Cost to Charge Ratio – A ratio of the cost divided by the charges. Generally used with acute inpatient or outpatient hospital services.
The following CCRs can be calculated from the Hospital cost reports:
» Total Hospital (all payers, all patients)
» Hospital level
» Cost center specific
» Medicare specific
» Hospital level
» Cost center specific
Further reading –
The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many reforms of the Affordable Care Act, the historic health reform bill that was signed into law March 23, 2010. CCIIO oversees the implementation of the provisions related to private health insurance. In particular, CCIIO is working with states to establish new Health Insurance Marketplaces.
CCIIO works closely with state regulators, consumers, and other stakeholders to ensure the Affordable Care Act best serves the American people.
Further reading –
The CMS Chronic Conditions Data Warehouse (CCW) provides researchers with Medicare and Medicaid beneficiary, claims, and assessment data linked by beneficiary across the continuum of care. In the past, researchers analyzing data files were required to perform extensive analysis related to beneficiary matching, deduplication, and merging of the files in preparation for their study analysis. With the CCW data, this preliminary linkage work is already accomplished and delivered as part of the data files sent to researchers.
The Chronic Conditions Data Warehouse (CCW) is a research database designed to make Medicare, Medicaid, Assessments, and Part D Prescription Drug Event data more readily available to support research designed to improve the quality of care and reduce costs and utilization.
Further reading –
Congressional Budget Office – Since 1975, CBO has produced independent analyses of budgetary and economic issues to support the Congressional budget process. Each year, the agency’s economists and budget analysts produce dozens of reports and hundreds of cost estimates for proposed legislation.
CBO is strictly nonpartisan; conducts objective, impartial analysis; and hires its employees solely on the basis of professional competence without regard to political affiliation. CBO does not make policy recommendations, and each report and cost estimate summarizes the methodology underlying the analysis. Learn more about CBO’s commitment to objectivity and transparency.
CBO’s work follows processes specified in the Congressional Budget and Impoundment Control Act of 1974 (which established the agency) or developed by the agency in concert with the House and Senate Budget Committees and the Congressional leadership.
If you are new to the Congress or are unfamiliar with CBO, you may find yourself aski
Further reading –
The Commission on Accreditation of Rehabilitation Facilities (CARF) is an international, non-profit organization founded in 1966 with the assistance of Mary E. Switzer, then U.S. Social and Rehabilitation Services commissioner. For some institutions, it represents an alternative to Joint Commission certification. Revenue sources include contributions from the International Advisory Council, which comprises entities being accredited.
CARF’s mission is to provide accreditation standards and surveyors for organizations working in the human-services field worldwide with a base in traditional facilities and institutional settings. Among the many areas of practice represented in the CARF standards are aging services; behavioral health, which replaces institutional behavior management; psychosocial rehabilitation; child and youth services (with younger and established family services and support); durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS); employment (e.g., work readiness and evaluation) and community services; medical (and “community”) rehabilitation; and opioid treatment programs.[1]
CARF International is based in Tucson, Arizona, in the United States, with offices in Washington, D.C., and Edmonton, Alberta, Canada. It is considered a system of rehabilitation facilties (now growing larger and associated with private criminal justice facilities) that monitor and accredit themselves, in order to maintain standards and state certifications. Brian J. Boon, Ph.D., is president/CEO.
Further reading –
The Behavioral Risk Factor Surveillance System (BRFSS) is a United States health survey that looks at behavioral risk factors. It is run by Centers for Disease Control and Prevention and conducted by the individual state health departments. The survey is administered by telephone and is the world’s largest such survey. In 2009, the BRFSS began conducting surveys by cellular phone in addition to traditional “landline” telephones. The BRFSS is a cross-sectional telephone survey conducted by state health departments with technical and methodological assistance provided by the CDC. In addition to all 50 states, the BRFSS is also conducted by health departments in The District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. [1]
Individual states can add their own questions to the survey instrument, which consists of a core set of questions on certain topics like car safety, obesity, or exercise. States get funding from the federal government to administer these questionnaires, and they pay for the additional questions themselves.
The U.S. federal government can then compare states based on the core questions to allocate funding and focus interventions. The states themselves also use the survey results to focus interventions for the public and to decide what is worth their while to focus on. City, county, tribal, and local governments also rely on BRFSS data for information about their jurisdictions.
Further reading –
The Better Care Reconciliation Act of 2017 is an amendment in the nature of a substitute proposed in the Senate on June 22, 2017 and revised on July 13, 2017, as a plan to repeal and replace the Affordable Care Act (ACA) and make fundamental changes to Medicaid financing through the Fiscal Year 2017 budget reconciliation process.
Further reading –
http://files.kff.org/attachment/Summary-of-the-Better-Care-Reconciliation-Act
The National Association of Medicaid Directors (NAMD) began as an independent, bipartisan, nonprofit professional organization in 2011. NAMD represents the leaders of state Medicaid agencies across the country. Established in 2011, NAMD’s mission is to support Medicaid Directors in administering the program in cost-effective, efficient and visionary ways that enable the over 70 million Americans served by Medicaid to achieve their best health and to thrive in their communities.
Further reading –
Long-term services and supports (LTSS) are defined as the services and supports used by individuals of all ages with functional limitations and chronic illnesses who need assistance to perform routine daily activities such as bathing, dress- ing, preparing meals, and administering medications.
Further reading –
https://www.medicaid.gov/medicaid/ltss/index.html
Institutions for Mental Disease – In 1988, P.L. 100-360 defined an institution for mental diseases as a hospital, nursing facility, or other institution of more than 16 beds that is primarily engaged
in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services. This definition is in §1905(i) of the Act and in 42
CFR 435.1009. The regulations also indicate that an institution is an IMD if its overall character is that of a facility established and maintained primarily for the care and treatment of individuals
with mental diseases.
Facilities with fewer than 17 beds that specialize in treating persons with mental disorders can provide the types of services discussed in item 1 if they meet the regulatory requirements to
provide these institutional benefits, but these facilities are not technically IMDs. Because IMDs are defined to be institutions with more than 16 beds, the IMD exclusion applies only to
institutions with at least 17 beds.
Further reading –
http://dhhs.ne.gov/medicaid/Documents/4390.pdf
