Health Outcomes

Crystal Formation

Health Outcomes Measurement

Improving healthcare delivery hinges on clear performance measures. RDA designs research that evaluates patient-centered results of medical processes. High-quality outcomes are the result of several factors and actions that when properly aligned measure effectiveness of care, patient satisfaction and value.

RDA uses the scientific method to design and evaluate medical outcomes. We design a variety of studies from third-party payor integrity to determining the effects of medical intervention.

The validity of the experimental results depends on:

Correct design

Reliable and valid measurement

Proper statistical methodology

Health research often requires expertise beyond the scope of an individual researcher. RDA provides this expertise.

Case Studies

What Are the Health Effects of Meditation?

Meditation-based interventions have improved health for a wide variety of patient populations as well as in healthy individuals. Research has shown that meditation can improve psychological functioning and a wide range of medical issues such as chronic pain, high blood pressure, and irritable bowel syndrome.

Read more …

Immunology: Where Intuition Goes to Die?

Whether in sweat lodges, hot springs, or baths, heat has been used for ages as a healing modality. Joining ongoing research, Research Design Associates scientists have confirmed the wisdom of these ancient practices.

Read more …

Measuring Third Party Payer Accuracy

Third party payment for healthcare is big business. And it is highly regulated at the federal and state levels. Beyond well documented instances of fraud and abuse there are considerable problems in routine payment for services rendered. Payment for healthcare services has a dynamic tension between the interests of the provider and payer. Many professional norms and business practices have been established to address this interplay that often produces undesirable incentives. Government and industry have moved to more inform policy decisions regarding the provision of quality health care with reduced costs and disparities. Yet no payment method is neutral on quality because each incentivizes or disincentivizes the provision of care in particular situations. One study shows promise to improve healthcare outcomes through AI.

Medicare and Medicaid Payer Audits

In an effort to establish oversight of these governmental medical programs, CMS has established an assemblage of contractors to control compliance. Remarkably these contractors have taken a one-size-fits-all audits approach to defining the unit of payment (per time period, beneficiary, recipient, episode, day, service, dollar of cost, or dollar of charges for a very wide range of medical services). Health care differs from many other industries in that the unit of payment remains variable and unsettled. Conflicts between care provision and cost reduction arise.

Are billing irregularities actually fraud, consistent mistakes or the failure of the coding and billing systems currently in place? Most medical record software was designed around third-party payer and computer programming preferences substantially ignoring the clinical medical record perspective. Not surprisingly the system is unsatisfactory to the medical professionals themselves.

When using sampling and extrapolation contractors often miss key and essential steps necessary for using samples and inferential statistics. This inevitably leads to mismeasurement and conflict over results.

Voluntary Repayments

Compliance regulation requires providers and hospitals to conduct ongoing assessments to determine systemic mistakes in billings. When found it is important that overpayment sources are identified and corrected. This includes repayment as well as preventive training and the establishment of systems to preclude further mistakes. RDA helps medical organizations accurately determine repayment amounts. Further we assist in system designs to encourage compliance and reduce billing mistakes at all levels of the organization. 

The 8 Basic Payment Methods in Health Care, Kevin Quinn Ann Intern Med 2015 Aug 18;163(4):300-6. doi: 10.7326/M14-2784.

Underpayment by Third Party Payers

For many years providers and hospitals have documented insufficient payments by third-party payers. This problem has led to numerous law suits, class actions and arbitrations as these cases involve very large disputed dollar amounts. Headlines decry insurance companies “once again” being sued for underpayment issues. Medical providers work has been exceedingly hard during the pandemic. Their bottom line has suffered.  As they work through the backlog of patient services there is a strong desire to be paid for the work provided.

It is important that the patient not be lost in the battle between third-party payors and providers or in the pressure to accept AI data as an alternative to the human experience and deep emotions experienced by beneficiaries of healthcare.

Empirical Outcomes

Guided by scientific experimentation, RDA uses concrete verifiable evidence to address healthcare outcomes.

 

AI In Healthcare

Artificial Intelligence - AI in healthcare is big business. Several major data companies around the world are targeting the sector. A serious limitation of medicine today is the lack of full understanding of the biology of disease. Big Data provides the opportunity to aggregate volumes of information around multiple scales for what constitutes a disease—from the DNA, proteins, and metabolites to cells, tissues, organs, organisms, and ecosystems.

Developing models for drug interactions, risks and alerts, dosing and outcomes all hold great promise utilizing AI. Work tying the models to clinical detail that demonstrate the richness and judgement impacting an enriched understanding of the correlations will be critical. RDA can help researchers design the research that integrate AI insights to the clinical reality.

Currently AI data volume is far more advanced than the applications in medicine. We are at the very beginning of creating meaningful models which are well integrated into medical knowledge.

Empirical Healthcare Outcome Studies

RDA engages in the experimental design and implementation of a variety of healthcare outcome content areas. Controlled studies allow the advancement of knowledge in the physical and life sciences while explaining uncontrollable impacts. Beyond determining the cause and effect empirical testing allows for the measurement of real-world patient outcomes.

More Case Studies

Permanent Fix to Physician Billing Mistake

A complex of hospitals was having problems with physicians upcoding for services where the procedure required their physical intervention which was not consistent with billing protocols.

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AI in the Service Delivery, Prevention, Treatment at the Individual Level

Prevention. Identifying important components of the prevention of a health care crisis Is already successful in diabetes, cardiology, asthma, cancer, genomics are well established.

Read more …

What Are the Health Effects of Meditation?

Meditation-based interventions have improved health for a wide variety of patient populations as well as in healthy individuals. Research has shown that meditation can improve psychological functioning and a wide range of medical issues such as chronic pain, high blood pressure, and irritable bowel syndrome.

Read more …

Immunology: Where Intuition Goes to Die?

Whether in sweat lodges, hot springs, or baths, heat has been used for ages as a healing modality. Joining ongoing research, Research Design Associates scientists have confirmed the wisdom of these ancient practices.

Read more …

Treatment of Depression: Psychotherapy vs. Medication

RDA is collaborating with researchers in Emory University’s Department of Psychiatry and Behavioral Sciences on evaluation of depression scales were used to determine the efficacy of psychotherapy and antidepressant medications.

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AI's Promise to Healthcare Delivery

There is a critical necessity for health care delivery systems to evaluate their performance relative to quality care and health outcomes. Health care systems face growing pressures to provide more effective programs, treatments, and interventions. The scientific pursuit of measuring, reporting and evaluating health care delivery and results creates effective outcomes measurement. The findings from such research can improve the health of populations as well as the patient experience of care. This information is essential to the reduction of healthcare costs and burnout among healthcare workers. RDA assists providers to develop objective, independent and transparent measurement tools and protocols in the evolution and measurement of health outcomes.

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How You Say It Matters: Chaplain Linguistic Behavior and Patient Depression

Research Design Associates scientists and colleagues from the Emory University Department of Family and Preventative Medicine are investigating how hospital chaplains’ compassion capacity is associated with their linguistic behavior with hospitalized inpatients, and how their language in turn relates to patient outcomes.

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AI in Healthcare - Big Data Opportunity

Developing models for drug interactions, risks and alerts, dosing and outcomes all hold great promise utilizing AI. Work tying the models to clinical detail that demonstrate the richness and judgment impacting an enriched understanding of the correlations will be critical. RDA can help researchers design the research that ties the numbers to the clinical reality.

Read more …

AI in Healthcare - Healthcare is Big Business

According to a recent report by McKinsey & Company, healthcare costs now account for 17.6 percent of the GDP of the country. There is considerable success in payments, staffing, cost containment and administration.

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Contact Us

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