Tag Archives: Jocelyn Lau

Real-world evidence presents immense potential when done right

Real-world evidence (RWE) is key to understanding health-related experience in everyday settings. Stakeholders seek to use RWE for specific reasons related to their roles in healthcare innovation and decision-making. For example, health insurers may use it to make determinations about coverage and benefit design for specific medical products or services. Healthcare providers may use RWE to develop evidence-based clinical guidelines and to develop tools to guide a patient’s clinical care.

RWE relies on dependable real-world data (RWD). Administrative claims data, a type of RWD, offer a valuable combination of costs and information on patients’ diagnoses and service usage that can be leveraged for population estimates of important clinical and economic measures of healthcare.

As RWE plays an increasingly important role in healthcare decision-making, the translation of RWD into actionable and meaningful evidence requires the use of high-quality data and rigorous, meticulously developed analytic methodologies in order to establish confidence in the findings.

In this paper, Milliman consultants discuss using administrative claims data to expand the use of RWE in healthcare decision-making.

Comprehensive Care for Joint Replacement Performance Year 1 results: Key considerations

The Comprehensive Care for Joint Replacement (CJR) model is a bundled payment model in which 799 participating hospitals from 67 metropolitan statistical areas are required to participate. The first CJR reconciliation for Payment Year 1 (PY1) was completed in spring 2017. This paper by Milliman’s Pamela Pelizzari, Jocelyn Lau, and Harsha Mirchandani combines data from the report of PY1 results and other publicly available sources to compare hospitals that received payments in CJR PY1 to those that did not.