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  1. HHS

    Measuring Prevention More Broadly, An Empirical...

    Measuring Prevention More Broadly, An Empirical Assessment of CHIPRA Core Measures Differences in CHIP design and structure, across states and over time, may limit the usefulness of select claims-based core measures for detecting disparities accurately. Additional guidance and research may be necessary before reporting of the measures becomes mandatory.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Aug 22, 2013

  2. HHS

    Effect of Long-term Care Use on Medicare and Medicaid...

    Individuals eligible and enrolled simultaneously for Medicare and Medicaid commonly referred to as dual eligible or duals have often been cited as accounting for a disproportionate share of Medicare and Medicaid spending compared with non-dual eligible beneficiaries. In the Medicare program, dual eligible beneficiaries account for 16 percent of enrollees, but about 25 percent of expenditures. In Medicaid, they account for 18 percent of enrollees, but about 46 percent of expenditures. Despite important policy implications presented by duals, published information on this population is sparse.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Sep 3, 2013

  3. HHS

    Standardizing Medicare Payment Information to Support...

    Examination of efficiency in health care requires that cost information be normalized. Medicare payments include both geographic and policy-based facility type differentials (e.g., wage index and disproportionate share hospital), which can bias cost comparisons of hospitals and averages across geographic areas. Standardizing payment information to remove the area- and policy-based payment differentials should normalize much of the observed geographic variability in payments, allowing for a more accurate comparison of resource use between providers and across geographic regions. Use of standardized payments will ensure that observed payment variation is due to differences in practice patterns and service use, rather than Medicare payment differences over which the providers have no control. This paper describes a method for standardizing claim payments, and demonstrates the difference in actual versus standardized payments by geographic region.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Sep 11, 2013

  4. HHS

    Episode-Based Payment, Evaluating the Impact on Chronic...

    Policy makers are interested in aggregating fee-for-service reimbursement into episode-based bundle payments, hoping it will lead to greater efficiency in the provision of care. The focus of bundled payment initiatives has been upon surgical or discrete procedures. Relatively little is known about calculating and implementing episode-based payments for chronic conditions.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Sep 19, 2013

  5. HHS

    Utilization of Dental Services Among Medicaid-Enrolled...

    Medicare and Medicaid Research Review published data brief. Ellen Bouchery

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Sep 23, 2013

  6. HHS

    Medicare Non-Payment of Hospital-Acquired Infections...

    Medicare and Medicaid Research Review research article, published 9-25-13. Samuel Peasah

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Sep 25, 2013

  7. HHS

    Readiness for Meaningful Use of Health Information Tech...

    According to findings reported in Readiness for Meaningful Use of Health Information Technology and Patient Centered Medical Home Recognition Survey Results, published in Volume 3, Issue 4, of the Medicare and Medicaid Research Review, nearly 70 percent of community health centers (CHCs) had full or partial Electronic Health Record (EHR) adoption at the time of the survey. Of CHCs with EHR systems, 30 percent had been in operation for less than one year, 31 percent for one to two years, and 39 percent for three or more years. Survey results were combined with 2009 Uniform Data System data to determine which factors impact use of Health IT and Meaningful Use readiness. Significant differences, by length of EHR operation were found for Medicaid patients, full or partial EHR adoption, and Patient Centered Medical Home recognition. Results for Stage 1 Core and Menu compliance and CHCs Technical Assistance or training interests are also presented.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Oct 31, 2013

  8. HHS

    Physician Referral Patterns

    The physician referral data was initially provided as a response to a Freedom of Information (FOIA) request. These files represent data from 2009 through June 2013 showing the number of referrals from one physician to another.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Updated: Mar 19, 2014

  9. HHS

    Provider of Services File

    The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it is fairly large (125MB in CSV). The POS Extract is created from the QIES (Quality Improvement Evaluation System) database. These data include provider number, name, and address and characterize the participating institutional providers. The data are collected through the Centers for Medicare and Medicaid Services (CMS) Regional Offices. The file contains an individual record for each Medicare-approved provider and is updated quarterly. For a list of provider types, layout files, and how to order previous annual files, please see the Source Link in the About tab.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: Nov 7, 2013
    Date Updated: Nov 7, 2013

  10. HHS

    Supplier Directory Data

    These are the official datasets used on the Medicare.gov Supplier Directory provided by the Centers for Medicare and Medicaid Services. They provide names, addresses, and contact information for suppliers that provide services or products under the Medicare program.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  11. HHS

    Physician Compare Data

    This is the official dataset associated with the Medicare.gov Physician Compare Website provided by the Centers for Medicare and Medicaid Services (CMS). These data give you useful information about the physicians and other healthcare professionals currently enrolled in Medicare. Currently, Physician Compare includes general information, such as demographic information and Medicare quality program participation. Quality of care measure data will be added to the site and to this database in 2014.

    Because of data use agreements with data vendors, not all data on Physician Compare can be shared in this downloadable file. For more information about what is included in this database and how it differs from the information on the Physician Compare Website, refer to the data dictionary.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  12. HHS

    Physician Compare

    Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in the Medicare program.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  13. HHS

    Nursing Home Compare Data

    These are the official datasets used on the Medicare.gov Nursing Home Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to compare the quality of care at every Medicare and Medicaid-certified nursing home in the country, including over 15,000 nationwide.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  14. HHS

    MDS 3.0 Frequency Report

    The MDS 3.0 Frequency Report summarizes information for active residents currently in nursing homes. The source of these counts is the residents MDS assessment record. The MDS assessment information for each active nursing home resident is consolidated to create a profile of the most recent standard information for the resident.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  15. HHS

    Hospital Compare Data

    These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to compare the quality of care at over 4,000 Medicare-certified hospitals across the country.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  16. HHS

    Dialysis Facility Compare Data

    These are the official datasets used on the Medicare.gov Dialysis Facility Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to compare the quality of care provided in Medicare-certified dialysis facilities nationwide.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  17. HHS

    Accounting for Unobservable Exposure Time Bias Wh...

    Accounting for Unobservable Exposure Time Bias When Using Medicare Prescription Drug Data Unobservable exposure time is common among Medicare Part D beneficiaries, and they are often in worse health. To retain patients with unobservable exposure time, we recommend stratifying patients on receipt of post-acute facility-based care, calculating and using observable days as a covariate and, when appropriate, using the discharge date from contiguous post-acute facility care for beginning the exposure assessment period.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

  18. HHS

    OPPS Provider Summary for 30 Selected APC Groups- CY2011

    A provider level summary of Outpatient Prospective Payment System (OPPS) average estimated submitted charges and average Medicare Payments for 30 selected Ambulatory Payment Classification (APC) Groups.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Released: May 1, 2013
    Date Updated: Jun 2, 2014

  19. HHS

    IPPS Provider Summary for the Top 100 DRGs- FY2011

    A provider level summary of Inpatient Prospective Payment System (IPPS) discharges, average charges and average Medicare payments for the Top 100 Diagnosis-Related Groups (DRG)

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare
    Date Updated: Jun 2, 2014

  20. HHS

    Therapy Provider Phase Information

    The Therapy Provider Phase Information dataset is a tool for providers to search by their National Provider Identifier (NPI) number to determine their phase for manual medical review of therapy claims.

    Agency: Centers for Medicare & Medicaid Services
    Subject: Medicare

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