The reviews are coming in
and the verdict is clear:

Cracking Health Costs and
Why Nobody Believes the Numbers
are the best books ever written.*

* By me



FAQs about CORA Certification

(1) How much math do we need to know?

I find there is a negative correlation between someone's background in math and their ability to pass the CORA exam. 8th grade math is plenty (and even then, you won't need to prove that two triangles are congruent).

For instance, many actuaries either barely pass or fail. For instance, the team that wrote the Mercer report for North Carolina had multiple actuaries, but that report was full of obvious errors that any CORA-certified person would spot.

And the person who I think is the (second) best in the world at spotting these mistakes is an RN, though many RNs don't pass.

Most of the mistakes you'll need to be able to identify are findable through simple common sense or the most elementary knowledge of study design, and require only the ability to find things that literally or figuratively do not add up. Right now, most people read outcomes reports like guys looking at an engine in front of an auto mechanic — frowning, knitting their brow, rubbing their chin — to try to show the mechanic they totally get what's going on under the hood, and why the car is making a funny noise when in reality they have no idea. (They'll probably say something like "I think it's the distributor caps," only to be told their engine doesn't have a distributor, let alone caps.)

There is also a specific knowledge base you'll need that most people don't have but should, like knowing a typical heart attack rate, admits/1000, cost/CHF patient etc. You'll be provided with a list of those items. Once you internalize them, you’ll more readily spot places where they are wrong.

(2) What is the difference between Advanced CORA and Standard CORA

The difference between Standard CORA and Advanced CORA is that the Standard CORA involves a test where you know that each slide has something wrong with it because otherwise the slide wouldn't be on the test. Advanced CORA tests the ability to look for mistakes where someone hasn't told you in advance that there are mistakes.

It's like when my esteemed Scrabble partner and I trash-talk each other during our we-need-a-life all-night Scrabble marathons. Last night I made "ASCETIC" and our standard repartee following a Bingo is that she'll say "I would have found that too," and I'll say, "Sure you would, if you knew there's a 7-letter word to be made, but if you're sitting on two c's, you never would have thought to look." CORA is about recognizing mistakes. Advanced CORA is about learning to intuit where to look for them.

(3) Does CORA require using a specific outcomes methodology?

No, CORA training is to help you do the best with the methodology you've settled on or that your vendor is using — or that your competitors are using that needs to be debunked. Ironically, CORA training is probably more important to complement use of pre-post than for event-rate "plausibility"-driven methodologies. Why? Because pre-post has many more moving parts, and therefore more opportunity to make mistakes, whereas the DMPC-favored event-rate methodology is transparent and simple.

(4) Can CORA Certification help me get a job?

Several answers here. First, any employer who knows of CORA will favor a CORA-certified applicant. Second, I have on several occasions received inquiries from employers who had not heard of it, but who saw it on applicants' resumes, calling me to ask what it is, meaning that they are noticing it.

Third — and this is just intuitive — perhaps paradoxically, the more people who have the certification (and I think the website lists about 250 right now), the more valuable it is. If there are ten applicants for a job and one has it, well, that one just looks like an outlier, and it raises more questions to be answered (hence the second point directly above). But if 3 applicants have it and 7 don't, you can imagine that CORA becomes a screen. Once again, just conjecture.

Finally, any job I post on the disease management listserve will either require CORA or disproportionately favor CORA.

Hope this is helpful. If not I just wasted 45 minutes (equivalent to an entire game, as measured in Scrabble time).

PS A "for instance" of Advanced vs. Standard CORA is that the subject header said three questions whereas I just listed four. The trick is to be aware that there could be mistakes as much as to spot them when someone tells you there are mistakes.


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