Evaluation and Performance of Medicare Part D Organizations

To support the Centers for Medicare & Medicaid Services (CMS) in developing performance metrics to rate Medicare Part D prescription drug plans, AIR assembled a team of health economists, pharmacoepidemiologists, seasoned SAS programmers, health IT specialists, and research analysts with experience and capacity in CMS methodology and application of statistical quality and performance measurement. Combining decades of experience in quantitative and qualitative research methods and statistics and economic modeling with health policy experience, the team conducted analyses to support CMS with decisions on performance star rating measures, display measures, compliance thresholds, as well as developing business rules and composite score logic for evaluating the performance of organizations providing drug benefits.

The project supported Part D organizations in performance improvement, including plan-specific quality improvement strategies. Additionally, the project supported CMS in more accurately reflecting Part D plan performance as well as making policy and operational changes in the Star Ratings program. During the project, the team collected data and used quantitative methods, including univariate, bivariate, and multivariate statistical analyses; trend analysis; weighting methods; order statistics, including nonparametric and ranking order methodology; and statistical outlier analyses.