Policy Research and Support Services

To support our clients, we offer the specific capabilities and skills described below. The capabilities have been divided into two sections, Policy Research and Support Services.

Policy Research

Auditing and Validation

SPHERE has several teams dedicated to auditing and validating health care program data to promote compliance with and integrity of various Medicare programs. This work often involves auditing the accuracy and availability of marketed plan benefits and services and reviewing marketing materials and communication to enrollees to ensure that health plans are meeting compliance standards.

Program Design and Implementation

When introducing new programs and policies to the public, clients often require data and analytic support throughout the development and implementation phases. SPHERE is an industry expert in supporting the design and implementation of public health care delivery programs and payment systems. Our expertise encompasses a wide range of care settings, including nursing facilities (NFs), skilled nursing facilities (SNFs), long-term care hospitals (LTCHs), and inpatient rehabilitation facilities (IRFs), as well as outpatient services, physician reimbursement, and disease-specific Medicare benefits, such as the End-Stage Renal Disease (ESRD) benefit.

Measure Development

Policymakers, providers, and consumers use health care measures to incentivize effective care, and to evaluate provider performance with regard to cost, quality, and other domains. SPHERE has extensive experience developing, reporting, and evaluating health care performance measures, with a particular focus on cost and quality measures. Our group currently develops and reports episode-based cost measures and quality measures for clinicians, hospitals, and post-acute care providers.

Program Evaluation

As Federal, state, and local agencies continue to test improvements to their health care systems, robust evaluations are necessary to evaluate their impact and determine best practices. SPHERE has significant experience designing and implementing flexible and insightful evaluations of federal and state health care programs, specifically programs testing innovations related to payment policy and care delivery. Our group conducts a wide range of mixed methods and quantitative program evaluations to assess the programs’ impact on health care costs, standards of care, and patient health and quality of life.

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Real-Time Monitoring

SPHERE has extensive experience providing policymakers with easily accessible information and tools for monitoring health care program operations and outcomes after a policy change or program rollout. When government agencies roll out major programs and policy changes, they often require support to ensure that such changes are not limiting access to care or contributing to other negative health outcomes.

Support Services

Clinical Expertise

SPHERE’s staff includes a broad and expanding network of clinicians who take on varying roles in SPHERE’s work. They serve in managerial roles on projects requiring significant clinical expertise and in consulting or supporting roles in nearly all of SPHERE’s work. These clinicians come from a diverse range of medical specialties and backgrounds, all with Medicare population experience, understanding of policy implications, and expertise in health services and administrative claims research.

Data and Statistical Support

SPHERE’s data systems programmers and statisticians play an integral role in supporting SPHERE’s research staff and their clients and work to provide research-ready data resources to the entire firm. Our group’s data and statistical support staff update and maintain large databases, including all Medicare, Medicaid, and commercial health care claims data used across projects teams, and streamline the processes for querying datasets. SPHERE’s statisticians also work with our group’s research teams in the development of statistical methods for complex analyses.

Data Visualization

Our data visualization specialists work directly with our research teams to elicit requirements, develop specifications, and design appropriate solutions. These products are designed to answer applicable research questions in a visually intuitive interface, allowing our clients to easily extract needed information.

Information Systems and Tools

In addition to data analytics, SPHERE builds secure analytic environments (SAEs) that empower government clients, as well as SPHERE's own researchers, to answer pressing questions about sensitive health care data, using file formats they prefer, and analytical software they know.

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