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Projects
Value Incentives and Quality Reporting Appeals Support
Client: Centers for Medicare & Medicaid Services (CMS)
Services: Quality assurance, policy support, post-annual payment update determination support, technical assistance, consolidated quality assurance, policy support, technical support for 12 programs
Key Work Areas: Quality Reporting Program (QRP) with standardization of appeals, government efficiency, Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act of 2015 (MARCA), Affordable Care Act (ACA), American Recovery and Reinvestment Act (ARRA)
Status: In Progress
The Centers for Medicare & Medicaid Services (CMS) engaged Econometrica to provide support on the Value Incentives and Quality Reporting (VIQR) Appeals project. CMS quality reporting is a requirement for healthcare entities required by law. VIQR appeals support gives CMS the bandwidth to focus on policy development rather than individual appeals.
Econometrica was able to streamline the appeal review process, allowing for timely resolution of quality and payment appeals. Econometrica’s efficiency limited over-utilization of government resources and ensured the payments were proportional to healthcare performance metrics. Additionally, Econometrica facilitated communication between healthcare providers (hospitals, skilled nursing facilities, home health care providers, and post-acute care services), CMS and other stakeholders regarding quality measures and federal standards of care.
Economic Analysis Consulting Services