Ambulance Technical Support
Centers for Medicare & Medicaid Services
Econometrica, Inc.
7475 Wisconsin Avenue, Suite 1000 Bethesda, MD 20814
p: (301) 657-9883
f: (301) 657-3140
Understanding of the Ground Ambulance Industry
The Econometrica Team brings an unparalleled understanding of ground ambulance operations, health policy, program design, and cost allocation methodologies. Our team has more than 14 years of experience helping emergency medical services (EMS) agencies across the country maximize their cost reimbursement and improve operational efficiencies, as well as more than 30 years of experience collaborating with state-operated facilities on cost report submissions. We understand the diversity of operations and cost structures among ground ambulance service providers and the regulatory guidelines they must follow.
Benefits to CMS
Through our work developing cost reports for more than 500 Fire/EMS providers—which included collaborating with ambulance service providers to collect, aggregate, and analyze data similar to that required for the Medicare Ground Ambulance Data Collection System (GADCS)—we understand data collection and reporting challenges from the provider’s perspective and will use this knowledge to inform strategies for training and technical support.
Past Performance
Our subject matter experts (SMEs) have been monitoring requirements and changes in the GADCS since its inception with the Bipartisan Budget Act of 2018, and we understand the program’s history and functions. In addition to recently participating in the Centers for Medicare & Medicaid Services’ (CMS) user testing of the GADCS Instrument, for example, we are currently working with more than 50 ground ambulance transport providers on compliance and collecting accurate data for the GADCS.
Research Management Approach
For all projects, the Econometrica Team uses Project Management Body of Knowledge principles to develop a Task Order Project Plan that details milestones, task due dates, interim due dates, allocated resources, and critical path tasks. This Task Order Project Plan will be used by the Project Director and project staff to objectively assess how the project is doing on a monthly basis by each task and subtask. In addition to the daily involvement of project leaders and staff, this assessment examines the project in terms of timeliness, adherence to the Statement of Work, finances, and potential areas of concern.
Given our understanding of how LEAN principles impact project success, we will seek to identify the factors that are critical to quality and incorporate these principles into the design, along with factors to increase efficiency in monitoring and quality control, risk mitigation, and reducing waste.
Benefits to CMS
Our team is made up of Project Management Professionals, instructional designers, SMEs, data analysts, and professional writers who are well versed in efficiently developing timely and accurate deliverables for a variety of audiences. We work collaboratively with our clients and stakeholders to create appropriate and user-friendly information that is easily accessible and ready to disseminate.
This team will translate its extensive national, state, and local experience to contribute subject matter and project management expertise and apply lessons learned to promote the project’s success.
Past Performance
Successful Management of Large Complex Projects
The Econometrica Team has more than 50 years of experience in understanding health systems, cost analysis, and CMS priorities, which enables our team to fully understand the significance and impact that the GADCS will have in helping CMS and the Medicare Payment Advisory Commission (MedPAC) evaluate Medicare payment rates for ground ambulance services and provide rate setting recommendations. We have a long history of successfully managing large, complex projects that involve swiftly developing research approaches, engaging stakeholders, identifying inputs and supports, and activating strategies.
Benefits to CMS
Our ability to manage complex projects also enables our team of experts to deliver innovative, impactful data analysis and technical support.
Past Performance
We use efficient oversight and powerful data analytics to report out 150 tables per week in our Open Payment Program Analytics project. In our work as the State Data Resource Center (SDRC), we not only responded to 2,153 inquiries in 2021 from state Medicaid agencies on Medicare claims, including Part B ambulance data, while receiving all Excellent and Very Good ratings for our TA support, but we also used this dynamic exchange of queries and answers to develop a number of training resources and engagements.
On the Competitive Bidding Surveys contract, Econometrica was able to recruit suppliers, providers, and beneficiaries; develop surveys to learn more about their experience and satisfaction with the program; and provide CMS with actionable data from those surveys.
For PAC Training, our LEAN project management workflows enable us to deliver increasing numbers of training deliverables each year by seamlessly pivoting to address new priorities established by the COR, including producing multiple deliverables for different training projects simultaneously. In addition, the management team also uses a system of daily huddles and tracking documents to ensure timely and high-quality deliverables.
Medicare Programmatic and Cost Reporting Knowledge
The Econometrica Team is well versed in the statutory requirements of Section 1834(I)(A) of the Social Security Act and has already engaged in helping ambulance providers understand the requirements. Our multidisciplinary team of experts is well versed not only in the regulations themselves but also in managing large, complex projects requiring Medicare programmatic and cost reporting knowledge; program implementation; training development and delivery; and research and data analysis.
Benefits to CMS
Our understanding of the stakeholders and technical systems involved and experience with the ambulance industry, Medicare policy, data analytics, cost reporting, training, and customer service will enable us to respond swiftly to develop approaches, engage partners, identify needed inputs/supports, and activate strategies.
Past Performance
“When the COVID-19 stay-at-home order started, the contractor raised a very important question regarding the physical data shipments to states. By quickly identifying this issue and moving to resolve any disconnects, the contractor not only provided excellent customer service to states but protected CMS data with PHI/PII.”
– SDRC CPARS, Management
Stakeholder Buy-In and Change Management
Stakeholder engagement is a key communication function that leads to buy-in, aligned objectives, and, ultimately, the success of the project. Stakeholders will feel engaged if they are aware of being listened to and see that their input matters; therefore, our project approach involves obtaining significant stakeholder input to effectively analyze education and TA needs. To build awareness and gain stakeholder engagement, we will conduct outreach and workgroup sessions that will be instrumental in granting new stakeholders access to participate in this important program.
Benefits to CMS
We recognize that the GADCS was delayed due to the COVID-19 pandemic, pushing back data submission timelines for ambulance service providers and posing implementation challenges for CMS as data collection and reporting timelines have been “squeezed” into a shorter period. As such, we understand the comprehensive scope of work that the selected vendor will take on (e.g., iteratively supporting 5,000 providers in data collection in a condensed timeframe) and the importance of close collaboration with CMS to the initiative’s success.
Past Performance
On the PAC project, Econometrica employed flexible project planning to respond to changes in circumstances and priorities created by the COVID-19 pandemic; after quickly assessing training needs, we were able to pivot our approach to deliver training to more than 34,000 providers nationwide using different modalities, including webinars, tip sheets, web-based training, videos, and virtual live events.
Technical Assistance
From the provider perspective, we appreciate the challenges that providers face in collecting data, from difficulties understanding requirements to data formatting and aggregation issues when pulling data from their reporting systems. Because we regularly analyze cost, revenue, and response data to develop cost reports, we also understand how the technical systems work as well as the viewpoint and needs of the data collection agency (in this case, CMS).
Benefits to CMS
Our team of analysts regularly provide technical assistance (TA) through training, data collection tools/templates, and answering provider questions, and our SMEs include a retired Fire/EMS Chief, who will provide practical operations expertise to help put data into context.
Past Performance
In our project with Colorado’s HCPF Department, our team worked with federal and state agencies to stand up new programs; manage complex and high-stakes projects; provide technical support to Fire and EMS agencies through a help desk; develop training materials, tools, and procedures for program implementation; design, build, and implement web-based systems; and understand provider financial, CAD, revenue, and operational data.
Efficiency / One Stop Shop
The Econometrica Team offers in-depth ambulance industry knowledge; programmatic experience; survey and policy assessment expertise; and established processes for communication planning, stakeholder engagement, TA, and training to help CMS and ground ambulance providers successfully implement GADCS requirements. Our communication and coordination with stakeholders will be proactive and as transparent as possible, based on our process gathering information about training needs from states and providers.
Benefits to CMS
The Econometrica Team understands current CMS policy and procedures on deliverables, and we have a track record of delivering high-quality work to CMS.
Past Performance
Econometrica has proven expertise planning and delivering TA and training, including engaging stakeholders and planning appropriate communication strategies, through our work as the SDRC contractor since 2017 and the PAC Training contractor since 2015.
PCG is a large business and a recognized leader in the ambulance industry and health benefits exchange consulting, as well as a leading provider of revenue enhancement, rate setting, cost settlement services, and healthcare expense management services to the ambulance industry and other healthcare settings.
Data Analysis
Our goal is to deliver the right resources, education, and TA to support providers in successfully collecting and reporting data, and to conduct data analysis to paint an accurate and detailed picture of the diversity of ambulance service providers and variation in costs. We routinely prepare analytic reports, other technical reports, memos, briefings, and dashboards (including data visualizations in Section 508 compliant formats) in both plain language and for technical audiences.
Benefits to CMS
Our software was designed for surveys that collect multiple subsamples over time, so it includes options to automatically prevent resampling of the same unit, and it can automatically adjust the size of the sample drawn from each stratum based on the observed response rates. The Contracting Officer’s Representative can thus easily direct the Econometrica Team to draw new samples using the previous method.
Past Performance
Our previously developed sampling software uses a space-filling design to implement stratified random sampling and can easily be used to implement existing methodologies. This program reduces coverage bias by considering all of the units’ important characteristics when defining strata, then randomly selecting survey invitees to produce an equal allocation across the strata. This results in more robust survey results by accounting for all relevant supplier/provider characteristics when selecting the samples. For example, if the majority of providers in rural areas are nonprofit organizations, there is an increased probability of drawing a random sample that does not contain any for-profit organizations even though they may respond very differently than their nonprofit counterparts. If CMS requests, our software could be used to ensure that this does not occur, even if the population sizes are too small to analyze as separate strata. Following survey completion, the population parameters can be reconstituted from the disproportionate sample allocation using design weighting, or the program can easily be adjusted to perform proportionate sampling.
Why Our Team
Experience
Econometrica, Inc.
Econometrica, Inc., is a research and management organization with extensive expertise in providing high-quality, cost-effective analyses; large, quantitative surveys; rapid and innovative technical assistance; and economic evaluations for clients in the public and private sectors.
Public Consulting Group
Public Consulting Group offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies—including EMS and Fire—respond to regulatory change, improve access to healthcare, maximize program revenue, improve business processes, and achieve regulatory compliance.
Execution
Four-Tier Execution
Strategy:
Our experience managing large-scale projects allows us to establish proven strategies to successfully standup and manage new projects while reducing risks. We bring an understanding of all stakeholders involved (CMS, ambulance service providers, and associations), ambulance industry experience, Medicare policy, data analytics, cost reporting, training, customer service, and knowledge of technical systems that allows us to respond swiftly to inform approaches, engage partners, identify needed inputs/supports, and activate strategies.
Communication:
Effective verbal and written communication is essential to project success – whether we are facilitating project meetings, developing training materials, conducting user testing, providing technical assistance, or drafting recommendations.
Training:
Our team excels at training, TA, and creating learning networks, grounding our work in the ADDIE Model. The ADDIE model utilizes five distinct phases of training development that includes, analysis, design, development, implementation, and evaluation.
Analysis and Reporting:
We bring a powerful combination data analytics and subject matter expertise to inform analysis and reporting. Our team includes skilled data analysts and SMEs who know provider data, understand cost allocation and reporting methodologies, and recognize the impact of Medicare/health policies. They will be able to provide meaningful data results to inform decision making.
Samples
SDRC Technical Support Web Portal
The Econometrica team has developed two new education & outreach websites for CMS in support of the State Data Resource Center. We frequently hear from providers that the main CMS.gov site is difficult to navigate and find resources. Our custom portals make it easy for providers to connect with the right information, right away. Take a look at the public portal of the SDRC site to see how it works, and get a sense of what we could do in support of the GADCS implementation.
Training and Education Videos
We’ve made dozens of high-quality training videos for CMS on the PAC QRP Training Project. These videos are posted to the public YouTube channel, and help IRF, LTCH, SNF, Home Health, and Hospice providers understand the nuance of data collection and reporting across different instruments. Press the play button to see an example of one of these videos.