of care provided by each physician group/clinic and hospital in the state of Minnesota. The reports will help providers understand how the quality and efficiency of the care they provide compares to that of their peers. The information will also inform consumers and payers of the differences. |
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| Project Name |
Rehospitalization in New York State and Implications for Avoidable Cost |
| Client |
New York State Health Foundation |
| Description |
To address the knowledge gap related to the frequency and cost of avoidable hospital readmissions in New York, Mathematica estimated the potential savings that might be obtained from targeted interventions to reduce avoidable readmissions. The study identified geographic areas, conditions, and patient cohorts in New York with high rates of readmissions; reviewed current payment reforms and care interventions that showed promise for reducing hospital readmissions; and estimated the potential savings in New York from targeted interventions such as hospital procedures to reduce infection rates and improve discharge protocols. |
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| Project Name |
Consult with UnitedHealth Group on the Design of Its Medical Home Demonstrations |
| Client |
UnitedHealth Group |
| Description |
In this project Mathematica helped design an intervention and began work on an evaluation to test the effects of additional payments and practice supports for primary care physicians who become medical homes on quality and cost of care. The pilot serves patients with insurance coverage by United Healthcare's commercial, Medicare Advantage, and Medicaid products. |
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| Project Name |
Analysis of the Medicare Advantage (MA) Marketplace |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation |
| Description |
Mathematica supported ASPE on Medicare Advantage (MA) policy options. Specifically, Mathematica tested the underlying assumptions about competition among MA health plans and the ability of consumers to navigate the market by examining the link between enrollment and disenrollment patterns and plan characteristics, and explored potential options for enhancing value-driven health incentives in the MA marketplace. |
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| Project Name |
Identifying Mental Health Policy Issues in the Context of Health Care Reform |
| Client |
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation |
| Description |
This project identified mental health policy issues that relate to current proposals for health care reform and informed policymakers of the relevance of mental health to important areas under consideration. Policy issues were identified based on the findings of commissioned research papers, expert meetings, and synthesis reports. The project focused on two topic areas: (1) identifying mental health-related policy issues in the context of health care reform and (2) identifying promising models of comprehensive community-based crisis systems in the management, care, and diversion of people with mental illnesses. Read more. |
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