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Conditions of Participation for Hospitals

Conditions of Participation for Hospitals
Author: United States. Social Security Administration
Publisher:
Total Pages: 72
Release: 1966
Genre: Hospitals
ISBN:

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Leadership by Example

Leadership by Example
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 206
Release: 2003-05-21
Genre: Medical
ISBN: 0309168880

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The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.


Federalism and Health Policy

Federalism and Health Policy
Author: Alan Weil
Publisher: The Urban Insitute
Total Pages: 448
Release: 2003
Genre: Medical
ISBN: 9780877667162

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The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.


Administrative Burden

Administrative Burden
Author: Pamela Herd
Publisher: Russell Sage Foundation
Total Pages: 360
Release: 2019-01-09
Genre: Social Science
ISBN: 1610448782

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Bureaucracy, confusing paperwork, and complex regulations—or what public policy scholars Pamela Herd and Donald Moynihan call administrative burdens—often introduce delay and frustration into our experiences with government agencies. Administrative burdens diminish the effectiveness of public programs and can even block individuals from fundamental rights like voting. In AdministrativeBurden, Herd and Moynihan document that the administrative burdens citizens regularly encounter in their interactions with the state are not simply unintended byproducts of governance, but the result of deliberate policy choices. Because burdens affect people’s perceptions of government and often perpetuate long-standing inequalities, understanding why administrative burdens exist and how they can be reduced is essential for maintaining a healthy public sector. Through in-depth case studies of federal programs and controversial legislation, the authors show that administrative burdens are the nuts-and-bolts of policy design. Regarding controversial issues such as voter enfranchisement or abortion rights, lawmakers often use administrative burdens to limit access to rights or services they oppose. For instance, legislators have implemented administrative burdens such as complicated registration requirements and strict voter-identification laws to suppress turnout of African American voters. Similarly, the right to an abortion is legally protected, but many states require women seeking abortions to comply with burdens such as mandatory waiting periods, ultrasounds, and scripted counseling. As Herd and Moynihan demonstrate, administrative burdens often disproportionately affect the disadvantaged who lack the resources to deal with the financial and psychological costs of navigating these obstacles. However, policymakers have sometimes reduced administrative burdens or shifted them away from citizens and onto the government. One example is Social Security, which early administrators of the program implemented in the 1930s with the goal of minimizing burdens for beneficiaries. As a result, the take-up rate is about 100 percent because the Social Security Administration keeps track of peoples’ earnings for them, automatically calculates benefits and eligibility, and simply requires an easy online enrollment or visiting one of 1,200 field offices. Making more programs and public services operate this efficiently, the authors argue, requires adoption of a nonpartisan, evidence-based metric for determining when and how to institute administrative burdens, with a bias toward reducing them. By ensuring that the public’s interaction with government is no more onerous than it need be, policymakers and administrators can reduce inequality, boost civic engagement, and build an efficient state that works for all citizens.


Developments in Aging

Developments in Aging
Author: United States. Congress. Senate. Special Committee on Aging
Publisher:
Total Pages: 496
Release: 1987
Genre: Older people
ISBN:

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Medicare

Medicare
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 462
Release: 1990-02-01
Genre: Medical
ISBN: 0309042305

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Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of careâ€"how it is defined, measured, and improvedâ€"and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students.


Extending Medicare Coverage for Preventive and Other Services

Extending Medicare Coverage for Preventive and Other Services
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 410
Release: 2000-05-07
Genre: Medical
ISBN: 0309068894

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This report, which was developed by an expert committee of the Institute of Medicine, reviews the first three services listed above. It is intended to assist policymakers by providing syntheses of the best evidence available about the effectiveness of these services and by estimating the cost to Medicare of covering them. For each service or condition examined, the committee commissioned a review of the scientific literature that was presented and discussed at a public workshop. As requested by Congress, this report includes explicit estimates only of costs to Medicare, not costs to beneficiaries, their families, or others. It also does not include cost-effectiveness analyses. That is, the extent of the benefits relative to the costs to Medicareâ€"or to society generallyâ€"is not evaluated for the services examined. The method for estimating Medicare costs follows the generic estimation practices of the Congressional Budget Office (CBO). The objective was to provide Congress with estimates that were based on familiar procedures and could be compared readily with earlier and later CBO estimates. For each condition or service, the estimates are intended to suggest the order of magnitude of the costs to Medicare of extending coverage, but the estimates could be considerably higher or lower than what Medicare might actually spend were coverage policies changed. The estimates cover the five-year period 2000-2004. In addition to the conclusions about specific coverage issues, the report examines some broader concerns about the processes for making coverage decisions and about the research and organizational infrastructure for these decisions. It also briefly examines the limits of coverage as a means of improving health services and outcomes and the limits of evidence as a means of resolving policy and ethical questions.