Health Care Financ R
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Health Care Financ R · Jan 2002
Comparative StudyDeveloping dialysis facility-specific performance measures for public reporting.
The Balanced Budget Act (BBA) of 1997 directed CMS to implement a system to measure and report the quality of dialysis services under Medicare by 2000. Because of this tight timeframe, a rapid-cycle measurement development process was initiated to develop dialysis facility-specific measures that could be released to the public. The result was "Dialysis Facility Compare" which has served as a template for the development of public reporting initiatives for other providers in the Medicare Program. This article describes the process used for developing and reporting these performance measures and the lessons learned for future work in this area.
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Health Care Financ R · Jan 2002
Post-acute service use following acute myocardial infarction in the elderly.
This exploratory study examined the extent to which factors beyond characteristics of the patient, such as discharging hospital attributes and State factors, contributed to variations in post-acute services use (PASU) in a cohort of elderly Medicare patients following acute myocardial infarction (AMI). Thirty-seven percent of this cohort received PAS within 30 days of discharge and home health care was the most common type of service used. Patient severity of illness at hospital discharge, for-profit ownership of the discharging hospital, and discharging hospital provision of home health services were shown to be important predictors of PASU. After adjusting for many patient and hospital characteristics, however, variation in PASU remained across States.
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Health Care Financ R · Jan 2002
Comparative StudyHome and community-based services in seven states.
As part of a CMS-funded study, case studies were conducted in Alabama, Indiana, Washington, Wisconsin, Maryland, Michigan, and Kentucky to assess the major features of the home and community-based services system for older people and younger adults with physical disabilities in each State. The case studies analyzed the financing of services; administrative systems; eligibility, assessment, and case management structures; the services provided, including consumer-directed home care and group residential care; cost-containment efforts; and quality assurance. The role that Medicaid plays in home and community-based services is a major focus of the study.