Download the report: Clinically Appropriate and Cost Effective Placement (CACEP) Final Report October, 2012

Link to the report page: Clinically Appropriate and Cost Effective Placement Report 10-12

In 2009, staff at the Centers for Medicare & Medicaid Services (CMS) informally
recommended that the Alliance for Home Health Quality and Innovation (Alliance)
acquire research-identifiable Medicare claims data to rigorously study outcomes and Medicare payments for patients who receive home health care and other post-acute care services. The Alliance’s objective in commissioning the study was to assess the quality and cost-effectiveness of post-acute and other care services provided to Medicare beneficiaries and to identify areas for potential Medicare savings under a variety of policy alternatives.

After careful deliberation, the Alliance commissioned Dobson DaVanzo & Associates, LLC (Dobson | DaVanzo) in April 2010 to develop a research protocol, obtain Medicare claims data, and conduct a series of descriptive and statistical modeling analyses. The Alliance Research Working Group, comprised of clinicians and health care professionals, oversaw the project and advised the research team on clinical issues. The Alliance’s work was also informed by the Center for Medicare & Medicaid Innovation’s (CMMI) Bundled Payments for Care Improvement (BPCI) initiative, which solicited applications in the spring of 2012.

This project is known as the Clinically Appropriate and Cost-Effective Placement
(CACEP) study. The attached report contains the research findings. Under the guidance of the Alliance Research Working Group, the project has moved through four distinct phases. In the first phase, Dobson | DaVanzo requested and was granted a data use agreement (DUA) from CMS to obtain and make use of three years of Medicare Parts A, B, and D patient-level claims and post-acute care patient assessment data. The second phase consisted of a literature review, which identified many viable home-based approaches that have been, and are being, developed to improve patient care coordination across sites of care and reduce patient difficulties during care transitions.