Clinical Expertise

 

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Acumen’s staff includes a growing number of clinicians who take on varying roles in Acumen’s work. They serve in managerial roles on projects requiring significant clinical expertise, and in supporting roles in nearly all of Acumen’s work. Clinicians come from a diverse range of medical specialties and backgrounds, with some specialized in treatment and policy relevant to the Medicare population.

Acumen’s clinicians have the opportunity to directly impact health care policy: they participate in the design and execution of statistical analyses; interpret data from Medicare claims; draft and conduct client, stakeholder, and public communication; and provide ad-hoc clinical advice to other team members and clients.

Acumen’s clinicians are especially involved in Acumen’s work on value-based purchasing and health care measure development, medical product safety, and Medicare payment policy.

 

Case Study:

Technical Support for the Production of Medicare Outpatient Prospective Payment System (OPPS Rates); 2010-present; Prepared for the Centers for Medicare and Medicaid Services, Center for Medicare


Every year, CMS evaluates new outpatient technologies to identify those eligible for Medicare reimbursement, and determines payment rates for those technologies. Acumen clinicians and other project members support this CMS activity by reviewing scientific and clinical trial research for a given technology and soliciting input from other experts in the field. Our team then consolidates their research to make recommendations for payment rates for new outpatient technologies. Specific avenues of inquiry include:

  • Investigating whether there is substantial similarity with existing technologies
  • Assessing clinical improvement over existing treatments
  • Identifying any populations for whom the new technology would serve a unique function.

In this way, Acumen’s clinicians contribute to CMS’ efforts to accurately evaluate emerging technologies and establish fair and accurate reimbursement rates.