TITLE: Evaluation of Customer Service Projects

ABSTRACT: This project involves a series of evaluations focusing on customer service projects. Current examples of such projects are the Western Consortium Trailblazers and Correspondence Tracking. There were four types of evaluations: (1) Formative, (2) Process, (3) Outcome and (4) Impact. The specific projects to be evaluated will be designated during the process of the contract.

AGENCY SPONSOR: Center for Beneficiary Services

FEDERAL CONTACT: Elizabeth Goldstein, Ph.D.

PHONE NUMBER: 410-786-6665

PIC ID: 7201

PERFORMER ORGANIZATION: Booz, Allen and Hamilton Bethesda, MD

TITLE: Evaluation of Rural Health Clinics

ABSTRACT: The Rural Health Clinic Services Act of 1977 authorized a new type of provider for certification and licensure. A rural health clinic (RHC) must be located in a rural health professional shortage area, medically underserved area, or Governor-designated shortage area, and it must make use of mid-level practitioners. The legislation provides for cost-based reimbursement for the clinics for Medicare and Medicaid. After a slow start in certifying clinics in the first years of the program, there has been rapid growth in the numbers of these clinics in the past few years. According to a count by the Health Care Financing Administration (HCFA), there were 3,067 RHCs listed nationwide in September 1996, compared to 1,157 certified clinics in August 1993. This contract evaluated the program, and focused on several broad issues that have implications for rural health policy at the Federal and State levels. These overall issue areas were: (1) What are the reasons for the growth in the numbers of the RHCs? (2) What has been the impact on access to health care for rural populations as a result of the growth in these clinics, especially the Medicare, Medicaid, and otherwise underserved populations? (3) What have been the costs to the Federal Government and the States for the program? Other broad questions pertinent to the entire spectrum of rural health policy were also addressed, such as whether these clinics increased the supply of physicians in rural areas, what implications the growth in clinics had for Federal policy for rural hospitals and other providers, and whether these clinics should be protected in the development of State managed care plans.

AGENCY SPONSOR: Center for Health Plans and Providers

FEDERAL CONTACT: Siddhartha Mazumdar

PHONE NUMBER: 410-786-6673

PIC ID: 6299

PERFORMER ORGANIZATION: Mathematica Policy Research, Inc. Plainsboro, NJ

TITLE: Evaluation of the Demonstration to Improve Access to Care for Pregnant Substance Abusers

ABSTRACT: The evaluator examined access to prenatal care and substance abuse treatment services and assessed the effects of these services on the health of drug-addicted pregnant women and birth outcomes of their infants. This report evaluates demonstration project effectiveness in: (1) outreach and assessment; (2) expansion, integration and coordination of program services; and (3) improvement of client case management. The evaluation showed that the number of abusers enrolled in the demonstrations were low relative to all pregnant substance abusers in the area, since women were reluctant to be identified. The project found higher enrollment rates in States which implemented broad-based outreach efforts and higher levels of retention in substance abuse treatment, resulting in higher birth weight infants. (Final report 104 pages plus appendices.)

AGENCY SPONSOR: Center for Beneficiary Services

FEDERAL CONTACT: Suzanne Rotwein, Ph.D.

PHONE NUMBER: 410-786-6621

PIC ID: 6297

PERFORMER ORGANIZATION: Mathematica Policy Research, Inc. Washington, D.C.

TITLE: PACE Rate Work: Final Report

ABSTRACT: The Program for All-Inclusive Care of the Elderly (PACE) is a voluntary program that coordinates all acute and long-term care services and coordinates multiple sources of funding (usually Medicare and Medicaid), for elders who are deemed to be "nursing home certifiable" (NHC) under the laws of their State. The Balanced Budget Act of 1997 makes PACE a permanent provider category and mandates that future Medicare payment be based upon the rate structure of the new Medicare + Choice program. This study revisits the calculation of an appropriate frailty adjuster for use in this expanded setting. In particular, the study samples several State NHC definitions and summarizes the similarities and differences. Using data from the National Long Term Care Survey and the Medicare Current Beneficiary Survey, cost and population models are developed to explain and predict the monthly fee-for-service expenditures that Medicare would be expected to pay for these NHC individuals if they do not enroll in PACE. A capitation model assembles the results of these models, providing a tool for deriving capitation rates for an NHC population of interest over a specified rating period. The report also discusses the determination of an appropriate frailty adjuster for PACE.

AGENCY SPONSOR: Office of Strategic Planning


PHONE NUMBER: 410-786-6648

PIC ID: 6309

PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA

TITLE: State-Administered Programs for HIV- Related Care

ABSTRACT: This study describes and analyzes a range of State-administered programs which cover and finance health care for people infected with the human immunodeficiency virus (HIV). The study focused on: (1) Title II programs of the Ryan White CARE Act; (2) Medicaid 2176 home and community-based care waiver programs; (3) State-funded, non-Medicaid, medical assistance programs; and the actions of State health departments that address the incidence of tuberculosis, especially among people with HIV illness. The research also presents assessments that administrators of AIDS service organizations at the State and local level have about how well each State-administered public program (as well as the Federal Medicare program) addresses the health care needs of people with HIV. The project collected data on these State-administered public programs with a series of nine separate surveys which were mailed to program administrators in each State. Successful innovations developed by individual States implementing a comprehensive range of State-administered programs can serve as models to guide other States in developing AIDS-related policies to assure that all people with HIV have access to necessary health and care-related services. (final report is 223 pages)

AGENCY SPONSOR: Office of Strategic Planning



PIC ID: 6993

PERFORMER ORGANIZATION: Department of Health Administration and Health Policy Harborview Office Tower, Charleston, SC