Evaluating the Community-based Care Transitions Program

Evaluating the Community-based Care Transitions Program

From 2012 to 2017, Econometrica conducted an evaluation of the Community-based Care Transitions Program (CCTP) on behalf of the Centers for Medicare & Medicaid Services (CMS). As part of the Partnership for Patients 1.0 initiative, which aimed to improve the quality, safety, and affordability of healthcare in the United States, the CCTP supported partnerships between community-based organizations (CBOs) and hospitals to provide transition services to Medicare beneficiaries. The goals of the program included:

  • Decrease readmissions rates among high-risk Medicare beneficiaries.
  • Improve quality of care through the transition.
  • Provide savings to Medicare.

A driving force in the construction of the program as CBO-based partnerships was awareness of the critical role the community (e.g., family, caregivers, primary care physicians, CBOs) can play in improving hospital-to-home transitions and reducing avoidable readmissions.

The evaluation of the CCTP aimed to identify whether (and how) the program was associated with key outcomes, as well as whether program characteristics and care transition service components might have driven favorable key outcome findings. Key outcome measures included 30-day readmissions, expenditures, post-discharge service utilization, emergency department visits, and observation stays. In addition, the evaluation assessed implementation of the program across sites, utilization of community services by participants, and beneficiary and provider participation in the program.

Econometrica implemented three quantitative strategies to analyze the CCTP’s impacts:

  1. A pre-post regression model.
  2. Difference-in-differences regression models at the beneficiary and hospital levels.
  3. A time-series model.

We also conducted qualitative research based on annual telephone interviews with CCTP sites and 10 in-person site visits per year. We used qualitative data to broaden our understanding of program features, the challenges CBO partnerships encountered in implementing the CCTP, the implementation process, contextual and environmental factors influencing implementation and outcomes, successful strategies, and other programs that could confound findings.

We reported the findings of the evaluation in two published reports in 2014 and 2017, including recommendations about program expansion.

About Econometrica:
Founded in 1998, Econometrica is a research and management organization in Bethesda, MD, established to provide public- and private-sector clients with customized program support services. Econometrica works with multiple agencies to provide high-quality, cost-effective analyses, modeling, and economic evaluations. The company consistently receives exceptional scores from its clients and believes in three principles: technical capabilities, happy customers, and business development.

Key outcome measures included 30-day readmissions, expenditures, post-discharge service utilization, emergency department visits, and observation stays.

Read more about Econometrica’s work on the CCTP here.

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Econometrica to Help State Programs With Medicare–Medicaid Enrollees

Econometrica to Help State Programs With Medicare–Medicaid Enrollees

Econometrica will help CMS provide support services to State programs to improve the experience of Medicare–Medicaid enrollees

Bethesda, MD, September 2017

Econometrica, Inc., was recently awarded a contract by Centers for Medicare & Medicaid Services (CMS) to provide support for State programs to integrate care and ensure program integrity for Medicare–Medicaid enrollees.

In partnership with Acumen, LLC, Econometrica will help State programs integrate care for Medicare–Medicaid enrollees by (1) helping States access data and (2) aiding Medicare-Medicaid Plan access to Medicare historical claims data (Parts A, B, and D). In addition, Econometrica will assist CMS to process data requests, conduct reviews, maintain the tracking system, and find opportunities to improve efficiencies in the process.

“Econometrica has a long history of dedicating itself to improving healthcare processes. We are proud to build on our experience working with the Affordable Care Act (ACA) and look forward to continuing to support CMS and State programs with valuable services,” President and CEO Cyrus Baghelai said.

Currently, millions of individuals enrolled in the Medicare and Medicaid programs receive fragmented care. The ACA established the Medicare–Medicaid Coordination Office within CMS to advance quality, reduce costs, and improve the experience of Medicare–Medicaid enrollees.

Econometrica will assist State Medicaid agencies with technical advice, including providing information on linking databases, creating analytic databases, conducting training calls and webinars, and providing consultation and data support. To improve efficiency, Econometrica will guide States on ways to address the limitations in CMS data and help States optimize their use of available data.

About Econometrica:
Founded in 1998, Econometrica is a research and management organization in Bethesda, MD, established to provide public- and private-sector clients with customized program support services. Econometrica works with multiple agencies to provide high-quality, cost-effective analyses, modeling, and economic evaluations. The company consistently receives exceptional scores from its clients and believes in three principles: technical capabilities, happy customers, and business development.

The ACA established the Medicare–Medicaid Coordination Office within CMS to advance quality, reduce costs, and improve the experience of Medicare–Medicaid enrollees.

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Econometrica Partners With Acumen on RMADA Task Order

Econometrica Partners With Acumen on RMADA Task Order

Econometrica is partnering with Acumen, LLC, as a subcontractor on the RMADA Episode Payment Model (EPM) and Cardiac Rehabilitation (CR) Payment Contractor Task Order for the Centers for Medicare & Medicaid Services (CMS). CMS is implementing two new EPMs to test the use of episode-based payment for an episode of care during and after a hospital stay related to cardiac disease. The models will provide retrospective, bundled payments to hospitals for episodes of care consisting of inpatient hospital stays followed by post-acute care. Specifically, these new models will apply to acute myocardial infarction treated either medically or with revascularization and a coronary artery bypass graft. A third model that falls under this project will test the effectiveness of incentive payments in increasing the use of CR and intensive cardiac rehabilitation (ICR) services.

The team’s work on this contract will involve developing the payment calculation methodologies, calculating payment amounts for both EPMs, and calculating incentive amounts for the CR and ICR service provision. Econometrica will provide technical assistance and support to model participants and work to ensure that the participating hospitals are confident in the calculation methods used for the episode-based payments and understand the processes in place for payment reconciliation under the models. Econometrica will provide a variety of services to achieve this goal, including developing clear and concise resources (e.g., factsheets, FAQ documents, and scenario sheets) and distributing them to model participants. Further, we will offer on-demand support by responding to inquiries from hospitals on a flow basis and produce monthly webinars to disseminate the information hospitals need for the model to be successful.

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