A public resource designed to bring together high-value datasets, tools, and applications using data about health and health care to support your need for better knowledge and to help you to solve problems. These datasets and tools have been gathered from agencies across the Federal government with the goal of improving health for all Americans.
The CMS Office of Information Products and Data Analytics produces an annual CMS Data Compendium to provide key statistics about CMS programs and national health care expenditures. The CMS Data Compendium contains historic, current, and projected data on Medicare enrollment and Medicaid recipients, expenditures, and utilization. Data pertaining to budget, administrative and operating costs, individual income, financing, and health care providers and suppliers are also included. National health expenditure data not specific to the Medicare or Medicaid programs is also included making the CMS Data Compendium one of the most comprehensive sources of information available on U.S. health care finance. This CMS report is published annually in electronic form and is available for each year from 2002 through present.
Reports from the Centers for Medicare & Medicaid Services sponsored research available on a broad range of health care issues. Recent documents include: 2nd Report to Congress on the Evaluation of Cancer Prevention and Treatment for Ethnic and Racial Minorities; A Comparison of the Explanatory Power of Two Approaches to the Prediction of Post Acute Care Resources Use; A Comparison of the PACE Capitation Rates to Projected Costs in the First Year of Enrollment; A Study of Charge Compression in Calculating DRG Relative Weights.
The Affordable Care Act requires that the Secretary of Health and Human Services submit to Congress a report on the Innovation Center’s activities at least once every other year, beginning in 2012. This report covers activities between January 1, 2011 and October 31, 2012. During that time, the Innovation Center announced 14 initiatives under the authority of section 1115A of the Social Security Act (Appendix 1). Interest in these initiatives has been significant and the level of public and provider engagement has been high. Hundreds of ideas for improvement in care delivery and payment have been shared with the Innovation Center through its web site. One initiative – the Health Care Innovation Awards – received almost 3,000 applications.
The Center for Medicare & Medicaid Innovation (CMS Innovation Center) conducts research to better understand the effects of new payment models on beneficiary health, healthcare and costs. Numerous researchers from academia share this interest, and are presently conducting studies or plan to conduct studies to also learn about new payment models. This page outlines criteria that the CMS Innovation Center will use to determine whether or not the CMS Innovation Center will provide letters in support of research activities conducted by academic research groups.
This study aimed to identify the impact of 2010 Part D Medication Therapy Management (MTM) programs on Medicare beneficiaries’ adherence, medication use, drug therapies and resource utilization associated with hospital and emergency room (ER) visits, medications, and costs. Although the same Part D MTM programs serve enrollees with a variety of chronic conditions, this study focused on high-cost, high-risk beneficiaries with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), because these individuals stood to benefit significantly from MTM program interventions, and their health impacts would be expected to be identified in the claims data within a six-month outcome period. Of the 678 different Medicare Part D MTM programs that existed in 2010, 93.7% reported that they targeted CHF, and 52.8% reported that they targeted COPD beneficiaries for MTM. Findings indicate that MTM programs improved evidence-based medication adherence in Medicare patients with CHF and COPD, with beneficiaries who received CMRs more likely to benefit. MTM programs administered to patients with PDP and MA-PD plans had similar effects. Medicare MTM programs did not consistently affect resource utilization. Beneficiaries receiving CMRs had lower risk of hospitalization and accrued cost-savings for all-cause hospitalizations but these were not mitigated by reductions in disease-specific outcomes. Patients who received CMRs were more likely to benefit and accrue savings compared to those who did not. Further research is needed to determine whether improved adherence in this population is maintained over longer periods of time and whether MTM programs lead to improved health. Additional research is needed to determine how to optimize the cost-effectiveness of MTM programs in the Medicare context.
The report describes the HAC program, summarizes the findings of the study that RTI International1 conducted under a contract with the Centers for Medicare & Medicaid Services (CMS), and presents the Secretary’s recommendations. These recommendations include development of additional measures of conditions acquired in a variety of health care settings, in alignment with the National Quality Strategy and Inpatient Quality Reporting Program, and exploration of other payment policies that help reduce the occurrence of these conditions.
Because multiple new initiatives involving shared savings may be operating within a State implementing a managed fee-for-service (MFFS) Financial Alignment Demonstration, the Centers for Medicare & Medicaid Services (CMS) is providing this guidance on how beneficiaries will be aligned with different models for purposes of calculating shared savings. In all of these Medicare fee-for-service initiatives, beneficiaries will continue to have the freedom to receive care from any provider of their choosing.
In the year since opening its doors, the Innovation Center’s work is well underway. It has introduced 16 initiatives (see Table at end of report) involving over 50,000 health care providers that will touch the lives of Medicare and Medicaid beneficiaries in all 50 states and will continue to expand its partnerships and reach in the years to come. These initial efforts are focused on improving patient safety, promoting care that is coordinated across health care settings, investing in primary care transformation, creating new bundled payments for care episodes, and meeting the complex needs of those dually eligible for Medicare and Medicaid.
With a Medicare budget of approximately $460 billion and serving nearly 46 million beneficiaries, the Centers for Medicare & Medicaid Services (CMS) plays a key role in the overall direction of the health care system. CMS has developed the Innovators’ Guide to Navigating Medicare to assist stakeholders in understanding the processes used to determine coverage, coding, and payment for new technologies under the Medicare fee-for-service program. (Note: this document does not address the provision of the Affordable Care Act)