Developing Outpatient Therapy Payment Alternatives

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Dynamic List Data
Title
Developing Outpatient Therapy Payment Alternatives
Project Officer(s)
Ann Meadow
Start Date
End Date
Award
Task Order (MRAD)
Description
CMS envisions a new method of paying for outpatient therapy services that is based on classifying individual beneficiary's needs and the effectiveness of therapy services. CMS does not currently collect the appropriate data elements for this type of study, and therefore cannot evaluate or implement this type of approach. However, the therapy community has been working on these issues and may have data relevant to CMS's intended goals. This project will identify, collect and use therapy related information that is tied to beneficiary need and the effectiveness of outpatient therapy service. The ultimate goal of the task order is to develop payment method alternatives to the current cap on outpatient therapy services. The 5-year contract has three main tasks: 1) identify and collect beneficiary measures of health and functional status which are not available to CMS currently through claims; 2) provide high-level analysis of the annual utilization and expenditures for outpatient therapy services to enable CMS to monitor changes; and 3) use the collected beneficiary level data to conduct and report analysis that provide the basis for payment method alternatives.
Funding
$2,923,940.00
Principal Investigator(s)
Barbara Gage
Project Number
HHSM-500-2005-00029I/0012
Status
A Technical Expert Panel was convened to obtain expert and stakeholder input on the feasibility and value of proposed measures of therapy related information. A Special Open Door Forum (ODF) was held. This ODF introduced to a broad audience the Developing Outpatient Therapy Payment Alternatives (DOTPA) project with a special emphasis on how data will be collected and how facilities, practices, and individual providers may become involved and contribute to the research. A variety of meetings with stakeholders have been conducted to obtain input, disseminate information about the project, and to lay the foundation for recruiting provider participants for the data collection activities. The annual therapy utilization report based on 2007 claims was completed and made available to the public (http://optherapy.rti.org/). The DOTPA Project Annual Report was completed and made available to the public (http://optherapy.rti.org/). The data collection design and instrument development were completed and a Paperwork Reduction Act (PRA) package was submitted for approval by the Office of Management and Budget (OMB). The Federal Register notice for public comment on this package was published on October 9, 2009 (Vol 74, No 195, page 52236). Once the PRA package is approved, the contractor will begin data collection. While approval is pending, the contractor is recruiting potential participants in the data collection, developing training materials for participants, and updating the project website http://optherapy.rti.org/ .
Awardee Address

P.O. Box 12194, 3040 Cornwallis Road
Research, Triangle Park,
United States

Awardee Name
Research Triangle Institute, (NC)