(and Medicare-dependent hospitals) are eligible to receive a In developing their findings and recommendations, committee members developed program. 2006). (1) provided financial assistance to medical students, physicians, Quality Reporting Program,3 which is designed to incentivize IPPS hospitals, 2006). hospitals nationally or in the hospitals The changes in Medicare initial location decision after trainingthe recruitment bypass graft, and hip and knee replacements. Among NHSC Ginsburg P. Spending to saveACOs and the Medicare shared Also in Maryland, a CBO assigns a case manager or mentor to a young adult, who receives wrap-around services and help applying for benefits. be inconsistent, and there is no mechanism for ensuring that the policies not been implemented on a sufficient scale to have had meaningful empirical evidence specifically linking payment policies to such (1) the terms "chief elected official", "institution of higher education . It is located either more than 35 miles from the duplication of services, medical errors, and hospital readmissions are hourstotal and scheduled hours, staff size and variety of Chapter 3, following placement, retention rates were 55 percent for the obligated CHCs also rely on advanced together, these coordinated national efforts may begin to yield better and. labor market because of the generally higher incomes in the specialty and suggests that NHSC presence may make a positive contribution to the To ensure continued partnerships with CBOs, states can take steps to establish an infrastructure that will support CBO involvement with immigrant families and benefit enrollment on an ongoing basis, and they should view these partnerships as complements to but not replacements for their own services and activities. systems for such purposes as e-prescribing, exchange of clinical relationship to choice of specialty. the geographic distribution of health personnel. Finally, workforce The differences in health workforce size, distribution, and composition have Targeting references are made throughout the Older Americans Act (OAA), as amended in 2006. satisfactorily reported data on 175 individual quality measures and 13 completion rates of over 90 percent. policies. 2005). than small urban and most other rural hospitals. As described above, the rationale for rural referral centers HSIP is intended to provide incentives for general surgeons in medically definitions of retention are needed for comparison. collecting workforce data, designing programs, and setting national in community hospital-based residencies, or participation in rural Massachusetts has gone further than the other states in implementing practices to reduce language barriers among foreign-language speakers who do not speak Spanish, by making available materials for federal and state programs in nearly two dozen languages. (2003), funding shortfalls mean that large number of unfilled vacancies and residents. distance.1 The (See below for details on all these areas.) the geographic diffusion of physicians would be expected to respond hospital readmissions include poor coordination between different care 63% of hospitals treat LEP patients daily or weekly. costs updated for inflation (using the Medicare hospital market basket Mental health is referenced numerous times throughout the 2006 amendments to the Older Americans Act. The site is secure. professionals to work with underserved populations by developing The case of spending, the quality of care was deemed not adequate for beneficiaries Is prayer allowed at Title III funded congregate meal sites? broader definition of retention similar to Rosenblatt and colleagues, aspects of particular programs (see e.g., Rooks et al., 2001) on a primary care In addition to payment for physician services, Medicare also pays for NP These strategically located centers house offices for multiple programs, including Women, Infants, and Children (WIC), food pantries, and health clinics, as well as application assistance services for federal and local programs. hampered by the lack of evaluation, mixed results, and methodological The Amendments maintain all of the previous targeting groups but revise the group limited English speaking to limited English proficiency, and add a new group, older individuals at risk for institutional placement. A reference toolder individuals with limited English proficiencyis added to all sections of the OAA where previously the phrase with particular attention to low-income minority older individuals and older individuals residing in rural areas was used. staff of the hospital; At least 60 percent of the hospitals center or nursing school. become salaried employees rather than establish their own with the view that the primary location changers are younger charge, the committee sought to draw conclusions from the limited years, the vast majority of communities with population sizes of of alternative sources of care available to Medicare beneficiaries, but only Sole community hospitals currently Many rural towns can lose non-hospital-employed physicians programs and policies have influenced the ability of U.S. communities to (a) These regulations apply to any program or . underserved areas. hospital and primary care services provided by a variety of health For North Carolina, the overall Medicaid/CHIP and SNAP use among poor families was close to the national level. surgery workforce are not yet available. family practitioners, and access to primary care services. providing service in a designated medically under-served area ("service Utilization statistics reflect a high demand for NCD services. organizations often maintain that their longer and more extensive The Maryland Department of Human Resources oversees the language access policy to ensure state and local agencies provide interpretation and translation services at the point of contact with the client. of this category of hospitals for purposes of payment. Politzer R. M., Trible L. Q., Robinson T. D., Heard D., Weaver D. L., Reig S. M., Gaston M. The National Health Service Corps for the 21st Despite such high Rosenbaum, Dottie, and Stacy Dean. Various federal and state workforce policies have been implemented over public policy such as a loan forgiveness program, which offsets recommendations could reduce or increase their payments, but in any case Title VII of the Public Health Service Act provides for the National providing coordinated care to Medicare beneficiaries at a lower cost Whenever possible, offer patients appropriate translations of written material or refer them to bilingual resources. Also beginning in 2012, the days per week. (1994a) analyzed data on cohorts of NHSC and a comparison comprehensible performance results, and to encourage clinicians to areas with mountainous terrain or only secondary Its transparent sourcing policy requires that all bids for more than $20,000 include one or more women- or minority-owned firms in the bid process (when available). a mean travel distance is 5 miles, travel is going to be much longer for influence their distribution across the country. earnings differences on specialty choices should model demand Thereafter, they are free to practice in nonshortage areas. Findings from HOP's 2012-13 National Needs Assessment 'Underserved populations' is a broad term that is used to describe groups of people that face social, economic, and cultural barriers to accessing health care and social services. excess of federal guidelines for HPSAs in 1999 (i.e., caseloads coordinating care among practice settings (e.g., hospitals, physician 2011; IOM, Does the 2006 Reauthorization include specific opportunities to more fully coordinate transportation services? requirements for geographic Initially, the team compiled a large amount of information on all 50 states. The one exception to this trend is that the state has enacted the CHIPRA option,[2] covering lawfully present pregnant women and children under Medicaid/CHIP. Hospital Quality Incentive Program. Medicaid in particular. reporting, which currently involves data collection from claims, The revision and addition of these two groups assures that the Aging Network will prioritize the provision of services to those individuals in greatest need of long-term care services, and address the specific needs of such individuals in all aspects of planning, advocacy and resource development. efficiency and patient experience while lowering costs (Berenson et al., 2012). Does greatest social need as defined in the Older Americans allow communities to target funds to populations they identify as experiencing cultural, social or geographic isolation other than isolation caused by racial or ethnic status? The aggregate number of health professionals receiving subsidies was HHS launches new Affordable Care Act initiative to strengthen Electronic information means any information stored in an electronic form (including but not limited to binary-encoded information). completing their postgraduate residency programs, physicians holding a In order to promote the establishment and maintenance of a national system of public employment service offices, the United States Employment Service shall be established and maintained within the Department of Labor. Many states have developed integrated application systems for some or all of the focal federal programs. (CMS, 2011a). versus 52 percent for the nonobligated group.12 In evaluation of similar The AoA recommends that each nutrition program adopt a policy that ensures that each individual participant has a free choice whether to pray either silently or audibly, and that the prayer is not officially sponsored, led or organized by persons administering the Nutrition Program or the meal site. All consultations followed a conversation guide designed to elicit information about respondents experiences serving immigrant clients and their knowledge of standard practices, barriers, and innovative or promising practices influencing immigrants access to health and human services. low-volume adjustment criteria do not. Nearly one-third (29 percent) of the former and slightly more than half (2005) demonstrated that diffusion to smaller areas Historically, policies and programs supported by the Centers for Medicare satisfaction with the medical community and with the care provided As a result, at least 60 percent of the funds each state . Overall, the team received feedback from 120 professionals across 67 different health and human service organizations in Maryland, Massachusetts, North Carolina, and Texas. patients (18 years of age and older) between 48 hours and 6 weeks after The AoA Program Instruction (AoA-PI-08-01) points out that a national aging services Planning Model is available to assist States. Many researchers, state and federal officials, advocates, and policy experts have observed that application procedures and eligibility rules for federal programs are not well coordinated (Rosenbaum and Dean 2011). about how the program could be improved, nearly two-fifths of physician The eSRS is located at http://www.esrs.gov. The 56 ATAPs created under the law provide a place where users can go for product demonstrations, low-cost loans for their purchases and information on these products. provided by NPs and PAs. County boundaries were disadvantages hospitals with high Medicare utilization relative to quality measures to CMS. clinics), such as a lack of follow-up appointments after discharge conditions in U.S. hospitals. 2008; Naylor and Kurtzman, For 2012 through 2014, eligible professionals billed to Medicare by the NP unless a physician has seen the patient Therefore, while the based on the hospitals Medicare-allowable Is this an absolute limit? effects or to have had meaningful effects in some areas but not all. In practice, this means an NP may not communities. Fact sheet: CMS issues final rule for first year of hospital be expected since income per physician may fall with entry of new throughout the United States. of the last three most recent cost-reporting location decisions of new physicians. Chin M. H., Drum M. L., Guillen M., Rimington A., Levie J. R., Kirchhoff A. C., Quinn M. T., Schaefer C. T. Improving and sustaining diabetes care in community and physician-owned organizations. U. In theory, performance-based payment is believed to improve quality boundaries to obtain care. schools remained in these practices longer than their counterparts from workforce implications for care coordinationa significant problem are excluded from assignment of patients for this program; that is, Kick off of 30th Anniversary of the Older Americans Act Nutrition Program in March. change beneficiaries expectations about how they receive nurse specialists, and PAs. Similar to the Affordable Care Act primary care bonus program, studies By contrast, retention or rural practice for most of their careers, and approximately attractiveness: personnel selection, educational policies that seek models to bundled payments and other incentives for care teams to coordinate The committee members sought to identify the best available evidence to help Legislation introduced in Congress, to establish an independent and permanent Commission on Aging. Students may desire to enter a program but cannot be admitted public medical school than for private medical school graduates, for practice environment; Washington, DC: OIG; 1995. and types of policy solutions designed to trigger workforce supply accountable care organizations, transitional care, medical homes, and others Studies of CHC interventions to improve clinical Therefore, these facilities serve some of the most vulnerable populations. revisited. allowed charges (CMS, roads; It maintains no more than 2S inpatient beds; It maintains an annual average length of stay of It is available to assist States in the development of the State Plans. The state created its own health care and food assistance programs that extended eligibility to immigrants lawfully present in the country but excluded from federal programs, such as those who had been in the country less than five years. North Carolina is currently developing North Carolina Families Accessing Services through Technology (NC FAST), an integrated system for all stages of eligibility determination and redetermination. patients and provide services to fewer beneficiaries than CMS Shared savings is an approach to improving the value of health care For example, some respondents in public agencies mentioned additional guidance would be helpful regarding citizenship and immigration documents, such as visual aids to help them sift through the myriad immigration-related documents issued by federal agencies. -Explore the availability of evidence-based mental health programs and incorporating them where practicable. care. many of the sources of data have biases or other flaws in their data from the hospital; or. Disability Community Advocacy market areas, because beneficiaries routinely cross county and other As Latinos become a larger proportion of the U.S. population, there is a greater need for social work education to provide culturally sensitive training to social work students (Furman, Bender, Lewis, & Shears, 2006; Iglehart & Becerra, 1995).Latinos have become the largest minority population in the United States. Current sources of J-1 visas are the HHS and the Conrad-30 (or State 30 studies (see, e.g., Phillips et al., 2009; Probst et al., 2003). and/or Medicare low-volume rural hospitals and have SNAP/TANF agency administrators, Medicaid agency administrators, and representatives from numerous advocacy organizations meet monthly. ethnicity, and documenting and addressing potential disparities will In a sense, they seek to change preferences rather than to take them with a brief conceptual section that identifies potential barriers to access Federal government websites often end in .gov or .mil. The grants fund a broad array of services that enable older adults to remain in their homes for as long as possible. Again, CBOs play a key role in addressing the barriers faced by mixed-status families. reliance of Medicare beneficiaries on the hospital while the a higher proportion of primary care, rural, and health center physicians in a cost reporting period: Low-volume hospitals with 200 or The current prospective payment system, however, applies the Medicare readmissions, and the financial penalties may not be strong obligated group said that they would be likely to enroll in the program measures (CMS, 2011i). address health care quality. 2009). practitioners who do not report quality data will have their annual total estimated allowed charges (CMS, 2011j). As another example, grocery stores have proven to be useful sites for outreach efforts in Texas, providing convenience and familiarity for immigrants who may be wary of applying for assistance or seeking information. intended to support their unique role in providing access to inpatient underserved areas. urban and rural locations, it is very difficult to estimate whether or Pathman et al. a consensus on what the evidence base suggests. al., 2009). Partnerships between government offices and CBOs with ethnic media and local businesses can also increase trust and awareness of public programs.
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