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The surveys are free to anyone who wants to use them. They focus on aspects of healthcare quality that patients find important and are well-equipped to assess, such as the communication skills of providers and ease of access to healthcare services. [2] To customize a standardized CAHPS survey, users can add questions on a variety of topics.
Administrative data are electronic records of services, including insurance claims and registration systems from hospitals, clinics, medical offices, pharmacies and labs. For example, a measure titled Childhood Immunization Status requires health plans to identify 2-year-old children who have been enrolled for at least a year.
Consumer Reports has helped start several consumer groups and publications, in 1960 helping create global consumer group Consumers International and in 1974 providing financial assistance to Consumers' Checkbook which is considered akin to Consumer Reports for local services in the seven metropolitan areas they serve.
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
On the whole, Medicare Advantage advertising is so misleading that the federal Centers for Medicare & Medicaid Services (CMS) put out a 226-page rule in 2023 to reign in MA's marketing practices ...
The Commonwealth Fund. Accessed October 16, 2024, U.S. Centers for Medicare and Medicare Services. Accessed October 16, 2024. Medicare Part B Giveback Benefit explained, Humana. Accessed October ...
The committee surveyed 15 states about complaints about Medicare Advantage marketing, finding that 9 of 10 states that tracked such complaints saw an increase in reports from 2020 to 2021.
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.