Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services (2012) / Chapter Skim
Currently Skimming:
Appendix D: Sources and Uses of Data Within the Centers for Medicare and Medicaid Services
Appendix D: Sources and Uses of Data Within the Centers for Medicare and Medicaid Services
Pages 146-153
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 146... ...
Managed-care plans serving Medicare beneficiaries (Part C of Medicare) are required to submit extensive "benefit utilization" reports, which provide encounter data for these beneficiaries very similar to data from claims submitted on behalf of those in fee-for-service Medicare.
|
From page 147... ...
Physicians' quality reports are based on measures developed by the National Quality Forum. End-stage renal disease facilities report patient outcome measures into a system known as CROWNWeb, for Consolidated Renal Operations in a Web-enabled Network.
|
From page 148... ...
were collected at the time of enrollment. While the categories have expanded since then, data available for Hispanic/Latino and Asian beneficiaries remain of limited accuracy despite efforts to repopulate SSA data received through focused outreach efforts, arrangements with the Indian Health Service and the collection of self-reported data through the Medicare Current Beneficiary Survey.2 As a result, accurate demographic information is often lacking on Medicare beneficiaries, posing a challenge in terms of identifying and reducing racial disparities in health and treatment.
|
From page 149... ...
Supplementing the MDRI is the Medicaid Drug Rebate Utilization file, which captures drug utilization and vendor payments data submitted to CMS by the states in order to calculate state reimburse ment amounts. The Payment Error Rate Measurement is an annual compilation of error rates in payments to states for Medicaid and the Children's Health Insurance Program (CHIP)
|
From page 150... ...
Accessing demonstration data may or may not warrant CMS approval or HIPAA protections, depending on the data collected. Consumer assessment data such as those collected in the MCBS and the HOS are in the form of survey responses from beneficiaries as consumers on the interpersonal aspects of health care.
|
From page 151... ...
, CMS, or its predecessor agencies, have had responsibility for monitoring the quality of care in part of the health care system. The focus of the original law was exclusively on establishing minimum standards for institutional providers, particularly hospitals and nursing homes.
|
From page 152... ...
• The value of the program could be enhanced through the use of strategies designed to focus the QIOs' attention on the provision of technical assistance in support of quality improvement, to broaden their governance base and structure, and to improve CMS's management of related data systems and program evaluations.4 EXTERNAL SECONDARY USES OF CMS DATA The various data sets described here, particularly those produced by Medicare, have served as a rich base for health services research in the United States. Among current researchers, the best known is probably the Dartmouth Atlas of Health Care,5 which began with studies of variation in hospital use and now reports on a wide variety of issues such as the number of individuals who see 10 or more doctors in the last 6 months of life.
|
From page 153... ...
health care system.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.