Emory University School of Medicine has entered into an agreement with RealTime Medicare Data, LLC (RTMD), a Birmingham-based healthcare analytics company that specializes in Medicare Fee-for-Service paid claims data. Under the agreement, RTMD will provide Emory with key Medicare claims data to enable its researchers to assess the utilization of Medicare preventive services across Georgia.
"We are excited to partner with Emory," says Gina McWilliams, CEO of RTMD "With the largest privately held collection of Medicare Fee-for-Service paid claims data in the U.S., we can provide a valuable resource to researchers at leading institutions like Emory."
Historically, Medicare has concentrated on treating beneficiaries' diseases rather than emphasizing preventive care. In recent years, however, that focus has been changing.
In 2011, with the goal of increasing the provision of preventive healthcare to the elderly and the disabled, Medicare began paying for health screenings in the form of an Initial Preventive Physical Examination (IPPE) and an Annual Wellness Visit (AWV). These services provide free co-payments for eligible patients to receive 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.
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, there are still questions as to how widely healthcare practitioners are offering them and whether utilization rates vary across geographical areas. Emory launched the research project to investigate this.
"When Emory approached us about this project," RTMD 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 they needed."
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 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 in which they plan to design an educational intervention.