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Policy Analysis and Research

To support our clients, we offer expertise in the research areas described below.

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 measures. Our group currently develops and reports episode-based cost measures for clinicians, hospitals, and post-acute care providers.

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 in a wide range of care settings, including skilled nursing facilities, outpatient services, physician reimbursement, and the End-Stage Renal Disease (ESRD) Medicare benefit.

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.

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.

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, as well as reviewing marketing materials and communication to enrollees to ensure that health plans are meeting compliance standards.