Comparative Analysis of Methods for Health Plan Performance Assessment

Organization: 
US Office of Personnel Management
City: 
Washington
State: 
District of Columbia
Organization Overview: 

The US Office of Personnel Management (OPM) seeks to provide affordable, high quality health benefits as part of the agency's vision to empower excellence in government through recruitment and retention of top talent. OPM's Healthcare and Insurance team has successfully administered the Federal Employees Health Benefits (FEHB) Program since 1959. The FEHB covers approximately 8.2 million enrollees including employees, retirees, and their families at a combined annual premium value of $52 billion. Enrollees select from a broad variety of health plans available in their local area, ranging from national Preferred Provider Organizations (PPOs) to community based Health Maintenance Organizations (HMOs). All plans include a comprehensive pharmacy benefit. 

In 2016, OPM linked health plan profit to performance on a select number of quality, customer service, and resource use measures. Measures are chosen from those in common use across the industry, weighted for priority, and scored relative to external benchmarks. Highest priority is assigned to measures reflecting timely prenatal care, blood pressure control, and prevention of hospital readmission. Plans may also earn an "improvement increment" for year over year progress.

Project Name: 
Comparative Analysis of Methods for Health Plan Performance Assessment
Project Type: 
Program Evaluation; Performance Management
Project Overview: 

OPM seeks a formal comparison of our Healthcare and Insurance Plan Performance Assessment methodology to the Medicare STARS program. Final product would be a detailed paper assessing issues like the effect of domains, composites, explicit weighting, and number of measures on the output/result of the measurement system. The analysis would include an evaluation of the strengths and weaknesses of each method, the applicability of results to policy decision-making, and the likelihood that either system would drive meaningful improvements in population health. The analysis will be incorporated into deliberations on potential refinements to the OPM Plan Performance Assessment. 

As part of the project, we will invite the student to attend up to 5 key meetings onsite at OPM.

Spots Available: 
1
Eligibility: 
Executive; Full-Time
To Apply: 

To apply for this project, please contact Cassie Tomkins at ctomkins@upenn.edu.

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Contact Information

Fels Institute of Government
University of Pennsylvania
3814 Walnut Street
Philadelphia, PA 19104

Phone: (215) 898-2600
Fax: (215) 746-2829

felsinstitute@sas.upenn.edu