Emory University Partners with RealTime Medicare Data to Study Medicare Preventive and Wellness Services
ATLANTA – Emory University School of Medicine has entered into a data use agreement with RealTime Medicare Data, LLC (RTMD), a healthcare analytics company based in Birmingham, Alabama that specializes in Medicare Fee-for-Service paid claims data. Under the agreement, RealTime Medicare Data will provide Emory with key Medicare claims data to enable its researchers to assess the utilization of Medicare preventive and wellness services across the State of Georgia.
“We are very excited to be partnering with Emory on this project,” says Gina McWilliams, CEO of RealTime Medicare Data. “Having the largest privately held collection of Medicare Fee-for-Service paid claims data in the U.S., we believe that RealTime Medicare Data is uniquely positioned to provide a valuable resource to researchers at leading academic institutions like Emory, with the ultimate goal of helping to improve healthcare for the elderly and disabled in the U.S.”
Historically, Medicare has concentrated on treating beneficiaries’ conditions and diseases rather than emphasizing preventive care to help keep people healthy in the first instance. In recent years, however, that focus has been changing.
In 2011, with the goal of increasing the provision of consistent, regular, preventive healthcare to the elderly and the disabled, Medicare began paying for health screenings in the form of an Initial Preventive Physical Examination (IPPE) (also known as the “Welcome to Medicare Preventive Visit”) and an Annual Wellness Visit (AWV). These services provide co-payment free mechanisms for an eligible patient to receive an age-appropriate health screening and counseling, including a review of family and medical history, immunizations, blood pressure, and screenings for depression, cognitive impairment, and functionality.
“These IPPE and AWV services have a great deal of potential in the early diagnosis of diseases that Medicare beneficiaries, due to their age, are at greater risk of contracting,” says McWilliams. “And they could be of help even when diseases currently have no cure.”
Alzheimer’s disease may be one such area. Indeed, according to the Alzheimer’s Association, “[t]he Medicare Annual Wellness Visit could increase timely diagnosis of Alzheimer’s to allow people affected and their families to better adjust current lifestyles, engage in learning about care and support, and plan for the future.” Such services may assume even greater importance as the baby boom generation ages; the CDC projects that Alzheimer’s will affect nearly 14 million Americans by 2050.
In addition to the potential benefits that may accrue to Medicare patients from IPPE’s and AWV’s, there may be benefits to providers as well in offering these services. As Emory lead investigator Miranda Moore, PhD notes, “As opposed to many recommended, non-reimbursed policies and screenings, there is a strong and positive business case for doing this work. Although these IPPE and AWV services are provided at no charge to the beneficiary, providers are reimbursed for the service at favorable rates, particularly if the services are not wholly performed by a physician.”
Despite the potential benefits of IPPE’s and AWV’s, given the relative newness of these services, there are still important questions as to how widely healthcare practitioners are offering them and whether utilization rates vary across different geographical areas. To investigate, Emory decided to launch this research project.
“When Emory approached us about collaborating on this project,” RTMD’s Research Director Curtis Spraitzar says, “we were able to query our vast Medicare claims database to give them both the breadth and depth of data that they needed. RTMD is unique among Medicare data vendors in being able to drill down to the level of the beneficiaries’ and providers’ five-digit Zip Codes.”
Through the use of quantitative analysis of RTMD’s data, Emory will be able to determine the geographic variation in completed IPPE’s and AWV’s in the State of Georgia, as well as the penetration rate among Medicare beneficiaries and providers. RTMD’s data will also allow Emory researchers to gain a very detailed perspective on which providers in the State of Georgia have completed and which ones have not completed IPPE’s and AWV’s in their practice.
Insights gained from this initial data analysis will inform the project’s next phase—designing an educational intervention. According to Moore, while the Centers for Medicare & Medicaid Services offers several tools and descriptions for how to perform these IPPE and AWV assessments, often specific, tailored guidance is needed by providers, practices, and health systems to do this work.
“It would be beneficial to provide primary care health systems, practices, and providers in the State of Georgia with targeted, specific, and practical information about performing the Medicare IPPE and AWV,” adds Moore. “Thanks to our collaboration with RealTime Medicare Data and the data they will be providing to Emory, we will be in a much better position to develop a targeted educational intervention aimed at increasing the provision of the AWV.”
About Emory University School of Medicine
Located in Atlanta, Georgia, Emory University School of Medicine is a leading institution with the highest standards in education, biomedical research, and patient care. Emory University School of Medicine has 2,440 full- and part-time faculty and 679 volunteer faculty. The school has 560 students and trains 1,209 residents and fellows in 98 accredited programs. Ranked 18th nationally in NIH dollars received, the school is best known for its research and treatment in infectious disease, neurosciences, heart disease, cancer, transplantation, orthopaedics, pediatrics, renal disease, ophthalmology, and geriatrics. For more information, please visit med.emory.edu.
About RealTime Medicare Data, LLC
RealTime Medicare Data was founded in 2002 in Birmingham, Alabama. Its core mission is to provide comprehensive, non-modeled, and the most current Medicare Fee-for-Service paid claims data that will allow healthcare organizations to develop and support strategic business initiatives. RTMD’s data is full census, current (generally within 90 days of adjudication), comprehensive (Inpatient Hospital, Outpatient Hospital, and Part B), and HIPAA-scrubbed. Using RealTime Medicare Data’s analytics platform, healthcare organizations can compare themselves to other providers in their market, including physician level data, thereby better positioning themselves for success in this era of healthcare reform. For more information, please visit rtmd.org.