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State organizations that provide data to HCUP are called Partners. HCUP includes multiyear hospital administrative (inpatient, outpatient, and emergency department) data in the United States, with all-payer, encounter-level information beginning in 1988. These databases enable research on health and policy issues at the national, State, and ...
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4] Communication and Care Coordination; Community/Population Health; Effective Clinical Care; Efficiency and Cost Reduction; Patient Safety
A data structure file is available separately from CMS. [6] As of June 2024, the file download size is 947.84 MB, and the raw database file (npidata_pfile_20050523-20240512.csv) is 9.3 GB when extracted. [7] The size of the data has been steadily growing over time. The size of the raw database file was 8.8GB in June 2023, and 8.2GB in June 2022.
These are generally applied through administrative data analysis, but referrals for peer review are frequently made by risk managers, nurses and medical staff. The median annual review volume is 1–2% of hospital inpatient admissions. Thus, case review may be the dominant form of adverse event analysis in US hospitals.
The Comprehensive Addiction Recovery Act of 2016 allowed for qualifying physician assistants and nurse practitioners to obtain DATA waivers. [1] In July 2016, the Department of Health and Human Services issued a final rule, “Medication Assisted Treatment for Opioid Use Disorders”, in the Federal Register (81 FR 44712). This rule, effective ...
In a 1997 analysis, it was estimated that in 1991–1993, the original four hospitals would have had expenditures of $110.8 million for coronary artery bypasses for Medicare beneficiaries, but the change in reimbursement methodology saved $15.31 million for Medicare and $1.84 million for Medicare beneficiaries and their supplemental insurers ...
Cost-minimization is a tool used in pharmacoeconomics to compare the cost per course of treatment when alternative therapies have demonstrably equivalent clinical effectiveness. [ 1 ] Therapeutic equivalence (including adverse reactions, complications and duration of therapy) must be referenced by the author conducting the study and should have ...