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A national coverage determination (NCD) [1] is a United States nationwide determination of whether Medicare will pay for an item or service. [2] It is a form of utilization management and forms a medical guideline on treatment.
Clinical measures use the administrative or hybrid data collection methodology, as specified by NCQA. Administrative data are electronic records of services, including insurance claims and registration systems from hospitals, clinics, medical offices, pharmacies and labs.
Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former president Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [6]
Clinical research is a branch of medical research that involves people and aims to determine the effectiveness and safety of medications, devices, diagnostic ...
Health services research (HSR) became a burgeoning field in North America in the 1960s, when scientific information and policy deliberation began to coalesce. [1] Sometimes also referred to as health systems research or health policy and systems research (HPSR), HSR is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services ...
The Medicare Shared Savings Program is a three-year program during which ACOs accept responsibility for the overall quality, cost and care of a defined group of Medicare Fee-For-Services (FFS) beneficiaries. Under the program, ACOs are accountable for a minimum of 5,000 beneficiaries. [21]
The Journal says it consulted over a dozen experts about its analysis of the Medicare data who concluded the methodology to be sound. The data was reviewed under a research agreement with the ...
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.