RESUMO
Senior hospital executives responding to a 2005 national telephone survey conducted for the Centers for Medicare & Medicaid Services (CMS) report that Hospital Compare and other public reports on hospital quality measures have helped to focus hospital leadership attention on quality matters. They also report increased investment in quality improvement (QI) projects and in people and systems to improve documentation of care. Additionally, more consideration is given to best practice guidelines and internal sharing of quality measure results among hospital staff Large, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredited hospitals appear to be responding to public reporting efforts more consistently than small, non-JCAHO accredited hospitals.
Assuntos
Benchmarking , Administração Hospitalar/normas , Disseminação de Informação , Notificação de Abuso , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Indicadores de Qualidade em Assistência à Saúde , Atitude do Pessoal de Saúde , Pesquisas sobre Atenção à Saúde , Administradores Hospitalares/psicologia , Humanos , Joint Commission on Accreditation of Healthcare Organizations , Liderança , Inovação Organizacional , Inquéritos e Questionários , Estados UnidosRESUMO
Beginning January 2006, Medicare beneficiaries will have limited ability to change health plans. We examine the Medicare managed care enrollment and disenrollment behavior of traditionally vulnerable beneficiaries from 1999-2001 to estimate the potential impact of the new enrollment restrictions. Findings that several such groups were more likely to make multiple health plan elections, leave their managed care plan midyear, and/or have higher voluntary disenrollment rates and transfers to original fee-for-service (FFS) Medicare suggest that the lock-in provisions may have greater negative impacts on vulnerable beneficiaries. This article identifies several recommendations that CMS might consider to lessen the detrimental effects on at-risk groups.
Assuntos
Comportamento de Escolha , Medicare/organização & administração , Medicare/estatística & dados numéricos , Populações Vulneráveis , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Humanos , Medicare/legislação & jurisprudência , Pessoa de Meia-Idade , Estados UnidosRESUMO
Medicare Current Beneficiary Survey (MCBS) Access to Care data indicate a five-percentage-point decline in the share of Medicare beneficiaries having Medigap coverage between 1996 and 1999; this was matched by a commensurate rise in the share enrolled in Medicare HMOs, contributing to an increase in the percentage with drug coverage. During this period, high-income beneficiaries, and to a lesser extent healthier and rural beneficiaries, experienced greater net declines in supplemental coverage and smaller relative gains in drug coverage, compared with others. By fall 1999, 38 percent of beneficiaries lacked drug coverage, based on point-in-time estimates. This is much higher than previous estimates that measured beneficiaries' drug coverage at any time during the calendar year. Many of Medicare's most vulnerable beneficiaries--rural (50 percent), near-poor (44 percent), and oldest old (45 percent)--were most likely to lack drug coverage in the fall of 1999.