From our synthesis of information from the analysis of Medicare OPPS facility data, the scan of existing performance measures being applied in other settings, and discussions with medical specialty societies and hospital associations, we find:
Based on our analysis of the Medicare OPPS facility data, in 2005 CMS was billed for 15,325,267 E&M encounters and 78,538,882 services/procedures in the HOPS. In the same year CMS was billed for 11,426,386 E&M encounters and 22,494,724 services/procedures in the ED. Overall, services/procedures represented a significant volume of the care
Performance Measurement in the Hospital Outpatient Setting. A Scan of the Hospital Outpatient Landscape
The program requirements mandated under TRHCA have created a need for performance measures that CMS could use in the HOP QDRP. To assist CMS with the task of identifying both measurement opportunities and potential measures, the DHHS Assistant Secretary for Planning and Evaluation (ASPE) in partnership with CMS issued a contract to the RAND Corpor
A variety of studies have documented substantial deficiencies in the quality of care delivered across the United States (Asch et al., 2006; Institute of Medicine [IOM], 2000, 2001, 2005; Schuster et al., 1998; Wenger et al., 2003).
In response to a legislative mandate set forth in Section 109 (Title I) of the Tax Relief and Health Care Act of 2006 (PL 109-432) (TRHCA), which established new requirements for reporting quality data for services paid under the Outpatient Prospective Payment System (OPPS), the Centers for Medicare & Medicaid Services (CMS) is currently worki
Prepared by: Stephanie S. Teleki, Melony e.s. Sorbero, Lee Hilborne, Susan Lovejoy, Lily Bradley, Ateev Mehrotra, Cheryl l. Damberg RAND Corporation This product is part of the RAND Health working paper series. RAND working papers are intended to share researchers’ latest findings and to solicit additional peer review.
The Surgeon General's call to action to prevent and decrease overweight and obesity 2001 . [Rockville, MD]: U.S. Dept. of Health and Human Services, Public Health Service, Office of the Surgeon General. 2001. Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288(14):1723-7.
Employers and health plans may have questions about how the Health Insurance Portability and Accountability Act of 1996, and the Americans with Disabilities Act, apply to wellness programs and incentives for their employees or enrollees. In particular, they may want to know whether these laws prevent employers and health insurers from providing
New Medicare Benefits in 2005 “Welcome to Medicare” visit (initial preventive exam) Diabetes screening Cardiovascular disease screening Immunizations & Vaccinations Influenza Pneumococcal Hepatitis B Screening & Detection
The President’s Challenge is a physical activity and fitness awards program—a long-standing program of the President’s Council on Physical Fitness and Sports that is designed to motivate Americans of all ages, backgrounds and abilities to be physically active every day. To advance this goal, individuals are challenged to build a personal
Innovation on the part of local groups and businesses is a central focus of the Steps Initiative . Secretary Thompson recently recognized eight organizations, in seven separate categories, for their creativity in helping Americans stay healthy in one or more of the following areas: asthma, cancer, diabetes, heart disease and stroke, obesity,
In 2003, HHS awarded 12 communities with five-year grants to implement effective community-based chronic disease prevention and control programs. Twelve communities were selected for their innovative proposals to improve the health of their target populations. (For more information, visit: www.healthierus.gov/steps/grants.html .)
Tobacco use cessation. A recent accomplishment is the Public Health Service document, Treating Tobacco Use and Dependence: Clinical Practice Guideline , which identifies treatments with demonstrated effectiveness in helping smokers quit. This resource will be a tremendous aid to Americans trying to quit tobacco use. It is available online
The Diabetes Prevention Program demonstrated that prevention of type 2 diabetes is possible in high-risk adults, including adults from minority populations who are at disproportionately increased risk  . The Diabetes Prevention Program clinical trial compared three approaches in overweight people with impaired glucose tolerance (IGT) to
Cross-cutting focus at NIH and the Food and Drug Administration.