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The Health Policy and Practice Projects (HP3) are comprised of several active contracts with the Centers for Medicare and Medicaid Services (CMS), notably the End Stage Renal Disease (ESRD) Quality Measure Development and Maintenance project, and its predecessor, the ESRD Measures Support Work project. HP3 also conducts research for CMS as part of the ESRD Disease Management Demonstration, and the Quality Incentive Payment project.
Arbor Research currently holds three umbrella contracts that confer preferred bidding status to the organization. These contracts are vehicles of current and future funding streams for HP3 and represent research growth areas. Two are with the CMS: the Medicare Research and Demonstrations contract (MRAD), and the Measure Instrument Development and Support contract (MIDS). The current ESRD Measures Support Work contract was awarded through the MRAD, and MIDS is the contract vehicle for the ESRD Quality Measure Development and Maintenance project. Arbor Research also holds an umbrella contract with the National Quality Forum (NQF). NQF is the recognized standards setting organization in the United States that 1) determines priorities and goals for performance measure development and 2) endorses national consensus standards for measuring and reporting healthcare quality performance. Arbor Research is one of a select group of contractors that is eligible to bid on future Quality Measure Development Task Orders, issued by NQF. These are in areas of chronic disease that were designated by the Department of Health and Human Services and CMS as high prevalence and high utilization conditions. Arbor Research’s work with the CMS and, imminently with the NQF represents a broadening focus on developing and implementing new measures for quality outcomes and payment in support of the 2008 Medicare Improvements for Patients and Providers Act (MIPPA). The contracts collectively demonstrate Arbor Research’s role as a preferred research contractor for the CMS and the NQF and presents a stream of continuous opportunities to provide expert scientific expertise that will influence health policy at the national level through high quality research.
ESRD Quality Measure Development and Maintenance Support
Arbor Research provides support to CMS for the development and enhancement of quality measurement within the ESRD setting. Quality measures and reporting through the Dialysis Facility Compare and Dialysis Facility Reports are used to ensure quality health care for the Medicare ESRD population. Achievement of targets for existing ESRD quality measures has led to substantial improvements in the lives of patients over the past decade. (Funding: CMS)
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Evaluation of ESRD Disease Management Demonstration (DMD)
The Demonstration tests the effectiveness of disease management services provided to ESRD patients enrolled in select Medicare Advantage plans collaborating with three disease management organizations. Disease management models can increase quality of care while ensuring it is provided more effectively and efficiently. The independent evaluation examines processes of care; hospitalization and mortality; and costs, patient satisfaction, and quality of life. (Funding: CMS)
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Quality Incentive Payments and ESRD Bundled Case-Mix Adjusted Payment System Demonstration (QIP)
Two key tasks are performed. Task 1 is the calculation of quality incentive payments to test the effectiveness of financial incentives on performance metrics. The study sample includes ESRD patients enrolled in the DMD. Task 2 (performed by University of Michigan under a subcontract) is the implementation and provision of support to an advisory board for the ESRD Bundled Case-Mix Adjusted Demonstration, including research on payment methodology and clinical factors. The bundled payment system will be implemented in 2011. (Funding: CMS)
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Oversights of Dialysis Facility Survey Process
Arbor Research led the development of the Dialysis Facility Reports website ( http://www.dialysisreports.org/). It provides secure access to facilities to download and comment on metrics reported in their dialysis facility reports and to state surveyors to assist in their oversight of dialysis facilities through the survey and certification process. This task is supported through a subcontract under the ESRD Facility Data Reports for CMS, State, and Facility Oversight contract. (University of Michigan is the primary contractor) (Funding: CMS)
National Kidney Disease Surveillance Initiative (CDC-CKD)
Specific aims include identifying topic areas, measures (e.g., proportion of subjects with CKD by estimated kidney function), and indicators; other aims include identifying national and regional data sources to enable an assessment of the identified topics, measures, and indicators for CKD surveillance. The project will develop a comprehensive plan for integration of all data sources/topic-measure-indicator combinations into a functional national surveillance system. A final report was produced in 2008 containing recommendations toward the implementation of a national CKD surveillance system. (University of Michigan is the primary contractor) (Funding: CDC)
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