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Toward an Evaluation of the Quality Improvement Organization Program: (Report)
Beyond the 8th Scope of Work |
Author(s): Janet P. Sutton, Lauren Silver, Lucia Hammer, Alycia Infante
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Organization(s): NORC |
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This project developed an inventory of Quality Improvement Program (QIO) activities and then proposed methodologies to evaluate Medicare's QIO in the future. The contractor gathered information from publicly available sources, from CMS data when available, and from nine site visits to a variety of QIOs. Based on the findings, NORC developed a list of potential projects to evaluate the QIO program. These were presented to a Technical Expert Panel, who provided input on their feasibility and priority. NORC used this information to prepare a report describing potential evaluation approaches.
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Published: January, 2007 |
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Executive Summary
PDF Executive Summary
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Continuation of Drug Risk Adjustment (Report)
Drug Risk Adjustment |
Author(s): Claudia Schur, Jack Hoadley, Chris Hogan
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Organization(s): NORC (National Opinion Research Center) |
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This project reports on analysis using linked Medicaid and FEHBP data examining refinements to the risk adjustment factors for drug plans for low income and institutionalized populations; geographic variation in drug spending by health plan area; and prior use models of drug plan risk-adjustment.
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Published: December, 2006 |
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Analysis of the Characteristics of Medicare Advantage Plan Participation: (Report)
Final Report |
Author(s): Marsha Gold and Stephanie Peterson
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Organization(s): Mathematica Policy Research |
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This project examines the Medicare Advantage (MA) products available in 2006, how they compare to past offerings when only local MA options were authorized, initial plan decisions and experiences under the new competitive bidding process, and how well available offers and enrollment meet Congress's overall objectives in enacting the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).
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Published: July, 2006 |
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Executive Summary
PDF Executive Summary
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Alternative Methods of Financing Graduate Medical Education (Report)
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Author(s): Barbara Wynn, Cassandra Guarino, Lindsey Morse, Michelle Cho
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Organization(s): RAND |
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The purpose of this study was to evaluate the current system of financing for graduate medical education (GME) and to assess the strengths and weaknesses of alternative methods for GME financing. In completing the project researchers from RAND performed a literature review and held discussions with experts in the United States and abroad. The study identified a number of ways in which the Medicare program's support for GME could be improved. Most of these improvements center on changes to the formulas used to determine the level of payments Medicare makes to teaching hospitals. The report also identified five elements on which to evaluate any alternatives to the current system equity, adequacy, efficiency, accountability, and administrative feasibility. The report made no specific recommendations.
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Published: May, 2006 |
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Assesment of Pay-for-Performance Options for Medicare Phsician Services: Final Report (Report)
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Author(s): Melony E.S.Sorbero, Cheryl L. Damberg, Rebecca Shaw, Stephanie Telekie,
Susan Lovejoy, Alison Dechristofaro, Jake Dembosky, Cynthia Shuster
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This analysis will examine the theory and practice of various pay for performance (P4P) approaches and the potential applicability of practical elements that could inform recommendations on future policy refinements to Medicare physician payment policy. Under this project, RAND will: 1) Identify and describe the concept of P4P; conduct a thourough review of the existing literature on P4P (theoretical and applied) and examine P4P as currently being applied in demonstrations and practice; and 2) identify design features of P4P programs and assess how these features might apply to the design of a P4P system for Medicare physician payments. Specifically, RAND will evaluate the benefits and challenges associated with various design features and how these benefits and challenges might impact the develoopment and implementaion of physician P4P in the context of the Medicare program.
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Published: May, 2006 |
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Report Abstract
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Action to Reduce Regulatory Burden (Website)
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Organization(s): ASPE and OMB |
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The Congress mandated that ASPE and OMB establish an interagency committee to examine major federal regulations governing the health care industry and to make suggestions regarding how health care regulation could be coordinated and simplified to reduce costs and burdens and improve translation of biomedical research into medical practice, while continuing to protect patients. This committee will examine the economic impact of the major federal regulations governing the health care industry, and will explore both immediate steps and longer-term proposals for reducing regulatory burden, while maintaining the highest quality health care and other patient protections.
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Published: October, 2005 |
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Social Security and Medicare from a Trust Fund and Budget Perspective (Issue Brief)
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Organization(s): ASPE |
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According to the annual reports of the Social Security and Medicare trustees, the financial outlook for the two programs is not favorable. Under the central forecasts reported for the past 16 years under both Republican and Democratic Administrations, both programs face significant long-range
financing problems arising largely from the aging of the population and the unrelenting rise in the price of health care. This Issue Brief examines the problem from a budget and economic perspective.
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Published: March, 2005 |
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Options for Defining Medicare Advantage Regions: (Report)
An Assessment of Tradeoffs |
Author(s): Paul B. Ginsburg, Len M. Nichols, Robert E. Hurley, Joy M. Grossman, Bradley C. Strunk, Cara S. Lesser, and Lydia E. Regopoulos
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Organization(s): Center for Studying Health Systems Change (HSC) |
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The Secretary of the Department of Health and Human Services (HHS) was charged with setting regional market areas for the implementation of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). This project sought to identify and analyze tradeoffs inherent in alternative strategies for setting region boundaries and to inform the policy process by articulating what some of the key implications relative to the very clear goals of the MMA.
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Published: July, 2004 |
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Executive Summary
PDF Executive Summary
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Effects of Congressional Proposals on Prescription Drug Costs for Medicare Beneficiaries (Policy Brief)
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Author(s): ASPE
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Published: June, 2002 |
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Medicare, Accountability, and Structural Reform (Report)
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Author(s): William T. Gormley, Jr.
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Organization(s): Public Policy Institute, Georgetown University |
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This report to the Secretary of HHS discusses several alternative ways to administer the Medicare managed care program, including a reconstituted HCFA (now known as CMS), a single-headed agency outside of HCFA (now known as CMS), and an independent board or commission. It sets the stage by developing an analytical framework for thinking about bureaucratic accountability and by reviewing empirical evidence on the consequences of administrative reorganizations and the establishment of boards or commissions.
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Published: September, 2000 |
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Executive Summary
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