The Centers for Medicare & Medicaid Services (CMS) operates the Quality Improvement Organization (QIO) Program to ensure and improve the quality of health care for Medicare beneficiaries. This report presents the results of an independent evaluation of the ninth scope of work, QIO Program,...

Explores a unique approach to performance measurement based on the Bayes theorem.

Before Medicare Part D, Congress authorized the Medicare disease management demonstration to evaluate whether disease management programs—in conjunction with a comprehensive prescription drug benefit—could improve health outcomes and reduce Medicare expenditures. The demonstration...

Presents results from the six-year evaluation, noting that the programs filled important gaps in services, that strong program administration and leadership are associated with better implementation and outcomes, and that coordination with existing clinical services is important.

This Highlight focuses on how North Carolina and Pennsylvania are testing how well the Children's Electronic Health Record (EHR) Format's requirements support the provision of primary care to children and how readily the requirements can be incorporated into existing EHRs.

This brief presents an analysis of the Database of Publicly Available Medicaid and CHIP Performance Measure Reports. It provides background on the database; highlights the types of documents and reports available; and discusses which measure domains are typically represented, including examples of...

Examines M+C participation issues from the perspective of eight national firms that account for more than 70 percent of M+C enrollment nationwide. Notes that M+C products generally do not represent a major line of business for most firms, with the exception of Humana and PacifiCare, where M+C...