TITLE: Design for Evaluation of the New York Medicare Graduate Medical Education Demonstration and Related Provisions in Public Law 105-33

ABSTRACT: This contract provides recommendations for designing an evaluation of the waivers provided to several New York State teaching hospitals in 1997. These hospitals volunteered to reduce the number of resident physicians in training by 20 percent or more over a five-year period. This is in return for transition payments for a portion of the Medicare payments that are foregone when the numbers of full time equivalent interns and residents declines.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: William Sobaski

PHONE NUMBER: 410-786-6588

PIC ID: 7178

PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA

PROJECTED DATE OF COMPLETION: 3/29/99
 

TITLE: Evaluating Alternative Risk Adjusters for the Medicare Risk Program

ABSTRACT: This project developed a risk adjuster that is based on: (1) a history of serious Disease (including cancer, heart Disease or stroke) and severity of illness; (2) the length of time since the last hospital stay; and (3) comorbidities. The predictive power from using history of serious illness will be compared to the predictive power of two existing risk adjusters--the diagnostic-cost-group and ambulatory-care-group models. Both predictive accuracy and operational features will be compared.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Levy, Jesse

PHONE NUMBER: 410-786-6600

PIC ID: 7190

PERFORMER ORGANIZATION: Virginia Commonwealth University, Dept of Health Administration Richmond, VA

PROJECTED DATE OF COMPLETION: 3/30/99
 

TITLE: Evaluation of Phase II of the Home Health Agency Prospective Payment Demonstration

ABSTRACT: This demonstration is testing two alternative methods of paying home health agencies (HHA) on a prospective basis for services furnished under the Medicare program: (1) per visit by type of HHA visit discipline (Phase I), and (2) payment per episode of Medicare-covered home health care (Phase II). The evaluation will combine estimates of program impacts on cost, service use, access and quality, with detailed information on how agencies actually change their behavior to produce a full understanding of what would happen if prospective payment replaced the current cost-based reimbursement system nationally.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Ann Meadow

PHONE NUMBER: 410-786-6602

PIC ID: 7203

PERFORMER ORGANIZATION: Mathematica Policy Research, Inc. Washington, DC

PROJECTED DATE OF COMPLETION: 9/29/99
 

TITLE: Evaluation of the Community Nursing Organization Demonstration

ABSTRACT: This demonstration tests a capitated, nurse-managed system of care. The two fundamental elements of the CNO are capitated payment and nurse case management. The evaluation tests the feasibility and effect on patient care of this capitated, nurse case-managed service delivery model. Both qualitative and quantitative components are included.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Melissa Hulbert, M.P.S.

PHONE NUMBER: 410-786-8494

PIC ID: 7205

PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA

PROJECTED DATE OF COMPLETION: 9/30/99
 

TITLE: Decision Making in Managed Care Organizations

ABSTRACT: This project examines a broad range of managed-care decision making strategies, their implications for the development and diffusion of new technologies, and their impact on future health care costs, especially Medicare program costs.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Brigid Goody

PHONE NUMBER: 410-786-6640

PIC ID: 7170

PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA

PROJECTED DATE OF COMPLETION: 1/28/00
 

TITLE: NAS/Institute of Medicine Study on Preventive Services

ABSTRACT: This is an analysis of the expansion or modification of preventive or other services covered by Medicare. The study includes coverage of: (1) nutrition therapy, including parenteral and enteral nutrition; (2) skin cancer screening; (3) medically necessary dental care; (4) routing patient care costs for beneficiaries enrolled in approved clinical trial programs; and (5) elimination of time limitation for coverage of immunosuppressive drugs for transplant patients. The IOM will consider both short-term and long-term benefits and costs to the Medicare program.

AGENCY SPONSOR: Office of Clinical Standards and Quality

FEDERAL CONTACT: Kathy Pirotte

PHONE NUMBER: 410-786-6774

PIC ID: 7174

PERFORMER ORGANIZATION: National Academy of Sciences Washington, D.C.

PROJECTED DATE OF COMPLETION: 2/28/00
 

TITLE: Evaluation of the Medicare Choice Demonstration

ABSTRACT: The HCFA is in the process of implementing the Medicare Choice Demonstration to test the feasibility and desirability of new types of managed care plans for Medicare, such as integrated delivery systems and preferred provider organizations. The purpose of this evaluation project is to provide a detailed assessment of the overall demonstration project, which looks specifically at beneficiary experiences in the demonstration, cost and use of services within the demonstration sites and quality of care issues.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Renee Mentnech

PHONE NUMBER: 410-786-6692

PIC ID: 6292

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

PROJECTED DATE OF COMPLETION: 6/30/00
 

TITLE: Evaluation System for Medicare + Choice

ABSTRACT: The purpose of this task order is to design and implement a strategy for tracking and evaluating the performance of managed health care organizations, both nationwide and within specific markets. Dimensions of performance to be tracked include beneficiary access to managed care, as well as the cost and quality of services delivered to beneficiaries by managed care organizations.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Brigid Goody

PHONE NUMBER: 410-786-6640

PIC ID: 7169

PERFORMER ORGANIZATION: Mathematica Policy Research, Inc. Washington, DC

PROJECTED DATE OF COMPLETION: 9/15/00
 

TITLE: Normative Standards for Medicare Home Health Utilization

ABSTRACT: This task order will develop a model that uses scientifically based, normative standards to determine thresholds for payment authorization within home health service categories, and will test the model to determine the extent of its validity and reliability. The contractor will also recommend an appropriate demonstration design to evaluate the use of the model by fiscal intermediaries prior to full implementation.

AGENCY SPONSOR: Office of Clinical Standards and Quality

FEDERAL CONTACT: Mary Wheeler

PHONE NUMBER: 410-786-6892

PIC ID: 7175

PERFORMER ORGANIZATION: Center for Health Policy Research Denver, CO

PROJECTED DATE OF COMPLETION: 9/24/00
 

TITLE: Evaluation of Medicare CAHPS/Bulletin/Medicare & You

ABSTRACT: The purpose of the study is to learn how effective print materials are in informing beneficiaries about the Medicare program. This study will cover the new Balanced Budget Act health plan choices and the quality of care provided by local health care plans as rated by their peers. It will be confined to about 2,400 randomly selected residents of the Kansas City area.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Sherry Terrell

PHONE NUMBER: 410-786-6601

PIC ID: 7168

PERFORMER ORGANIZATION: Research Triangle Institute Research Triangle Park, NC

PROJECTED DATE OF COMPLETION: 9/30/00
 

TITLE: Evaluation of the Evercare Demonstration Program

ABSTRACT: The major goals of the Evercare demonstration are to reduce medical complications and dislocation trauma resulting from hospitalization, and to save the expense of hospital care when patients can be managed safely in nursing homes with expanded services. The EverCare evaluation will combine data from site case studies, a network analysis of nurse practitioners, participant and caregiver surveys and participant utilization data to examine: (1) a comparison of enrollees and non-enrollees; (2) the process of implementation and operation of EverCare changes in the care process, as well as quality of care; (3) effects of the demonstration on enrollees' health and health care utilization; (4) satisfaction of enrollees and their families; and (5) effects of the demonstration on the costs of care, as well as payment sources.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Edgar Peden

PHONE NUMBER: 410-786-6594

PIC ID: 7185

PERFORMER ORGANIZATION: University of Minnesota Minneapolis, MN

PROJECTED DATE OF COMPLETION: 3/30/01
 

TITLE: Department of Defense Subvention Demonstration Evaluation

ABSTRACT: Under this demonstration, enrollment in the Department of Defense's (DoD's) Senior Prime plan is offered to military retirees over age 65 who live within 40 miles of the primary care facilities of one of the six sites, have recently used military health facility services and are enrolled in Medicare Part B. Medicare makes a capitation payment to the DoD for each enrollee, but the DoD must maintain a level of effort for health care services to all retirees who are also Medicare beneficiaries, whether or not they choose to enroll. The evaluation will examine issues in four basic areas: (1) enrollment demand, (2) enrollee benefits, (3) cost of the program, and (4) impacts on other DoD and Medicare beneficiaries.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: William Sobaski

PHONE NUMBER: 410-786-6588

PIC ID: 7171

PERFORMER ORGANIZATION: Rand Corporation Santa Monica, CA

PROJECTED DATE OF COMPLETION: 3/2/02
 

TITLE: End Stage Renal Disease (ESRD) Capitation Demonstration

ABSTRACT: This project will use survey, claims and medical records data to evaluate the efficacy and cost effectiveness of permitting Medicare beneficiaries with end stage renal Disease (ESRD) to enroll in managed care.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Michael Kendix

PHONE NUMBER: 410-786-6631

PIC ID: 7182

PERFORMER ORGANIZATION: The Lewin Group Fairfax, VA

PROJECTED DATE OF COMPLETION: 5/13/02
 

TITLE: Evaluation of the Medical Savings Account Demonstration

ABSTRACT: This evaluation of the Medical Savings Account (MSA) demonstration will compare the experiences of MSA enrollees with other Medicare beneficiaries. The evaluation will address access to care and determine if MSAs promote an inappropriately low use of services.

AGENCY SPONSOR: Office of Strategic Planning

FEDERAL CONTACT: Michael Kendix

PHONE NUMBER: 410-786-6631

PIC ID: 7172

PERFORMER ORGANIZATION: Barents Group, KPMG Peat Marwick LLP Washington, D.C.

PROJECTED DATE OF COMPLETION: 9/27/03