HERC: Bulletin
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HERC Bulletin - November 2017

Survey Highlights Needs of Health Economics Researchers

We sincerely thank all of you, our customers, who participated in a HERC needs assessment focus group or completed the HERC needs assessment survey and provided us with your invaluable insight. We were surprised to find such a large number (73%) of those who currently use VA cost data report using HERC average cost data in the past 2 years and of those who plan to use VA cost data in the future, 70% plan to continue using HERC average cost data in the future. For those of you who report MCA cost data will not meet your project needs, we plan to continue making the average cost data for the near future.

We have included a brief summary of the results below. A detailed summary of the results can be found on the HERC website.

Your feedback is helping us to form our future initiatives and we look forward to continuing our economics services to you.

-Todd Wagner, HERC Director


More than 250 HERC customers responded to online survey asking about their current and planned use of HERC products and services fielded last month.

Customers reported use of the HERC average cost data set (73%) and the VA Managerial Cost Accounting System (67%). Of those who plan to use VA cost data in the next 3 years, 78% plan to use MCA cost data, 70% plan to use HERC average cost data, and 70% plan to use Fee Basis/Purchased Care cost data. While most survey respondents said they could use MCA cost data if HERC data were not available, 31% said that the MCA cost data would not meet their project needs.

Most respondents said HERC services were important to their work, with highest ratings for HERC courses and seminars, cost data, and documentation of economics data and methods. Only 19% said that HERC consulting services were important to their work. The survey revealed an unmet need for economic research help, however, with 38% of respondents saying that they do not have adequate access to health economics expertise.

Those who responded to the survey included 41% who had graduate-level training in economics, while 45% were self-described health economics novices. Most respondents (73%) were primarily affiliated with VA.

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How can I identify a patient's primary care provider?

HERC economists discuss one method for identifying a patient’s primary care provider using Corporate Data Warehouse (CDW) data.

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What is the correlation between CMS and MCA RVUs?

Although they share the same name, Relative Value Units (RVUs) created for the Centers for Medicare and Medicaid Services (CMS) are not the same RVUs used in the VA Managerial Cost Accounting (MCA) system.

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HERC Discharge Data for FY 2016 Now Available

HERC Discharge data for Fiscal Year 2016 are now available at VINCI.

The Managerial Cost Accounting System (MCA) maintains National Data Extracts (NDE) that track cost and utilization for care provided by the U.S. Department of Veterans Affairs (VA) medical centers. The MCA Discharge (DISCH) NDE provides the discharge bed section (DBEDSECT), but does not have detailed information on other inpatient treating specialties (i.e. categories of care) during an inpatient stay. HERC created a new dataset that is identical to the DISCH with the addition of fields containing cost and length of stay subtotals for each inpatient category of care (e.g., acute medicine, psychiatry, nursing home, etc.).

The updated guidebook, which describes how HERC created the Discharge dataset, is available on the HERC website.

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Cost-Effectiveness Analysis Course Begins January 2018

The Health Economics Resource Center will offer a 12-session course in cost-effectiveness analysis as part of the VA HSR&D Cyberseminar series starting January 2018.

This introductory course covers cost-effectiveness and budget impact analyses using VA data. Cost-effectiveness analysis is a method to determine if interventions provide sufficient health benefit to justify their cost. Budget impact analyses complement cost-effectiveness analyses, providing decision makers with information on the effect of adopting cost-effective interventions. This HERC course will provide an overview these and other types of decision analysis and how to conduct these analyses with VA data.

The course is designed for researchers who would like an introduction to methods of cost-effectiveness analysis and budget impact analysis as applied to health services and medicine.

Participants may attend any or all the free sessions. The course takes place through conference calls with web-based slide presentations. Please visit the HERC website to register.

Please visit the HERC website for a summary of each session.

Session Listing
January 10, 2018 New Recommendations for the Conduct of Cost-Effectiveness Analysis from the Second Panel on Cost-Effectiveness in Health and Medicine
January 17, 2018 An Overview of Decision Analysis
January 31, 2018 Estimating the Cost of an Intervention
February 7, 2018 VA Costs: HERC versus MCA
February 14, 2018 Introduction to Effectiveness, Patient Preferences, and Utilities
February 28, 2018 Estimating Transition Probabilities for a Model
March 7, 2018 Medical Decision Making and Decision Analysis
March 14, 2018 Evidence Synthesis to Derive Model Transition Probabilities (Part I - Systematic Literature Review)
March 28, 2018 Evidence Synthesis to Derive Model Transition Probabilities (Part II - Quantitative Pooling)
April 4, 2018 Sensitivity Analyses
April 11, 2018 Budget Impact Analysis
April 25, 2018 How can cost-effectiveness analysis be made more relevant to U.S. health care?

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HERC Welcomes Two New Programmers

James Wong joined HERC as a Research Associate in September 2017. He graduated from UCLA in 2014 with a BS in statistics. His last position was as a Data Analyst at Sqor, a sports-based social media startup. His future career goal is to get into Machine Learning field for undetermined applications. One of James’ hobbies is changing board games into games requiring physical activity. This combines his interests in board games and casual sports playing.

Caitlin Chan joined HERC as a Research Associate in October 2017. She earned an SM in Epidemiology from the Harvard Chan School of Public Health, where she conducted research on mental health, family relationships, and health disparities. Her public health work prior to graduate school supported the implementation of the Affordable Care Act in California. In her spare time, she enjoys writing and travelling, and recently climbed an active volcano in the Democratic Republic of Congo.