Tuesday, June 6, 2017

Quick Guide to Using the Online Medicare Physician Billing Database

Since 2014, CMS has posted annual files of Part B billing data by provider name.  Available files are for CY 2012, CY2013. CY2014.  

Originally, you had to download many very large files by alphabet letter of provider's last name, or download a 2 GB database too large for Excel.   Now, you can go to the online web interface and instantly sort for data of interest and download that data quickly into an Excel file that can be easily studied.

For more about the history of this important data file and an example of analyzed data, here.

Some process steps are described below.

Find the home page for the data set here.   The path would be CMS home page > Research and Statistics > Medicare Provider Utilization > Physician and Other Supplier Data 2014.

Click on "Detailed Data: Interactive Dataset: Medicare Physician and Other Supplier PUF CY2014 Interactive Dataset."   Here.   Click yes on a CPT copyright screen.  You now are looking at the tip-to corner of a massive, 2 GB dataset with a couple dozen columns and millions of rows.

What you want to focus on is the FILTER button (above).  Click on this and see a drop down box that includes the button: "+ Add A New Filter Condition." (Below).

Click on "Add A New Filter Condition."  There will be another dropdown - you can choose to filter on NPI, Last Name, City, State, etc.   For example, filter on "HCPCS Code" 95004 to see all data on allergy skin testing.

Instantly, the screen you see in your browser is a far tinier dataset of the 4,114 providers who billed Medicare for "95004" skin allergy testing in CY2014.  

You're almost done.  Just click the pale blue EXPORT button and export CSV EXCEL (comma delimited file for Excel).  Save on your hard drive as 2014 95004.csv.  

Open it in Excel, and resave it right away as Excel Workbook.  

You have the 900 kb of data you need and are free of the 2 GB scale of the original data.   Now, you can delete unnecessary columns and sort and analyze with ease.  

One quirk.  The spreadsheet holds a column for "number of services allowed," and one for "average Medicare allowable price per service."  You probably will want to make an additional column that multiplies these two columns together to get the total dollars allowed for that provider for that service in that year.  E.g. 500 services allowed X $9.00 per service becomes a new column of $4,500.00.


I can't give a course in Excel and I'm not an expert with it, but two particularly useful functions are these.

"Sort and Filter" (upper right), click on  Custom Sort, click "Expand Selection" if offered, be sure "My Data Has Headers" is checkmarked, and filter on one or more columns.  For example, you can filter by state, then, by provider type, then, by services allowed in the year.  

To quickly see a line plot of data, select an entire column, click Insert, and click "Recommended Charts."  This instantly gives you graphics like this one:

Wednesday, May 17, 2017

Agenda of April 2017 Conference (RWE)


Day One

  • 08:15-09:00
    Opening Address
    Work cross-functionally to unlock new insights throughout the lifecycle
    • Adopt a cross-functional approach, enabling increased real-world understanding from discovery to post-approval
    • Understand how different teams can work together to break data silos, enhancing the internal spread of knowledge
    • Meet increasing regulatory requirements by engraining a continuous cycle of evidence generation into your company’s core efforts
    Insights, Ecosystems, and Outcomes: Using Data to Drive Value Based, Personalised Healthcare
    • Understand how the healthcare ecosystem is undergoing an unprecedented period of change
    • Explore how life science organisations are investing in end to end evidence approaches which require new operating models and technology choices
    • Industry Case Study - Implementing an enterprise wide RWE strategy
    Make sure your product is launch ready by integrating market access into drug discovery and development
    • Use payer insights to tailor clinical trial design to ensure the data collected meets market requirements
    • How to promote market access priorities in phase II and III to ensure a seamless, HTA-ready launch
    • Explore ways to engage payers early in order to evade potential pitfalls and hurdles to reimbursement
    Coffee break
    Panel discussion: Emerging data sources – meet evolving data needs with the latest innovations
    • Discover the increased patient insight offered by previously under-utilised data sources
    • Meet increased HTA/payer demands with increased value demonstration
    • Learn how to maximise analytical capabilities by harmonising data collection across multiple platforms
    Increase product launch success with a cross-functional use of real world evidence.
    • Prepare for future product development and launch by integrating RWE across functions (Clinical Development, Medical, Market Access, Marketing)
    • Enhance product understanding and communication with a fluid approach
    • Case example of innovative basal insulin launched in crowded diabetes market place and price containment context
    External collaboration with stakeholders to optimize patients access strategies “from clinical development to patient access”
    • Understand the principles of market access and medical teaming up to shape patients outcomes in unmet haematological malignancies
    • Hear how R&D innovation is being accelerated through the nurturing of a ground breaking public-private relationship
    • Genuinely maximise your real-world capability by building your strategy in partnership key stakeholders and competitors
    Driving Market Access with RWE: Rhetoric vs. Reality
    • Explore the different perceptions surrounding RWE and optimise your real-world access strategy with greater understanding of the other halves needs
    • Interactive session gauging the audience’s own perceptions on the Market Access/RWE relationship
    Lunch Break (New Chair: Agathe Le Lay, Head of HEOR Europe, Novo Nordisk)
    Multi-presentation feature: See how IMI’s ‘GetReal’ project is increasing RWE’s practical application with earlier adoption into the lifecycle
    • Hear how best to demonstrate effectiveness through real-life clinical studies with thought leadership from stakeholders across healthcare
    • Smoothly incorporate pragmatic trials into your operations with the latest methodological approaches
    • Delve into the range of tools developed from the program accelerating RWE development
    Lean Clinical Development - Adding value with visual evidence.
    • BDD Scintigraphy as a tool to maximise clinical investment
    • Seeing is believing - RWE to support product claims, marketing and strategy
    • Case study; In vivo imaging of novel complex oral product
    Coffee Break
    Optimise your clinical trials using Electronic Health Records
    • See how the EHR4CR project is increasing patient understanding through the catalyse of EHR use in Europe
    • Enhance your clinical trial efficiencies with RWD protocol data testing, accelerated patient recruitment and enhanced EHR data extraction
    • See how the new ‘Champion Programme’ is reducing the risk of investing in EHRs, encouraging growth of the EHR ecosystem
    The Importance of an Integrated Medical Plan
    • A review of recent drug launch success
    • Where RWE collection could have played its part
    • Building an Integrated Medical Plan to prepare for success: “Begin with the End in Mind”
    • The “Resource v Demand” Challenge in this environment
    Why choosing RWD from the right league changes everything.
    • What are the different leagues of real world data and how do they change the opportunities for relevant research?
    • Discover why Registry Based Randomized Clinical Trials will be the next disruptive technology in clinical research
    • Value Based Health Care examples based on high quality data sets
    Real World Data (RWD) and Real World Evidence (RWE): Turning the myriad of data sources into clinical practice evidence
    • Is RWE actually a new trend? Why are we talking so much about it now?
    • Explore the differences, perceived and real, between RWD & RWE
    • Understand the values and risk associated with adopting a real-world approach
    Networking Drinks
    End of Day One

Day Two

  • 09:00-09:30
    Expand your research capability by utilising CPRD as a tool for innovation
    • Explore how the CPRD is evolving to further vary and increase their sources of data, expanding research possibilities
    • Educate clinical trial design to improve clinical output with more targeted patient identification
    • Providing the data for different research purposes in clinical trials
    Unleashing data science in RWE via next generation tools
    • Machine learning, deep-learning, phenotyping or tensors can transform RWE 
    • Major barriers exist: lack of skills, using data scientists for simple data management
    • QuintilesIMS discusses case studies and next generation tools to unlock data science
    Draw further insight from your RWD with interactive visualization techniques
    • Understand how interactive visualization can help you explore your data in new ways, finding previously undiscovered hypothesis
    • Case study examples surrounding the latest Janssen work in partnership with Karolinska Institute and the Royal Institute of Technology
    Coffee Break
    The GSK Salford Lung Study: Lessons learnt
    • Hear how experiences from pioneering pragmatic phase III study can aid in pushing further real-world studies into reality
    • Understand how electronic health records allowed for quick and easy access of patient information – enabling the study to take place 
    • See the way the studies inclusive approach generated greater insight into drug effectiveness in a real-world setting
    • Learn how collaboration with local healthcare providers played a crucial role in the studies effectiveness and operational capacity 
    Innovative approaches to Real World uses of EHR data
    • Find out how Ignite are using EHR data to find and consent patients onto studies across the UK
    • Discover how current technology is being utilised to extract data across most UK healthcare settings
    • Understand how some traditional processes can support the use of technology and eSourced data
  • 12:15-13:15 Choose between the following 3 workshops
    Choice 1
    Interactive Workshop 1: The role of digital technology in RWD programs
    • Explore the use of technology to support patient data capture across observational, pragmatic and commercial health management programs
    • Build in representativeness through use of patient’s own devices
    • Understand how this approach facilitates the capture of high quality, regulatory compliant datasets built for analysis and mining in a real-world setting
    • Discuss how, where applicable, technology can support enhanced patient engagement and improved health outcomes
    Choice 2
    Interactive Workshop 2: Market Access - Back to The Future
    • In this interactive workshop, we will explore Market Access Reality vs Market Access Ideology, to test the hypothesis that:
    • “To improve post-launch market access success, market access activities must start early in a product’s lifecycle”
    • If the current reality is suboptimal, what opportunities are we missing?
    • If we could go back in time and change what was done, could things have been different - could the challenges have been predicted and addressed?
    Choice 3
    Interactive Workshop 3: Maximizing real world data with governance in a digital world
    • Gain insights into managing RWD with effective governance to help create tailored programs. This workshop will help you learn how to future proof your data with best practices (acquiring, qualifying and maximizing RWD)
    • Understand the challenges of acquiring data with a real-life case study of how pharma organizations are filling the gaps on their own compliance practices
    • Explore how RWD can be used to create an effective patient/HCP journey and analyse the campaign performance
  • 13:15-14:15
    Lunch Break
    The Patient Perspective: Real World Evidence = Real World Patients: Design your real-world strategy around the key stakeholder
    • Hear how to work with patients in your real-world set-up to change attitudes toward data collection; improving your collection techniques and results
    • Explore the opportunities social media offers for patient engagement and data collection
    • Understand why the strive for a patient-centric pharma does not exclude big data
    Real World Evidence: who cares? Investigating how EU payers actually base decisions on RWE
    • Address increasing evidence expectations from EU payers by exploring their usage of RWE in HTA and reimbursement decisions
    • Assess EU payer receptiveness and future trends for RWE, to build buy-in from partner functions for RWE investment
    • Share selected learnings on how industry leaders can use RWE for positive impact on payer decisions.
    Increase your understanding of the burden of illness through text mining
    • Break the traditional feedback model to discover new findings from the analysis of open-ended patient feedback
    • Explore how text mining advancements are expanding the traditional scope of data analysis
    Coffee to stay or go