Data Collection and Analysis

Helping health care organizations collect and use data

"I have to say that TMF’s Program for Evaluating Payment Patterns Electronic Report is one the most valuable tools CMS has provided. Once you dive into the reports, they are valuable for identifying more than just potential payment errors, but also potential quality issues."

-Nancy J. Meadows, RN, BS
Clinical Specialist
Health Care Excel

Health care organizations, professional medical associations and state and federal regulatory agencies rely on TMF Health Quality Institute to effectively collect, analyze and report health care data.

TMF provides data services faster, better and more cost-effectively than most organizations can handle in-house. We specialize in customizing solutions for assessing or improving the quality of health care services to meet our clients’ needs. TMF’s analytic staff includes master’s and doctoral level statisticians adept at analyzing health care data. We help identify trends, correlations and areas for further investigation.

Services

• Project management – Based on an organization’s policies, regulations and resources, we propose sample selection and data collection methods, develop strategies for achieving project goals and manage field staff to complete the project on time and on budget.
• Tool design – TMF works with each client to design and develop the best data abstraction and assessment tools for the specific data to be collected. We conduct literature searches for regulatory and quality of care standards and practice guidelines and couple this information with clients’ specifications. The final product is a well-developed, easy-to-use electronic tool.
• Data abstraction – We ensure consistent data abstraction and inter-rater reliability with thoughtfully designed tools and a well-defined process. Our abstraction tools and clear instructions, coupled with thorough training, lead the abstractor to correctly identify specific data elements, key sources and rules related to data inclusion or exclusion. We ensure consistent performance by selecting and training qualified nurse reviewers and other health care professionals as appropriate.
• Data analysis – Data analysis is determined by our clients' projects, taking into account organizational and reporting goals. Analysis can be performed on data abstracted by our staff or collected by others. Often, findings are compared to recognized standards of care, quality of care criteria or other state or national guidelines.
• Data reporting – Data report design and presentation are based on each client's needs. Project reports can be written to mirror federal or state grantee project reporting requirements or written for presentation to specific stakeholder groups, such as boards of directors or review boards.
• Development of recommendations – TMF can provide recommendations for action based on data analysis. Recommendations may include areas for further study or actions to improve processes and quality of care.

Clients

Data collection and analysis clients include federal, state and local government agencies, research organizations and other health care organizations.

Accomplishments

Comparative Billing Reports
Under contract with the Centers for Medicare & Medicaid Services, TMF provides comparative claims data reports, education and support to Medicare Administrative Contractors and Fiscal Intermediaries to assist in identifying patterns of inappropriate Medicare billing. In addition, TMF provides comparative claims data reports—referred to as Program for Evaluating Payment Patterns Electronic Reports—to acute care hospitals nationwide to help them proactively monitor internal patterns to prevent inappropriate payments.

TMF distributes comparative Medicare claims data reports nationally to 3,700 short- and long-term acute care hospitals each quarter. Hospitals use these reports, which contain provider-specific data on diagnoses and discharges at risk for payment errors, to guide their auditing and monitoring efforts.

Evaluation of Medical Checkup Completeness
Under contract with the Texas Health and Human Services Commission, TMF completed an independent, unbiased, statistically valid study of Texas Medicaid Early and Periodic Screening, Diagnosis and Treatment medical checkup completeness. Major components of the study included sampling, data collection, data analysis and reporting of findings and recommendations for improving various Medicaid delivery models.

This study involved the review of 6,951 medical records in four months to assess the level of completeness to which Medicaid medical checkups had been performed. A final report submitted by TMF to the State of Texas included several recommendations for policy and administrative interventions to continue improvement in checkup rates.

Standardizing Antibiotic Use in Long-term Care Settings Study
TMF serves as a subcontractor to the American Institutes for Research for the Standardizing Antibiotic Use in Long-term Care Settings study. The study, funded by the Agency for Healthcare Research and Quality, assesses current antibiotic practices in a group of long-term care facilities and develops new approaches to optimizing antibiotic prescribing practices in a subset of facilities.

In addition to collecting data and programming data files, TMF is leading the facility training efforts for this study, providing clinical input on the research plan and overseeing the pretest, pilot and field tests.