Integrated Public Use Microdata Series – IPUMS USA collects, preserves and harmonizes U.S. census microdata and provides easy access to this data with enhanced documentation. Data includes decennial censuses from 1790 to 2010 and American Community Surveys (ACS) from 2000 to the present.
Further reading –
Inpatient Prospective Payment System – Section 1886(d) of the Social Security Act (the Act) sets forth a system of payment for the operating costs of acute care hospital inpatient stays under Medicare Part A (Hospital Insurance) based on prospectively set rates. This payment system is referred to as the inpatient prospective payment system (IPPS). Under the IPPS, each case is categorized into a diagnosis-related group (DRG). Each DRG has a payment weight assigned to it, based on the average resources used to treat Medicare patients in that DRG.
Further reading –
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html
The Integrated Data Repository (IDR) is a high-volume data warehouse integrating Parts A, B, C, D, and DME claims, beneficiary and provider data sources, along with ancillary data such as contract information, risk scores, and many others. Access to this robust integrated data supports much needed analytics across CMS.
What benefits does IDR offer for business solutions?
Medical Trend & Utilization Analysis
Healthcare Cost & Assessment
Policy Analysis and Development
Provider Profiling & Management
Quality and Effectiveness: Pay for Performance
Program Integrity and Fraud, Waste & Abuse
Rapid response to legislative inquiries
Data available for claims-based program operational needs
The IDR offers even more than just integrated data:
State of the art business intelligence, reporting, and additional data access capabilities
Automated Finder File and Data Extract Process
Data dictionary, data limitations information, source to target mappings, etc.
Further reading –
https://www.cms.gov/Research-Statistics-Data-and-Systems/Research-Statistics-Data-and-Systems.html
International Classification of Diseases, 10th Edition – The National Center for Health Statistics (NCHS), the Federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) in the United States, has developed a clinical modification of the classification for morbidity purposes. The ICD-10 is used to code and classify mortality data from death certificates, having replaced ICD-9 for this purpose as of January 1, 1999. ICD-10-CM is the replacement for ICD-9-CM, volumes 1 and 2, effective October 1, 2015.
The ICD-10 is copyrighted by the World Health Organization (WHO), which owns and publishes the classification. WHO has authorized the development of an adaptation of ICD-10 for use in the United States for U.S. government purposes. As agreed, all modifications to the ICD-10 must conform to WHO conventions for the ICD. ICD-10-CM was developed following a thorough evaluation by a Technical Advisory Panel and extensive additional consultation with physician groups, clinical coders, and others to assure clinical accuracy and utility.
Further reading –
Founded in 1944, the Health Research & Educational Trust (HRET) is the not-for-profit research and education affiliate of the American Hospital Association (AHA). HRET’s mission is to transform health care through research and education. HRET’s applied research seeks to create new knowledge, tools and assistance in improving the delivery of health care by providers and practitioners within the communities they serve.
Further reading –
Medicaid Who’s Who: Joe Reblando – Media Relations Consultant for Medicaid Health Plans of America (MHPA)
1. Which segment of the industry are you currently involved?
A: Medicaid Managed Care
2. How many years have you been in the Medicaid industry?
A: Eight years
3. What is your focus/passion? (Industry related or not)
A: Helping tell the story of America’s under served and the industry that serves them. Also motorcycles, dogs, and bourbon.
4. What is the top item on your “bucket list?”
A: To remove the term “bucket list” from the American lexicon ?
5. What do you enjoy doing most with your personal time?
A: Spending time with family
6. Who is your favorite historical figure and why?
A: Winston Churchill for his charismatic leadership qualities, his courage and resolve in the face of tyranny, and his daily whiskeys.
7. What is your favorite junk food?
A: Pizza, but not just any pizza – I’m talking about real NY pizza where you fold slices in half before taking a bite
8. Of what accomplishment are you most proud?
A: Being quoted in the New York Times in a story by Robert Pear on Medicaid payments to physicians
9. For what one thing do you wish you could get a mulligan?
A: Not discovering health care public relations as a profession earlier. However, I think all my varied roles in health care up until now led me to where I am today (and I am a better health care public relations professional for it), so it’s all good.
10. What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?
A:
Health Risk Assesment – The HRA includes questions about chronic diseases, injury risks, modifiable risk factors, and urgent health needs. An HRA generally asks about overall health and functional matters such as ability to engage in activities of daily living (ADLs), level of physical activity, history with regards to falling, any experience with pain, eating patterns, fatigue, alcohol or tobacco use, and medication use.
Further reading –
Health Professional Shortage Area (HPSA) designations are used to identify areas and population groups within the United States that are experiencing a shortage of health professionals. There are three categories of HPSA designation based on the health discipline that is experiencing a shortage:
1) primary medical;
2) dental; and
3) mental health.
The primary factor used to determine a HPSA designation is the number of health professionals relative to the population with consideration of high need. Federal regulations stipulate that, in order to be considered as having a shortage of providers, an area must have a population-to-provider ratio of a certain threshold. For mental health, the population to provider ratio must be at least 30,000 to 1 (20,000 to 1 if there are unusually high needs in the community).
The number of mental health care HPSA designations includes HPSAs that are proposed for withdrawal and HPSAs that have no data. By statute, designations are not withdrawn until a Federal Register Notice is published, generally once a year on or around July 1.
Further reading –
Mental Health Care Health Professional Shortage Areas (HPSAs)
Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:
Healthy People 2020 continues in this tradition with the launch on December 2, 2010 of its ambitious, yet achievable, 10-year agenda for improving the Nation’s health. Healthy People 2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations. Read the press release for the Healthy People 2020 launch. [PDF – 149 KB]
Vision
A society in which all people live long, healthy lives.
Mission
Healthy People 2020 strives to:
Overarching Goals
Further reading –
The Healthcare Cost Report Information System (HCRIS) contains annual reports submitted by institutional providers to Medicare. It provides information to CMS that assists with the annual settlement summary between CMS and the institutional provider.
The cost report information includes facility level:
Further reading –
https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/Cost-Reports/
