Acronyms and Glossary 1915(c) waivers refers to section 1915(c) of the Medicaid program allowing the Secretary of HHS to waive certain program requirements in the law. Waivers permit States greater flexibility to target program eligibility and provide home and community based services for the disabled and/or elderly population
This study estimated inappropriate Medicaid rebate claims caused by unit of measure inconsistencies and determined how often States converted their Medicaid use data to correct for unit of measure inconsistencies. Prescription drugs are defined using two types of unit of measure standards. Inconsistencies between the two standards have potential
Performance Improvement 2009. Do Average Sales Prices Exceed Average Manufacturer Prices for Specific Prescription Drugs?
Pursuant to Federal statute, the Office of Inspector General must notify the Secretary of the Department of Health and Human Services (the Secretary) if the average sales price (ASP) for a drug exceeds the drug’s average manufacturer price (AMP) by a threshold of 5 percent. If that threshold is met, the statute grants the Secretary auth
Performance Improvement 2009. How Can We Improve Health Outcomes and Reduce Medicare Expenditures for Certain Medicare Beneficiaries With Heart Problems?
The evaluation examined the impact of providing disease management services and a prescription drug benefit for Medicare fee-for-service beneficiaries with congestive heart failure, coronary artery disease or diabetes. Three disease management organizations participated in the demonstration. The evaluation used a randomized design where eligible
Performance Improvement 2009. Do Nursing Homes Make Medicare Prescription Drugs Available to Their Medicare-Medicaid Dual Eligible Residents?
This study provided an assessment of the availability of Medicare Part D prescription drugs to dual-eligible nursing home residents. It focused on issues that arose in the early stages of implementing the new benefit. The study was based on structured interviews with a sample of nursing home administrators, medical directors, and directors of ope
Performance Improvement 2008. Appendix D - glossary of evaluation terms, terms-of-art used by some offices or agencies, and acronyms for the organizational units of HHS.
The glossary, new with this 2008 issue of the report, provides some assistance to readers who may be unfamiliar with the terms and acronyms found in the report. 1915(c) waivers – refers to section 1915(c) of the Medicaid program allowing the Secretary of HHS to waive certain program requirements in the law. Waivers permit States greater flexib
Performance Improvement 2008. Appendix C - table of the studies in this report, organized by agency and office, indicating the Objective where the study may be found.
Elements of evaluation: Effective programs achieve results. Results derive from good management which requires good decisions. Good decision-making depends on good information. Good information requires good data and careful analysis. Creative project officers, skillful researchers, thoughtful and receptive leaders contribute to value-added e
A series of focus groups were conducted to solicit user feedback regarding five on-line Web resources that are part of a site known collectively as "TOXNET," maintained by the National Library of Medicine. All five resources provide information on toxic chemicals, environmental health, and related areas.
Performance Improvement 2008. Do Average Sales Prices for Specific Prescription Drugs Exceed Average Manufacturer Prices?
This study examined whether the average sales prices (ASP) for individual Medicare Part B prescription drugs exceeded the average manufacturer prices (AMP) by at least five percent during the third quarter of 2006 and determined the impact of lowering reimbursement amounts for drugs that exceeded the five-percent threshold. Since January 2005, Med
Performance Improvement 2008. How Much Did Medicaid Pay for Medical Services and Prescription Drugs to Evacuees from Hurricanes Rita and Katrina?
This study examined Medicaid payments and services made for evacuees of Hurricanes Katrina and Rita for outpatient and medical services and for prescription drugs. It compared average Medicaid payments per evacuee to those per non-evacuee for medical services and prescription drugs. This provided an initial, aggregate-level analysis of medical ser
Performance Improvement 2008. Does Payment Source Predict Skilled Nursing Facility and Nursing Home Resident Use of or Expenditures for Drugs?
Using the 2001 Medicare Current Beneficiary Survey and Medicare Part A skilled nursing facility claims, researchers compared use and spending for prescription and over the counter drugs during qualifying skilled nursing facility stays and for the longer term nursing home stays. Researchers compared drug utilization patterns between beneficiaries w
Performance Improvement 2008. How Did Medicare Beneficiaries in Long-Term Care Facilities Use Drugs Compared to Community Residents Treated at the Same Time?
Researchers examined the drug use differences for Medicare beneficiaries depending on place of residence – in the community or in a long-term care facility. Differences existed in socio-demographic and drug utilization and costs by Medicare beneficiaries residing in long-term care facilities and those living in the community. Health status diffe
Performance Improvement 2008. What Was National Drug Spending for Residents of Long-Term Care Facilities, 1998-2001?
Researchers estimated the utilization pattern and expenditures for drug spending in long term care facilities by Medicare eligibility status and coverage source, as well as by type of facility. This was done using the 1998-2001 Medicare Current Beneficiary Survey Cost and Use Files.
Performance Improvement 2008. How Do Medicare Beneficiaries Use of Medications in Long-Term Care Facilities Compare to Community Residents' Use Before the Addition of Medicare Drug Coverage?
This study prepared nationally-representative estimates of drug spending in long-term care facilities, compared drug use and spending for beneficiaries in long term care facilities versus beneficiaries in the community, and examined medication use and spending by short-stay skilled nursing home facility residents who transition into long term care
Performance Improvement 2008. Goal 1 - Improve the Safety, Quality, Affordability and Accessibility of Health CARE Including Behavioral Health CARE and Long Term CARE
IMPROVE THE SAFETY, QUALITY, AFFORDABILITY AND ACCESSIBILITY OF HEALTH CARE INCLUDING BEHAVIORAL HEALTH CARE AND LONG TERM CARE This Strategic Goal targets the need for people to be able to obtain and maintain affordable health care coverage, receive efficient high-quality health care services, and access appropriate information for informed
Mission To provide analytical support and advice to the Secretary on policy development and assist the Secretary with the development and coordination of department wide program planning and evaluation activities. Evaluation Program
Outstanding Evaluation Reforming Medicaid: The Experiences of Five Pioneering States with Mandatory Managed Care and Eligibility Expansions
Performance Improvement 2002: Evaluation Activities of the U.S. Department of Health and Human Services is the eighth annual report to Congress summarizing previous fiscal year evaluation efforts. The purpose of this report is to provide Congress with outcome-oriented evaluation findings for the Department's programs, policies, and strategies. It