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HEALTH CARE FINANCING ADMINISTRATION
MISSION: To promote the timely delivery of appropriate, quality health care to the Nation's aged, disabled, and poor through administration of the Medicare and Medicaid programs.
Evaluation Program
The research arm of the Health Care Financing Administration (HCFA),
the Office of Strategic Planning (OSP), performs and supports research
and evaluations of demonstrations (through intramural studies, contracts
and grants) to develop and implement new health care financing policies
and to provide information on the impact of HCFA's programs. The scope
of OSP's activities embraces all areas of health care: costs, access, quality,
service delivery models, and financing approaches. OSP's research responsibilities
include evaluations of the ongoing Medicare and Medicaid programs and of
demonstration projects testing new health care financing and delivery approaches.
These projects address the following major themes:
Summary of Fiscal Year 1998 Evaluations
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TITLE: Access in Managed Care
ABSTRACT: This project developed and tested a set of performance indicators for Medicare managed care plans. The focus of this study was to develop a monitoring system that can be implemented using claims and encounter data from managed care plans, and was intended to serve as a pilot for determining what measures can be constructed and meaningfully interpreted. Using data from a managed care plan known to have high quality information systems already in place, a set of indicators can be constructed, and meaningful comparisons can be made between managed care and the fee-for-service sector. However, differences in databases can substantially complicate construction and interpretation of specific indicators. The final report contains a detailed discussion of the implications for developing a monitoring system such as the one tested during this study. The Health Care Financing Administration (HCFA) has begun the process of collecting encounter data from managed care plans. As the quality of the encounter data from managed care plans improves, the framework developed and tested through this project will serve as a foundation in future efforts to monitor and evaluate performance of the managed care sector relative to the fee-for-service sector.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Renee Mentnech
PHONE NUMBER: 410-786-6692
PIC ID: 7189
PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham,
MA
TITLE: Developing Cost Control Policies for Medicare Outpatient Services
ABSTRACT: This project involved an evaluation of the Ambulatory Patient Group (APG) Version II grouper. First, the grouper was evaluated for its ability to group 100 percent of Medicare outpatient department claims for the year 1993. No significant problems were encountered in grouping the outpatient claims using the grouper software. Secondly, charges were converted to costs and these data were then utilized to determine the homogeneity within and among the 290 groups. It should be noted that large cost coefficients of variation within and among the APGs are attributable to two primary causes. One is the grouping of unlike procedures into a single APG category. The other is variation in costs per unit at the procedure code level. The results of this analysis indicate that both factors are at work in varying degrees across the range of APGs. This analysis served to highlight those APG categories where additional refinement of the groupings might result in increased homogeneity of resource use. The third and final component of the project involved the calculation of cost-based payment weights and the performance of a financial impact simulation with the hospital as the unit of analysis. The findings are a cross-sectional, retrospective analysis that does not incorporate any behavioral offset response. They suggest there are almost no differences, on average, between the full packaged ancillary option and no packaging. However, adoption of an APG system will have varying impacts on different categories of hospitals. Hospitals in the Middle Atlantic, New England and Pacific regions and large urban facilities demonstrated losses. Hospitals in the other geographic areas and rural facilities showed gains relative to costs.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Mark Krause
PHONE NUMBER: 410-786-6683
PIC ID: 7166
PERFORMER ORGANIZATION: Urban Institute Washington, D.C.
TITLE: Disenrollment and Selection Experience Under the Medicare HMO Risk Program
ABSTRACT: This project consisted of a series of analyses comparing Medicare health maintenance organization (HMO) joiners and disenrollees to beneficiaries in fee-for-service (FFS). The purpose was to make several different estimates of the degree of biased selection in enrollment and disenrollment. Biased selection in Medicare HMOs is taken to mean the enrollment (or disenrollment) of beneficiaries whose average costs are not equal to the average costs of like beneficiaries in the fee-for-sector. Among differences measured were prior use characteristics such as hospitalization and costs, mortality and occurrence of selected procedures after disenrollment. The methodology included logistic models for probability of joining an HMO conditioned on prior use, and probability of an event after disenrollment. Data used were for counties with at least 1,000 HMO enrollees in the years 1993 and 1994. One set of analyses compared 1993 pre-enrollment data on utilization and expenditures for persons who joined an HMO in 1994, to those who stayed in the FFS sector. The subset of 1994 HMO joiners who then disenrolled was examined separately and compared to the same sample of FFS beneficiaries. The study found that, in every case, reimbursements and utilization measures were lower in 1993 for persons who joined HMOs in 1994 than persons who remained in the FFS sector.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Mel Ingber
PHONE NUMBER: 410-786-1913
PIC ID: 6294
PERFORMER ORGANIZATION: University of Minnesota Minneapolis,
MN
TITLE: Evaluating Alternative Risk Adjusters for Medicare: Final Report
ABSTRACT: This project looked at the merit of alternative survey and claims-based risk adjusters for the Medicare population. It used multiple years (1991-1994) of the Medicare Current Beneficiary Survey to evaluate alternative demographic, survey, and claims-based risk adjusters for Medicare capitation payment. The investigators found that survey health status models have three to four times the predictive power of the demographic models. The claims-based models performed better than the survey models in predictive power and across most non-random groups. The combined claims/survey models were only modestly better than the claims diagnostic models alone. No single model predicted average expenditures uniformly well for all beneficiary subgroups of interest, suggesting a combination model may be appropriate. Substantial redundancy existed among the survey adjusters, indicating that reduction of survey questions is possible and necessary. More data are needed to obtain stable estimates of model parameters before a risk-adjustment payment methodology can be implemented. In conclusion, risk adjustment should improve risk selection problems.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Sherry Terrell
PHONE NUMBER: 410-786-6601
PIC ID: 6989
PERFORMER ORGANIZATION: Center for Health Economics Research
Waltham, MA
TITLE: Evaluation and Technical Assistance of the Medicare Alzheimer's Disease
ABSTRACT: The purpose of the Medicare Alzheimer's Disease Demonstration was to determine the effectiveness, cost, and impact on health status and functioning of providing comprehensive in-home and community-based services to beneficiaries who have dementia. Two models of care were studied under this project. Both models included case management and a wide range of services, such as homemaker/personal care services, adult day care, companion services, caregiver education and family counseling. The two models varied by the intensity of the case management provided to beneficiaries and their caregivers and the amount of demonstration service costs that could be paid for by Medicare each month. The demonstration achieved a number of its goals, but showed mixed results in its usefulness to informal support systems. Access to community care increased by more than a factor of two and the level of unmet task assistance in caring for the person with dementia was reduced by half among those in the treatment group. These supports generally did not replace the amount of informal care, instead they allowed this time to be redirected to specific tasks. These instrumental program achievements did not lead to significant reductions in caregiver burden or depression, nursing home placement rates, or overall Medicare expenditures.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Dennis M.. Nugent
PHONE NUMBER: 410-786-6663
PIC ID: 6305
PERFORMER ORGANIZATION: University of California, San Francisco,
Institute for Health and Aging, 201 Filbert Street, San Francisco CA 94133
TITLE: Evaluation of Version Two of the Ambulatory Patient Group System
ABSTRACT: Medicare hospital outpatient department claims are evaluated employing 3M/Health Information Systems Ambulatory Patient Group (APG) Version II software. The evaluation of a Medicare Prospective Payment System (PPS) for hospital outpatient departments was based on the universe of claims submitted in 1993. This analysis focused on: (1) the ability of the grouping software to group outpatient claims, (2) the relative distribution of the respective groups, (3) the calculation of payment weights, and (4) the simulated effects of moving to an APG payment system when compared to outpatient facility costs.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Mark Krause
PHONE NUMBER: 410-786-6683
PIC ID: 6986
PERFORMER ORGANIZATION: Urban Institute Washington, D.C.
TITLE: Market Research for Providers and Other Partners: Final Report on Hospital Communication (February 9,1998)
ABSTRACT: The information needs of a hospital and the process by which these needs may be met are largely dictated by hospital characteristics. Several trends in the hospital market affect the way hospitals acquire knowledge and adapt operations, including: (1) the increasing prevalence of Medicare managed care; (2) consolidations, acquisitions, and mergers within the hospital market; and (3) the integration of hospital services with other types of care to form health systems and community networks. There are over 5,100 Medicare-certified short stay hospitals in the United States. The Health Care Financing Administration (HCFA) has initiated a comprehensive strategy to coordinate existing communication activities within HCFA and develop innovative, effective approaches that make information accessible to all program participants. This study addresses two central questions: (1) What information do hospitals need and want from HCFA? (2) How can this information be most effectively made available? Information on these issues was obtained from an expert Hospital Advisory Panel, Professional Review Organizations (PROs), and interviews with hospital staff, hospital associations and HCFA staff in the Central Office and Regional Offices. Additionally, reviews and content analyses of existing HCFA communication processes and written materials were conducted. Suggested areas for improvement include: (1) currency and accuracy of materials, (2) timeliness of communications, (3) consistency and coordination, (4) simplification, (5) availability, (6) dissemination, and (7) consultation with the hospital industry. Suggested changes would expand the use of some types of communication strategies, diversify communication methods and make certain specialized information more accessible. (final report is 110 pages)
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Sherry Terrell
PHONE NUMBER: 410-786-6601
PIC ID: 6992
PERFORMER ORGANIZATION: Barents Group, KPMG Peat Marwick LLP
Washington, D.C.
TITLE: Medicare Cataract Surgery Alternate Payment Demonstration: Final Evaluation Report
ABSTRACT: This report evaluates the demonstration of an innovative payment approach, known as package payment or bundled pricing, for cataract surgical episodes in the Medicare program. Officially known as the Medicare Cataract Surgery Alternate Payment Demonstration, the project sought to employ market forces to select providers and negotiate discounted prices for a package or bundle of specified pre-operative, operative and post-operative services associated with an episode of cataract surgery. The primary objective of the demonstration was to assess the potential benefits of a negotiated package pricing arrangement for cataract removal with an intraocular lens (IOL) implant. By testing this alternate payment system, the Health Care Financing Administration (HCFA) sought to: (1) allow provider flexibility in managing the mix and type of services used, (2) provide incentives to manage patient care so that cost efficiencies are realized and the procedure can be performed at a lower total cost, (3) reduce Government involvement in the pricing of individual services and in the providers' decision making, (4) provide insight into appropriateness indicators and effective quality assurance and utilization review mechanisms for cataract surgery, and (5) provide information regarding factors influencing providers' decisions to participate and beneficiaries' decisions to select designated providers under a demonstration that is completely voluntary. To test this approach, HCFA decided that the demonstration would be implemented in three geographic locations and would operate for a period of three years. Despite its modest savings impact, the demonstration was remarkably successful in meeting most of its original objectives. (final report is 129 pages)
AGENCY SPONSOR: Center for Health Plans and Providers
FEDERAL CONTACT: Cynthia K. Mason
PHONE NUMBER: 410-786-6680
PIC ID: 6998
PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA
TITLE: Medicare Participating Heart Bypass Center Demonstration Evaluation
ABSTRACT: This project was the second and final evaluation of the negotiated bundled payment demonstration, implemented in May 1991 to assess the benefits of a negotiated package pricing arrangement for heart bypass surgery. Under the demonstration, hospitals and physicians received a global payment (covering hospital and related physician services, including outliers and re-admissions), for each Coronary Artery Bypass Graft procedure. The negotiated rate represented a discount from what Medicare paid, on average, for these procedures. The demonstration was implemented at four sites in May 1991. An initial three year evaluation was completed and a second extended evaluation was started in 1994 for the remaining two years of the demonstration. At the end of the demonstration, over 10,000 procedures were performed under the demonstration with an estimated savings to the Medicare program of over $50 million. Findings suggest that both Medicare and hospitals can benefit from global payment arrangements through reduced costs, better coordination of services, and improved quality of care. The bundled payment arrangement provided incentives to facilitate more cooperative relationships between physicians and hospital staff, leading to quality improvement activities which resulted in high quality, efficient patient care delivery and lower costs. The demonstration led to innovative physician incentive programs to improve quality and reduce costs, a nationwide proliferation of private sector bundled payment arrangements based on the demonstration, proposed legislation to establish negotiated bundled payment arrangements under the regular Medicare program, and the design of a new bundled payment demonstration for orthopedic and cardiovascular services.
AGENCY SPONSOR: Office of Clinical Standards and Quality
FEDERAL CONTACT: Armen H..Thoumaian, Ph.D.
PHONE NUMBER: 410-786-6672
PIC ID: 5958.5
PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA
TITLE: Evaluation of Drug Use Review Demonstration Projects Final Report
ABSTRACT: The purpose of this project was to test the effectiveness of the drug use review (DUR) demonstration projects in improving drug use and reducing the negative consequences of drug misuse. Since 1990, the Medicaid program has been mandated to operate prospective and retrospective drug use review programs. In 1992, the Health Care Financing Administration (HCFA) funded two experiments managed by Iowa and Washington State Medicaid agencies. Project C.A.R.E., a joint effort between Washington's Department of Social and Human Services and the University of Washington School of Pharmacy, was evaluated to test the effects of paying pharmacists to provide cognitive services (CS). The Iowa Medicaid OPDUR Demonstration Project, involving Iowa's Department of Human Resources, together with researchers from the University of Iowa, Drake University and the Iowa Pharmacists Association, tested online prospective drug use review (OPDUR). Maryland and Georgia were included for experimental and comparative purposes. Both evaluations sought to improve drug prescription by influencing pharmacists' behavior. Findings indicate that prospective drug use review had no measurable effects on the frequency of drug problems, the utilization and expenditures on prescription drugs and other medical services. Further analysis revealed no behavioral changes in pharmacists who received OPDUR messages. Instead, the cognitive services most often provided by pharmacists involved counseling and educating patients, rather than interactions with prescribers or other pharmacists. Pharmacists who received payment for cognitive services provided more of this service than those who did not receive payment. These findings will be used to assess current DUR requirements for possible changes.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Jay P. Bae, Ph.D.
PHONE NUMBER: 410-786-6591
PIC ID: 6296
PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA
TITLE: Examination of the Medicaid Expansions for Children
ABSTRACT: This project looked at changes in Medicaid legislation as a result of the Omnibus Budget Reconciliation Acts of 1989 and 1990. Analyses on the impact of the expansions included: (1) examination of enrollment and expenditure trends from 1988 to 1992; (2) assessment of the extent to which the expansions penetrated the target population; and (3) multivariate analysis to examine the impact of State policies and the eligibility group on enrollment, expenditures, and utilization of services. The examination of access to care and utilization of services included the development of a theoretical model, an analysis plan and items that could be incorporated into an established national survey.
AGENCY SPONSOR: Center for Beneficiary Services
FEDERAL CONTACT: Suzanne Rotwein, Ph.D.
PHONE NUMBER: 410-786-6621
PIC ID: 6300
PERFORMER ORGANIZATION: Urban Institute Washington, D.C.
TITLE: Service Utilization Patterns for Preventive Care for Undocumented Alien Children Under California's Medi-Cal Program
ABSTRACT: This project provides an analysis of service utilization and expenditure patterns for preventive and illness-related care for undocumented alien children under California's Medi-Cal program. The contractor initially developed a database of undocumented alien children covered by Medi-Cal. The analysis was conducted using State-specific eligibility codes for the years 1989-1992. They will then provide descriptive analyses of enrollees, utilization and payments, the proportions of total Medicaid child enrollees, utilization and payments that these children represent, and a descriptive analysis of the classification of services, including emergency, preventive and non-emergency, and service sites were examined. Also examined were the magnitude of expenditures for this group of undocumented alien children and the average expenditures per child and per person for month of eligibility.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Paul W. Eggers
PHONE NUMBER: 410-786-6691
PIC ID: 7167
PERFORMER ORGANIZATION: Medstat Group Washington, DC
TITLE: The Evolution of the Oregon Health Plan: First Interim Report
ABSTRACT: Implemented in February 1994, the Oregon Health Plan (OHP) extends health insurance coverage (Medicaid eligibility) to uninsured State residents below the poverty level. The costs of expanded insurance coverage are financed through the use of a prioritized list of health care services (to determine the benefit package), increased enrollment in capitated managed care organizations (MCOs) and revenues generated by a cigarette tax earmarked for OHP. The program evaluation addresses both the implementation process and program impacts, using qualitative and quantitative approaches. Additionally, the evaluation focuses on the evolution of the OHP, its problems and challenges, and is based on State data and three site visits conducted in November 1994, October 1995 and June 1996. (final report is 226 pages)
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Paul J. Boben, Ph.D.
PHONE NUMBER: 410-786-6629
PIC ID: 6991
PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA
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
FEDERAL CONTACT: Nancy Miller
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
FEDERAL CONTACT: Michael Kendix
PHONE NUMBER:
PIC ID: 6993
PERFORMER ORGANIZATION: Department of Health Administration and Health Policy Harborview Office Tower, Charleston, SC
TITLE: Information Needs for Consumer Choice
ABSTRACT: This contract examined the types of information consumers find most useful in selecting health insurance plans, providers and practitioners, and in making the chosen health care plan/system work best for them. The study determined how to present this type of information in a user-friendly way, and developed and tested these consumer information approaches in given markets. The project addressed consumer information issues and needs in both the current health care system and in proposals for health care system reform, especially as they relate to three broad consumer groups: (1) Medicare beneficiaries, (2) Medicaid beneficiaries, and (3) the remaining U.S. population under 65 years of age. The project was conducted through the use of 24 focus groups, nine case studies of innovative consumer information projects, and by developing and testing information materials in two different media for six subgroups of the Medicare and Medicaid populations.
AGENCY SPONSOR: Center for Medicaid and State Operations
FEDERAL CONTACT: Maria Friedman
PHONE NUMBER: 410-786-9915
PIC ID: 7200
PERFORMER ORGANIZATION: Research Triangle Institute Research Triangle Park, NC
Evaluations in Progress
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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
TITLE: Evaluation of the Municipal Health Services Program
ABSTRACT: The Services Program (MHSP) is a four-site demonstration (Baltimore, Maryland; Cincinnati, Ohio; San Jose, California; and Milwaukee, Wisconsin) to improve access to primary care in underserved urban areas, and to reduce the costs of health care. Since 1979 the program has undergone two evaluations. The project focuses on: (1) consideration of costs to Medicaid and other payers if the MHSP is terminated; (2) access to care, (3) outcomes, (4) beneficiary satisfaction, and (5) utilization differences among different populations being served by the MHSP sites. Because of the long length of this mandated demonstration, three additional questions are also being addressed: (1) What can be learned from the MHSP experience about the demand for managed systems of care for the elderly? (2) How critical are copay-exempted pharmacy and dental benefits for low-income elderly in encouraging enrollment in systems of care that limit choice of primary care physician? (3) What is the future of community-based systems of care? The project is being carried out primarily through case studies. Cost report data will be used and supplemented with Medicare program data.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Spike Duzor
PHONE NUMBER: 410-786-1794
PIC ID: 7211
PERFORMER ORGANIZATION: Urban Institute Washington, D.C.
PROJECTED DATE OF COMPLETION: 12/31/98
TITLE: Comparison of Pharmaceutical Quality of Care for Pediatric Asthma
ABSTRACT: This project examines the quality of care in the treatment of asthma in Medicaid children in Alabama and Michigan. It assesses the extent of prescribing problems for pediatric asthma in these Medicaid programs.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Mary E. Benedict
PHONE NUMBER: 410-786-7724
PIC ID: 7192
PERFORMER ORGANIZATION: University of Alabama, School of Public Health Birmingham, AL
PROJECTED DATE OF COMPLETION: 3/30/99
TITLE: Evaluation of Oregon Medicaid Reform Demonstration
ABSTRACT: The Oregon Medicaid Reform Demonstration seeks to increase the number of individuals with access to affordable health care services and to contain State and Federal expenditures for health care. Under the demonstration, Medicaid coverage is made available to all State residents with family incomes less than, or equal to, the Federal poverty level (FPL) and who meet an assets test. The objectives of the evaluation are to determine the impact on: (1) access to care, (2) quality of care, (3) enrollee satisfaction, and (4) the cost of care, for both new enrollees and those previously enrolled in Medicaid. To the extent possible, the impact of the prioritized list and the increased use of managed care will be identified separately. Other areas of interest include: (1) the impact of the demonstration on the number of uninsured in the State, (2) provider participation and satisfaction, and (3) the number of private employers who offer health insurance as a fringe benefit.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Paul J. Boben, Ph.D.
PHONE NUMBER: 410-786-6629
PIC ID: 6166
PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA
PROJECTED DATE OF COMPLETION: 9/29/99
TITLE: Evaluation of the Diamond State Health Plan
ABSTRACT: The original purpose of this project was to evaluate the Delaware Health Care Partnership for Children, specifically the effectiveness of the demonstration in reaching its goal of improving access to, and the quality of, health care services delivered to Medicaid-eligible children in a cost-effective way. In May 1996, the contract was modified to focus more generally on the impacts of the Diamond State Health Plan (DSHP) on children, including children with special health care needs (the original evaluation had been limited to the Nemours Children's Clinics). The goal of the evaluation was broadened to assess whether this section 1115 demonstration's objective of increased access to high-quality, cost-effective care for Medicaid children is being met.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Penny Pine
PHONE NUMBER: 410-786-7718
PIC ID: 7207
PERFORMER ORGANIZATION: Research Triangle Institute Washington, DC
PROJECTED DATE OF COMPLETION: 9/29/99
TITLE: Evaluation of the Home & Community-Based Services Waiver Program
ABSTRACT: The Home and Community-Based Services (HCBS) waiver program has been operating since 1981 and has experienced tremendous growth in recent years. The percent of Medicaid long-term care spending devoted to HCBS has increased from 10 percent to 19 percent (between the financial and beneficiary-level impacts of the program) in over a decade. The aim of this task order is to gain a better understanding of the broader HCBS waiver program and determine what programmatic mechanisms have been successful.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Melissa Hulbert, M.P.S.
PHONE NUMBER: 410-786-8494
PIC ID: 7208
PERFORMER ORGANIZATION: The Lewin Group Fairfax, VA
PROJECTED DATE OF COMPLETION: 9/29/99
TITLE: Evaluation of the Demonstration Entitled Delaware Health Care Partnership for Children
ABSTRACT: This project will evaluate whether the demonstration is reaching its goal of improving access to, and the quality of, health care services to Medicaid-eligible children in a cost-effective way. The State believes that, by enrolling children in a managed care system operated by the Nemours Foundation, patients will reap the benefits from a higher level of coordinated care, while the State and Federal government will benefit from lower Medicaid costs.
AGENCY SPONSOR: Center for Medicaid and State Operations
FEDERAL CONTACT: Joan Peterson
PHONE NUMBER: 410-786-0621
PIC ID: 6288
PERFORMER ORGANIZATION: Research Triangle Institute Research Triangle Park, NC
PROJECTED DATE OF COMPLETION: 9/30/99
TITLE: Evaluation of the District of Columbia's Demonstration Project: Managed Care System for Disabled and Special Needs Children
ABSTRACT: This project tests the efficacy of a managed care service delivery system designed for children and adolescents under the age of 22 who are eligible for Medicaid and are classified as disabled according to Supplemental Security Income (SSI) Program guidelines. The study represents a unique opportunity to examine the experiences of a managed care system with voluntary enrollment of children with disabilities.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Paul W. Eggers
PHONE NUMBER: 410-786-6691
PIC ID: 7187
PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA
PROJECTED DATE OF COMPLETION: 3/24/00
TITLE: Impact of Welfare Reform on Medicaid Populations
ABSTRACT: This project will develop data and examine the impact of welfare reform on Medicaid eligibility, utilization and payments for various populations. It will study the effects of the following four changes: (1) de-linking Aid to Families with Dependent Children (AFDC) and Medicaid eligibility, (2) terminating access to Medicaid for some legal immigrants because of lost eligibility for Supplementary Security Income (SSI), (3) barring most future legal immigrants from Medicaid, and (4) narrowing Medicaid eligibility for selected disabled children and disabled alcohol and substance abuse populations.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Penny Pine
PHONE NUMBER: 410-786-7718
PIC ID: 7183
PERFORMER ORGANIZATION: Mathematica Policy Research, Inc. Washington, DC
PROJECTED DATE OF COMPLETION: 9/29/00
TITLE: Evaluation of the State Health Reform Demonstrations (OH, MN)
ABSTRACT: This project will evaluate Hawaii, Rhode Island, Tennessee, Oklahoma and Maryland State Health Reform Demonstrations. The evaluator is conducting State-specific and cross-State analyses of demonstration impacts on utilization, insurance coverage, public and private expenditures, quality, access and satisfaction.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Penny Pine
PHONE NUMBER: 410-786-7718
PIC ID: 6289.1
PERFORMER ORGANIZATION: Urban Institute Washington, D.C.
PROJECTED DATE OF COMPLETION: 9/30/00
TITLE: Evaluation of the Ohio Behavioral Health Program
ABSTRACT: This project will address the following two components: (1) a focused evaluation of the behavioral health component of OhioCare, and (2) a case study of the implementation of Ohio's section 1115 State health reform demonstration, OhioCare. The case study will complement the focused evaluation by providing a context for findings and supplementing findings.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Penny Pine
PHONE NUMBER: 410-786-7718
PIC ID: 7184
PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA
PROJECTED DATE OF COMPLETION: 9/14/01
TITLE: Economic and Cost-Effectiveness Studies for the U.S.
ABSTRACT: This interagency agreement (IAA) provided funds to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to cover the costs of having the coordinating center for the U.S. Renal Data System (USRDS) perform economic and cost-effectiveness studies. The NIDDK contracted with the University of Michigan to be the coordinating center for 5 years. The coordinating center conducts cost or cost-effectiveness components for at least four existing data studies and for one special study focused on economic issues.
AGENCY SPONSOR: Office of Clinical Standards and Quality
FEDERAL CONTACT: Connie Cole
PHONE NUMBER: 410-786-0257
PIC ID: 7198
PERFORMER ORGANIZATION: National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
PROJECTED DATE OF COMPLETION: 6/1/99
TITLE: Performance Assessment of Web Sites
ABSTRACT: This task order: (1) evaluates, (2) sets up an ongoing system for feedback from consumers, and (3) makes recommendations for future changes concerning two web sites sponsored by the Department of Health and Human Services. The web sites include www.medicare.gov, which was developed by the Health Care Financing Administration (HCFA), and www.healthfinder.gov, which was developed by the Office of Disease Prevention Health Promotion in collaboration with other agencies.
AGENCY SPONSOR: Center for Beneficiary Services
FEDERAL CONTACT: Elizabeth Goldstein, Ph.D.
PHONE NUMBER: 410-786-6665
PIC ID: 7212
PERFORMER ORGANIZATION: Barents Group, KPMG Peat Marwick LLP Washington, D.C.
PROJECTED DATE OF COMPLETION: 8/2/99
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
PROJECTED DATE OF COMPLETION: 9/30/99
TITLE: Maximizing the Effective Use of Telemedicine: A Study of the Effects, Cost Effectiveness, and Utilization Patterns of Consultation via Telemedicine
ABSTRACT: This project is conducting an evaluation of the Health Care Financing Administration's (HCFA's) medicare payment demonstration. The evaluation examines the medical effectiveness, patient and provider acceptance, and costs associated with telemedicine services, as well as their impact on access to care in rural areas.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Joel Greer
PHONE NUMBER: 410-786-6695
PIC ID: 6303
PERFORMER ORGANIZATION: Center for Health Policy Research Denver, CO
PROJECTED DATE OF COMPLETION: 9/28/00
TITLE: Evaluation of Group-Specific Volume Performance Standards Demonstration
ABSTRACT: The goal of the demonstration is to test the feasibility of this partial risk bearing payment arrangement between the Health Care Financing Administration and qualifying physician-based organizations in the fee-for-service (FFS) market. FFS rules apply within the context of a performance target, beneficiaries are not enrolled, and physician-sponsored organizations develop structures and processes to manage the services and cost of care received by FFS patients.
AGENCY SPONSOR: Center for Health Plans and Providers
FEDERAL CONTACT: Teresa De Caro
PHONE NUMBER: 410-786-6604
PIC ID: 7181
PERFORMER ORGANIZATION: Health Economics Research, Inc. Waltham, MA
PROJECTED DATE OF COMPLETION: 6/1/01
TITLE: Evaluation of Competitive Bidding Demonstration for DME and POS
ABSTRACT: This project will test the feasibility and effectiveness of establishing Medicare fees for durable medical equipment (DME) and Prosthetics, Prosthetic devices, Orthotics and supplies (POS) through a competitive bidding process. The evaluation will examine competitive bidding impacts in terms of expenditures, quality, access and product diversity, as well as other impacts of the demonstration.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Ann Meadow
PHONE NUMBER: 410-786-6602
PIC ID: 7173
PERFORMER ORGANIZATION: University of Wisconsin Madison, WI
PROJECTED DATE OF COMPLETION: 9/29/02
TITLE: Multi-State Evaluation of Dual Eligibles Demonstrations
ABSTRACT: This evaluation is designed to assess the impact of dual eligible demonstrations in the States of Minnesota, Colorado, Wisconsin and New York. Analyses will be conducted for each State and across States.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Noemi Villafranca
PHONE NUMBER: 410-786-6662
PIC ID: 7186
PERFORMER ORGANIZATION: University of Minnesota Minneapolis, MN
PROJECTED DATE OF COMPLETION: 9/29/02
TITLE: Maximizing the Cost Effectiveness of Home Health Care
ABSTRACT: Rapid growth in home health use has occurred despite limited evidence about the necessary volume of HHC needed to achieve optimal patient outcomes, and whether or not it substitutes for more costly institutional care. The central hypotheses of this study are that: (1) volume-outcome relationships are present in HHC for common patient conditions, (2) upper and lower volume thresholds define the range of services most beneficial to patients, and (3) a strengthened physician role and better integration of HHC with other services during an episode of care can optimize patient outcomes while controlling costs.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Ann Meadow
PHONE NUMBER: 410-786-6602
PIC ID: 7179
PERFORMER ORGANIZATION: Center for Health Policy Research Denver, CO
PROJECTED DATE OF COMPLETION: 12/1/98
TITLE: Development of a Global Quality Assessment Tool for Managed Care Health Plans
ABSTRACT: This project will develop and test a clinically based method for assessing the quality of care delivered for a broad range of services in managed care health plans. It will focus on the quality of care delivered to children and women under 45 years of age.
AGENCY SPONSOR: Office of Strategic Planning
FEDERAL CONTACT: Mary E. Benedict
PHONE NUMBER: 410-786-7724
PIC ID: 7194
PERFORMER ORGANIZATION: Rand Corporation Santa Monica, CA
PROJECTED DATE OF COMPLETION: 9/30/99
TITLE: Evaluation of the Nursing Home Case-Mix and Quality Demonstration
ABSTRACT: This project will help the HCFA determine the impact of specific ancillary services on the Resource Utilization Groups (RUG). It analyzes and potentially refines the extensive care and other categories to determine the impact on the prospective payment system for skilled nursing homes.
AGENCY SPONSOR: Center for Health Plans and Providers
FEDERAL CONTACT: Don Sherwood
PHONE NUMBER: 410-786-6651
PIC ID: 6307
PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA
PROJECTED DATE OF COMPLETION: 3/29/00
TITLE: Measurement, Indicators, and Improvement of the Quality of Life in Nursing Homes
ABSTRACT: This task order will design an evaluation to examine quality of life (QOL) issues for nursing home residents. It will focus on three topics: (1) measuring and developing indicators of QOL, (2) developing quality improvement programs for nursing home QOL, and (3) evaluating environmental design influences on QOL.
AGENCY SPONSOR: Office of Clinical Standards and Quality
FEDERAL CONTACT: Mary Pratt
PHONE NUMBER: 410-786-6867
PIC ID: 7176
PERFORMER ORGANIZATION: University of Minnesota Minneapolis, MN
PROJECTED DATE OF COMPLETION: 11/30/00
TITLE: Project Demonstrating and Evaluating Alternative Methods to Assure and Enhance the Quality of Long-Term Care Services for Persons with Developmental Disabilities Through Performance Based Contracts with Service Providers
ABSTRACT: This task order will develop and validate a comprehensive set of performance measures and indicators of quality for institutional post-acute and long-term care settings. The post-acute settings involved are: SNF short-stay units, inpatient rehabilitation facilities (which include hospital-based rehabilitation units) and long-term care hospitals.
AGENCY SPONSOR: Center for Medicaid and State Operations
FEDERAL CONTACT: Phyllis Nagy
PHONE NUMBER: 410-786-6646
PIC ID: 6310
PERFORMER ORGANIZATION: Abt Associates, Inc. Cambridge, MA
PROJECTED DATE OF COMPLETION: 9/29/02
TITLE: Evaluating the Use of Quality Indicators in the Long Term Care Survey Process
ABSTRACT: The Health Care Financing Administration's (HCFA's) goal is to move towards a regulatory monitoring system that allows for an appropriate use of indicators to evaluate the quality and appropriateness of care provided to residents, and to determine a facility's compliance with the long-term care requirements. This study will develop and test (with volunteering State survey agencies) various options for using a variety of quality indicators to improve the effectiveness and efficiency of the HCFA's facility performance monitoring.
AGENCY SPONSOR: Office of Clinical Standards and Quality
FEDERAL CONTACT: Sue Nonemaker
PHONE NUMBER: 410-786-6825
PIC ID: 7177
PERFORMER ORGANIZATION: Research Triangle Institute Research Triangle Park, NC
PROJECTED DATE OF COMPLETION: 9/29/03
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