Developing an Information Infrastructure for the Medicare+Choice Program

Developing an Information Infrastructure for the Medicare+Choice Program
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 75
Release: 1999-03-09
Genre: Medical
ISBN: 0309063884

On March 4 and 5, 1998, the Institute of Medicine (IOM) Committee on Choice and Managed Care held a 2-day workshop entitled Developing the Information Infrastructure for Medicare Beneficiaries. This workshop was a follow-up to the IOM report entitled Improving the Medicare Market: Adding Choice and Protections. The workshop focused on the Medicare provisions in the Balanced Budget Act of 1997, which mandate that the Health Care Financing Administration (HCFA) develop a "nationally coordinated education and publicity campaign" in 1998 and move Medicare beneficiaries to an open-season enrollment process by the year 2002.

Developing an Information Infrastructure for the Medicare+Choice Program

Developing an Information Infrastructure for the Medicare+Choice Program
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 75
Release: 1999-02-09
Genre: Medical
ISBN: 0309184509

On March 4 and 5, 1998, the Institute of Medicine (IOM) Committee on Choice and Managed Care held a 2-day workshop entitled Developing the Information Infrastructure for Medicare Beneficiaries. This workshop was a follow-up to the IOM report entitled Improving the Medicare Market: Adding Choice and Protections. The workshop focused on the Medicare provisions in the Balanced Budget Act of 1997, which mandate that the Health Care Financing Administration (HCFA) develop a "nationally coordinated education and publicity campaign" in 1998 and move Medicare beneficiaries to an open-season enrollment process by the year 2002.

Medicare Provider-Sponsored Organizations

Medicare Provider-Sponsored Organizations
Author: Peter N. Grant
Publisher: Jossey-Bass
Total Pages: 88
Release: 1998-08-29
Genre: Health & Fitness
ISBN:

Congress has adopted sweeping changes to the Medicare program that will have a significant impact on integrated delivery systems, physicians, IPA's, medical groups, hospitals, and health plans. This legislation is a significant step by the federal government as it provides the framework to transition the Medicare program from an open access fee-for-service system to a managed care-oriented program. This concise guide to developing and achieving certifications will be invaluable to understanding the new PSO regulations.

Medicare

Medicare
Author: United States. General Accounting Office
Publisher:
Total Pages: 44
Release: 2001
Genre: Medicare
ISBN:

Improving the Medicare Market

Improving the Medicare Market
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 385
Release: 1996-12-01
Genre: Medical
ISBN: 0309055350

Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services

Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services
Author: National Research Council
Publisher: National Academies Press
Total Pages: 192
Release: 2012-01-23
Genre: Medical
ISBN: 0309221978

The Centers for Medicare and Medicaid Services (CMS) is the agency in the Department of Health and Human Services responsible for providing health coverage for seniors and people with disabilities, for limited-income individuals and families, and for children-totaling almost 100 million beneficiaries. The agency's core mission was established more than four decades ago with a mandate to focus on the prompt payment of claims, which now total more than 1.2 billion annually. With CMS's mission expanding from its original focus on prompt claims payment come new requirements for the agency's information technology (IT) systems. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services reviews CMS plans for its IT capabilities in light of these challenges and to make recommendations to CMS on how its business processes, practices, and information systems can best be developed to meet today's and tomorrow's demands. The report's recommendations and conclusions offered cluster around the following themes: (1) the need for a comprehensive strategic technology plan; (2) the application of an appropriate metamethodology to guide an iterative, incremental, and phased transition of business and information systems; (3) the criticality of IT to high-level strategic planning and its implications for CMS's internal organization and culture; and (4) the increasing importance of data and analytical efforts to stakeholders inside and outside CMS. Given the complexity of CMS's IT systems, there will be no simple solution. Although external contractors and advisory organizations will play important roles, CMS needs to assert well-informed technical and strategic leadership. The report argues that the only way for CMS to succeed in these efforts is for the agency, with its stakeholders and Congress, to recognize resolutely that action must be taken, to begin the needed cultural and organizational transformations, and to develop the appropriate internal expertise to lead the initiative with a comprehensive, incremental, iterative, and integrated approach that effectively and strategically integrates business requirements and IT capabilities.