Clinical Expertise Spanning the Healthcare Continuum

The Clinical Practice Team includes a Physician, Geriatric Nurse Practitioner, and two Master’s prepared Registered Nurses. Collectively, their clinical experience spans the continuum of the primary care, acute care, rehabilitation, home health, and hospice settings. The team holds a total of eight advanced certifications. Areas of specialization include gerontology, medical coding, healthcare quality, quality reporting using the Outcome and Assessment Information Set (OASIS), LEAN Six Sigma methodology, project management, nursing professional development, and executive leadership.

Providing Insight Into Clinical and Health Operations

Our team provides clinical and health operations insights to a range of Econometrica’s projects, including supporting the Centers for Medicare & Medicaid Services (CMS). The team was involved in selecting clinically relevant quality measures for the CMS Bundled Payments for Care Improvement Model.

Team members are currently engaged in developing training content around patient assessment and coding for nurses and quality staff working in post-acute care (PAC) settings. On this project, the team has played a strategic role in creating and delivering multimodal training for providers across the Nation on the CMS Quality Reporting Program. This work is in response to the requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2015. Team members also provide valuable perspective on the challenges healthcare providers face in delivering and coordinating care in different PAC settings and the barriers beneficiaries experience attempting to access the care they need.

Supporting New Business Development

In addition to supporting Econometrica’s various healthcare projects, the Clinical Practice Team provides expertise to support new projects in the areas of medical records abstraction, electronic health records, and clinical consultation.

Innovating Client-Specific Approaches

With healthcare and related industry trends constantly evolving, Econometrica’s experts use a variety of research and evaluation methods to provide innovative and personalized approaches for each client.

Medical Coding Expertise

Our staff knows medical coding related to three main code books: Current Procedural Terminology CPT®, International Classification of Diseases, 10th Revision Clinical Modification (ICD-10-CM) Code Set, and Healthcare Common Procedure Coding System (HCPCS) Level II. Our capabilities include:

• Ability to identify the purpose of the CPT®, ICD-10-CM, and HCPCS Level II code books.
• Understanding and application of the official ICD-10-CM coding guidelines.
• Applying coding conventions when assigning diagnoses and procedure codes.
• Identifying the information in appendices of the CPT® code book.
• Explaining the determination of the levels of evaluation and management (E/M) services.
• Coding a wide variety of patient services using CPT®, ICD-10-CM, and HCPCS Level II codes.
• Listing the major features of HCPCS Level II codes.
• Providing practical application of coding operative reports and evaluation and management services.

Success Indicators

• Developed tailored technical assistance plans for CMS, including working with States in accessing and using CMS data sources under the State Data Resource Center contract.
• Facilitated more than 250,000 provider impacts based on trainings focused on understanding and complying with the IMPACT Act on the Post-Acute Care Training contracts.
• Developed three quality measures endorsed by the National Quality Forum under our Programs of All-Inclusive Care for the Elderly contract.