Medical Technology and Practice Patterns Institute Announces That It Has Been Awarded an R01 Research Grant by the Agency for Healthcare Research and Quality


Bethesda, MD, August 11, 2016 --( The Medical Technology and Practice Patterns Institute, Inc. (MTPPI) announces that it has been awarded an R01 research grant by the Agency for Healthcare Research and Quality (AHRQ). The grant will be used to investigate the impact of the End-Stage Renal Disease Prospective Payment System (ESRD PPS) reform that was enacted by Congress in 2011. The study will focus on analyzing how bundled payments have affected facility unit costs, profit margins (identified through public filings and Medicare cost reports), and various efficiency and productivity measures. Investigators will also determine how changes in efficiency and productivity measures differ by dialysis organizational status (i.e., chain, profit, and size) and which factors are most related to improvement in efficiency. The second major aim of the project will be to evaluate how the implementation of ESRD PPS has affected the relationship between efficiency and quality of care using innovative measures designing specifically for this study.

“This project is an important and timely evaluation with national coverage implications for ESRD care. Prospective payment systems are very popular yet rarely evaluated, especially in such a vulnerable population,” said Dr. Mae Thamer, Research Director at MTPPI. “We propose to use highly innovative modeling techniques to relate efficiency to quality using the conceptual framework that there is a cost/quality tradeoff that exists in the dialysis center and ESRD treatment environment. In the new era of pay for performance, it is important to continue to monitor dialysis center efficiency, and to concurrently investigate the use of efficiency models that incorporate quality of care dimensions as outputs.”

Researchers will design a retrospective cohort study that will utilize various large data sets including a national CMS database, Medicare Renal Cost Report data, and the Dialysis Facility Report to examine a four-year pre- and post-ESRD PPS period from 2007–2014 at the facility-level. Trend differences for the relationship between resource use and the delivery of dialysis care will be analyzed using a DEA-linked Malmquist index that evaluates changes in efficiency and productivity over time. This analysis will also produce and rank individual facility efficiency scores that will be used as an explanatory variable in subsequent facility based outcomes analyses. Results will be stratified by industry segment (i.e., chains and independent) and case-mixed adjusted using facility-level demographic and co-morbid factors. Dialysis providers that score high on both efficiency and quality measures could provide models for other providers to adopt and it is anticipated that the study results will have immediate value for CMS and inform providers, policy analysts and the ESRD community regarding important differences in the process and outcomes of care by comparing historical efficiency measures to those after the current bundled payment system.

MTPPI will be collaborating with the following researchers on this project:

Mr. Larry Emerson – an expert on the administration and operation of dialysis services delivery centers

Mr. Mark Stephens – researcher focusing on the fields of actuarial and financial modeling, systems and database development, data analysis, report development and research dissemination to industry and academic audiences

Dr. David Barrus – an expert on Econometrics and Statistics

Dr. Martin Ma – an expert on Health Economics, Applied Econometrics, and Industrial Organization

About the Medical Technology and Practice Patterns Institute

The Medical Technology and Practice Patterns Institute (MTPPI) is a nonprofit organization established in 1986 to conduct research on the clinical and economic implications of health care technologies. MTPPI's research is directed toward the formulation and implementation of local and national health care policies. With extensive investigator experience in both the public and private sectors, MTPPI's staff designs, implements, and conducts a full range of health services research activities. The staff includes clinicians, health services researchers, economists, statisticians, biomedical engineers, lawyers, and policy analysts. We specialize in using available administrative, survey or patient registry data to conduct 'real time', 'real world' studies that are both affordable and useful for decision making.

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Joyce Zhang
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