The primary data source for this challenge is the publicly available data from the Centers for Medicare and Medicaid Services (CMS). The CMS estimates the pevalence of 19 chronic conditions from 2007-2015. Tables by state, county, and hospital referral region geographies. The files include prevalence estimate for Medicare beneficiaries under/over 65 years old. There is also a file with state level utilization and spending estimates for each chronic condition (measures include actual per capita spending, standardized per capita spending, ED visits, and readmissions). There are many different data files available from the CMS, so your biggest challenge may be understanding them and identifying which ones are important for your model.
Chronic conditions included in these files are:
- Alzheimer’s Disease and Related Dementia
- Heart Failure
- Arthritis (Osteoarthritis and Rheumatoid)
- Hepatitis (Chronic Viral B & C)
- Atrial Fibrillation
- Hyperlipidemia (High cholesterol)
- Autism Spectrum Disorders
- Hypertension (High blood pressure)
- Cancer (Breast, Colorectal, Lung, and Prostate)
- Ischemic Heart Disease
- Chronic Kidney Disease
- Chronic Obstructive Pulmonary Disease
- Schizophrenia and Other Psychotic Disorders
We recommend that teams choose one of these conditions that they can also find evidence that there may be a future cure or treatment either recently released, or potentially coming soon to model. They should be able to find evidence that this cure or treatment is coming based on other scientific articles or papers online.
CMS Data Files
There is a lot of data on the CMS website (data.cms.gov). We recommend the students focus on data from a few tables that are publicly available:
- Chronic Condition PUF files: these files include information about the prevalence of each chronic condition. We recommend students focus specifically on these files if needing information about the prevalence of the condition they are modeling.
- Chronic Condition Spending and Utilization Files: these files include information on how much was spent for each condition. However, the conditions included are not independent. One medicare patient who has multiple conditions has their expenditures noted for each.
- CMS Provider Utilization and Payment files: these files have provider and procedure level spending and utilization data for all of the 19 conditions tracked. Each provider type has its own set of files and the measures included vary by the provider type. This is the most granular data that CMS releases publicly. For the topic for the competition the physician and supplier PUF may be useful for looking at the use and cost of specific procedures related to each disease identified by CPT/HCPCS codes. However, you can see expenditures in several different categories through their individual pages for: Physician and Other Suppliers, Inpatient, Outpatient, Part D Prescribers, Medical Equipment and Prostetics, home health, Nursing Facilities, and Hospice. Depending on the disease your team is analyzing, what kind of medical expenses are associated with it, and the focus of your models, teams may want to use any of these files.
HCC Co-Morbidity Data
The HCC comorbidity Data Spreadsheet was gathered for students to help them understand how many people with one disease, also have other diseases. This file is provided as a spreadsheet where you can see the percentage of patients who had one disease that also had another. This may help separate out costs for one disease versus another if your team desires.
Research Papers and Online Articles
We also recommend that students review research papers and online articles relevant to the disease and potential future cure or treatment that they are interested in modeling. These articles may provide valuable information to help them in creating their models and providing background information about the disease and future cure or treatment you are modeling. The links we have gathered are just a few that we thought were relevant. Each team should do their own background research to identify relevant information about their disease and future cure.
Overview of various types of future cures:
- Alliance for Regenerative Medicine: this organization includes good background information on multiple types of future cures including four major areas: (1) Gene-based medicine, (2) Genome Editing, (3) Cell Therapy, and (4) Tissue Engineered Products & Biomaterials.
- The Broad Institute: this page includes some good information about CRISPR technologies.
- Sculptio – What can we achieve with a bioprinter today: this article includes good background information on how 3D bioprinting works and where some of the big progress areas have been made.
- Precision Medicine Comes of Age: Scientific American recently wrote several articles on the new technologies coming out with creating medicine custom designed for each patient. Particularly these are related to CRISPR and Genetic modifications of cells. Check it out for more information on these types of future cures.
- Regenerative Medicine Takes Giant leaps: the American Society of Mechanical Engineers highlights several recent ways that regenerative medicine (stem cells, bioengineering, and other cell-therapies) are getting close to the clinic.
Disease Related Future Cures Articles:
- Cancer Immune Therapy Wins Nobel Prize! - The recently announced Nobel Prize for Medicine went to two pioneers of an exciting new treatment for cancers – immune therapy! Previously thought of as a wacky area that had little promise, new breakthroughs in scientific techniques developed by Dr. James P. Allison and Dr. Tasuku Honjo are poised to open an entirely new field of cancer treatments. Don’t miss this information about the exciting possibilities being brought forward with this future cure! View the article here.
- America's Health System Could Be So Much Better - Scientific American published an article on the current state of the healthcare system in America. It debates two different payment models used currently in the U.S. healthcare system: fee-based versus risk-based contracting models. It explores risk-based contracting models and how it may lead to more patient-centric, performance-based care. View the article here.
- Breakthrough: Identification of Human Skeletal Stem Cell - Identification of the human skeletal stem cell by Stanford scientists could pave the way for regenerative treatments for bone fractures, arthritis and joint injuries. View the article here.
- Regenerative Medicine: Cure for Epilepsy - Researchers work to cure epilepsy using a regenerative medicine approach to "induce self-healing of the dysfunctional brain." Learn how they are learning to cure epilepsy through a biohybrid approach merging tools from engineering and biology. View the article here.
- A Shot Instead of Joint Replacement Surgery? - "A new molecule may allow patients to opt for a shot instead of joint replacement surgery in the future." View the article here.
- Basics of Regenerative Medicine and Bioengineering therapies: check out this page from the National Institutes of Health for some great background information about how new bioengineering or regenerative medicine techniques are being developed to help tread a wide array of diseases. View the article here.
- Basics of Stem Cell Therapies: check out this page from the California Institute for Regenerative Medicine to learn the background about stem cell therapies that are being researched to provide future cures and treatments to many different conditions. CIRM is one of the world's leading funding agencies supporting stem cell research. View the article here.
- First time reprogrammed cells deployed to help regenerate injured hearts: Despite some risks and concerns, the promising first iPS clinical cell trial for heart disease is beginning early next year in Japan. View the article here.
- Immunotherapy nanodevice eliminates the need for multiple IV treatments: Scientists developed a nanodevice that delivers sustained-release immunotherapy doses into a tumor. It has fewer side effects and eliminates the need for multiple IV treatments than traditional therapies. View the article here.
- Biomechanics show stem cell necessity for effective treatment of volumetric muscle loss: Currently, while regeneration of muscle may occur, muscle volume is not restored after a traumatic injury or surgery excision. Muscle volume loss can be solved through the use of stem cells. View the article here.
- Pioneers of the tissue engineering field in regenerative medicine talk biomaterials, cell therapy: "Robert Langer, an MIT professor and chemical engineer who is widely regarded as the founder of the tissue engineering field in regenerative medicine discussed how advancements in tissue engineering can positively impact human lives." View the article here.
- Watch a 3D-engineered human heart tissue beat: "Researchers have developed a way to grow human heart tissue that can serve as a model for the upper chambers of the heart, known as the atria." View the article here.
- Twenty years on, measuring the impact of human stem cells: The exciting twenty-year timeline on the history, progress, and impact of human stem cell research. View the article here.
- A New Hydrogel for Repairing Cartilage: Aesearchers created a hydrogel that can carry repair cells for damaged areas. Two teams of researchers from the École Polytechnique Fédérale de Lausanne (EPFL) have created a material that can help heal damaged cartilages more effectively. View the article here.
- Growing Our Own Bones: Another step in regenerative medicine: A company, EpiBone, uses patients' own stem cells to custom-grow bones. View the article here.
- A New Vaccine for Alzheimers? Researchers at the University of Texas (UT) reported Tuesday that they have developed a vaccine that could arm the body to attack Alzheimer’s plaques and tangles before they even start to shut down the brain. They hope to begin testing the vaccines in humans soon. View the article here.
However, remember not to limit yourself to these articles, or these diseases/future cures. Teams should first research a disease and its future cure/treatments themselves to determine if they want to model how it may change in the future.