The Improving Medicare Post-Acute Care Transformation Act of 2014 mandates that the Centers for Medicare & Medicaid Services (CMS) use standardized patient assessment data elements across post-acute care settings. RAND was tasked by CMS with developing and testing the data elements. This report, Volume 3 of a series, provides information about the representativeness of the facility/agency and patient/resident samples used in the study.

Cover: Development and Evaluation of Candidate Standardized Patient Assessment Data Elements
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Development and Evaluation of Candidate Standardized Patient Assessment Data Elements

Findings from the National Beta Test (Volume 3: Sample Description)

by Maria Orlando Edelen, Anthony Rodriguez, Sangeeta C. Ahluwalia, Emily K. Chen, Catherine C. Cohen, Sarah Dalton, Jason Michel Etchegaray, Wenjing Huang, Brenda Karkos, David J. Klein, et al.

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Research Question

  1. How representative are the National Beta Test facility/agency and patient/resident samples — of the 14 sample markets, of the United States population overall, and of specific subsamples of patients/residents?

The Centers for Medicare & Medicaid Services (CMS) contracted with the RAND Corporation to evaluate candidate standardized patient assessment data elements (SPADEs) in a national field test titled the National Beta Test. The National Beta Test was conducted to evaluate the performance of candidate SPADEs in the clinical categories of (1) cognitive function and mental status; (2) special services, treatments, and interventions; (3) medical conditions and comorbidities; (4) impairments; and (5) other categories, for use in four post-acute care (PAC) settings: home health agencies, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.

This is Volume 3 of the final report on the National Beta Test. It provides a sample description and reports analyses that evaluate the generalizability of results from the National Beta Test sample, both in terms of the representativeness of the facility/agency-level sample to the national population of PAC facilities/agencies, as well as the patients and residents who participated in the National Beta Test relative to the national population of patients and residents receiving PAC in the United States.

Key Findings

Representativeness of the National Beta Test facility/agency sample

  • The sampled facilities/agencies in the 14 National Beta Test markets were somewhat representative of the population in the 14 markets and nationally. However, the National Beta Test facility/agency sample had low rural representation, and larger facilities/agencies were somewhat overrepresented. Volumes 4–8 include sensitivity analyses to determine the effects of these differences on SPADE performance.

Representativeness of the National Beta Test patient/resident sample

  • The National Beta Test patient/resident sample, overall, is generally representative of the national population on gender, age, race/ethnicity, marital status, and activities of daily living.
  • Differences according to PAC setting in tested data elements align with general differences in patient/resident populations.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Sample Description

  • Chapter Three

    Representativeness of National Beta Test Facility/Agency Sample

  • Chapter Four

    National Representativeness of National Beta Test Patient/Resident Sample

  • Chapter Five

    Representativeness of National Beta Test Communicative Admission Subsamples

  • Chapter Six

    Conclusion

  • Appendix

    Supplementary Tables

Research conducted by

The research described in this report was sponsored by the Centers for Medicare & Medicaid Services (CMS) and conducted by the Quality Measurement and Improvement Program within RAND Health Care.

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