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2003 Edition
The 2003 CMS Active Projects Report is an annual publication listing the research
projects that CMS supports in pursuit of better health care for our beneficiaries.
Just as CMS programs span a wide range of American health care, our research
needs cover a broad spectrum of topics, methods, and interests. The annual CMS
Active Projects Report describes the Agency's research priorities and lists
research activities by topic. This includes information on the project's
lead researcher, status, and focus. The report is a comprehensive listing of
Agency research, totaling over 200 pages.
You can use this page to read descriptions of the research priorities,
or to download chapters of the Active Projects Report that relate to
specific research areas.
The Agency's current research priorities fall into eight broad
themes, providing insight into the greatest interests for CMS and the
emerging research needs of the American health care system. This
year's priority themes are:
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Theme 1: Monitoring and Evaluating CMS Programs
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Theme 2: Improving Managed Care Payment and
Delivery
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Theme 3: Improving Fee-For-Service Payment and
Delivery
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Theme 4: Future Trends Influencing Our Programs
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Theme 5: Strengthening Medicaid, State Children's
Health Insurance Program (SCHIP), and State Programs
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Theme 6: Meeting the Needs of Vulnerable
Populations
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Theme 7: Outcomes, Quality and Performance
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Theme 8: Building Research Capacity
- Additional Information: Introductions to the Report
As the United States health care system continues to change, there is
an ongoing need to monitor and evaluate the performance of the
programs CMS administers. Beyond traditional measures of performance,
like cost containment, quality, health outcomes, and access to care,
we attempt to measure various beneficiary-focused attributes, such as
knowledge of health behaviors. In our monitoring, we track how well
Medicare, Medicaid, and the State Children's Health Insurance
Program (SCHIP) meet the needs of specific groups of beneficiaries,
including vulnerable populations. Our research also examines more
specific policy issues. For example, as Medicare and Medicaid continue
to pursue managed care options, we examine the cost-effectiveness and
quality of managed care, as well as beneficiary satisfaction. CMS
continuously monitors and evaluates the impact of Medicaid, Welfare
Reform, SCHIP, and our Beneficiary Information program on
beneficiaries. We continue to be custodians of the Nation's public
health -- studying regional, geographical and cultural differences in
health care, improving monitoring systems for prospective payment
systems, developing more detailed information on how many people and
what services are covered by Medicaid or SCHIP, and analyzing
variations in expenditures across different types of patients and
across settings.
Download project descriptions
(.pdf 74 KB:recommended)
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The Balanced Budget Act of 1997 created the Medicare+Choice (M+C)
program, coordinated care plans such as health maintenance
organizations (HMOs), preferred provider organizations, and
provider-sponsored organizations. Since 1997, CMS has been working
continuously to ensure that there is a wide range of high-quality
health care options available to Medicare beneficiaries. As part of
this effort, we continue to devote significant time and effort to
better understanding the M+C program's successes and shortcomings.
For example, we are researching favorable selection in enrollment,
developing systems for measuring beneficiary risk to refine capitated
payments, and conducting demonstrations that test and evaluate the
effectiveness of a wide range of capitated health plan arrangements.
CMS research and demonstration projects include Medicare capitation
demonstrations, Medicare capitation models that integrate acute and
long-term care services, refinement and/or development of risk
adjustment methodologies, an examination of trends in HMO enrollment,
a look at managed care outcomes for selected population, and other
aspects of M+C plans.
Download project descriptions
(.pdf 77 KB:recommended)
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CMS is working to ensure a wide range of high-quality health care
options for Medicare beneficiaries. Improving fee-for-service payment
and delivery involve activities that support efforts to modernize the
program, and exploring how Medicare can adopt successful innovations
of private purchasers. We test approaches that provide opportunities
and appropriate incentives for coordination of complex care and that
reward cost-effective decisions on the part of beneficiaries and
providers. CMS projects include: coordinated care models, prospective
payment for post-acute care services, payment systems focused on
vulnerable populations, implementing and evaluating the durable
medical equipment consumer direct purchasing demonstration, aligning
hospital and physician incentives by using an all inclusive payment
for hospital and physician services, competition-based payment models,
bonus payments for health care groups, preferred provider
arrangements, evaluating the graduate medical education payment
alternative demonstration, assessing the impact of private contracting
on beneficiaries and providers, evaluating work and practice expense
of physicians, and evaluating rural telemedicine projects.
Download project descriptions
(.pdf 123 KB:recommended)
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CMS performs environmental scanning, identifying, evaluating, and
reporting emerging trends in health care delivery and financing, and
their interactions with Agency programs. Our research and evaluation
projects study the effect on beneficiaries, providers, plans, States
and other partners and customers. Projects are designed to assess
potential improvements, and develop new measurement tools. For
example, we identify trends in health care delivery and assess the
impact of long-term structural reforms necessary to address major
demographic changes in the beneficiary population. Specific projects
in this area include examining the demographics of future Medicare
beneficiaries and considering the effect of "healthy aging,"
assessing the effect on quality of life, health and services as
beneficiaries move into "deinstitutionalized" settings,
assessing long term growth assumptions for health expenditures,
identifying the possible impacts of possible eligibility changes and
of potential changes in health status, technology, and the
marketplace, looking at potential changes in the benefit package
(including a prescription drug benefit), and examining how our payment
systems affect adoption of new technology.
Download project descriptions
(.pdf 49 KB:recommended)
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This effort includes research on ways to improve access to and
delivery of health care to the persons served by the Medicaid and
State Children's Health Insurance programs and to the uninsured.
An important set of projects is the Demonstration to Maintain
Independence and Employment, mandated by the Ticket to Work and Work
Incentives Improvement Act of 1999. We also continue the Nursing Home
Transition Grant program. Other projects in this area include the
Medicaid Oral Health Demonstration and the Children's Hospice Care
Demonstration, research to identify model approaches, evaluating the
effects of the Medicaid coverage expansions for children, the outcome
and expenditure effects of preventive services for children, the
effects of early intervention for Medicaid children with asthma,
Medicaid managed care demonstrations and evaluations, attendant care
and personal assistance services, assessing the cost and benefits to
the uninsured of Health Insurance Portability and Accountability Act
provisions, the costs and benefits to enrollees and taxpayers
associated with high-risk pools, examining how associations are
treated in the various State insurance reform laws, and the effect
that States' laws governing associations have on the more general
insurance reform law.
Download project descriptions
(.pdf 209 KB:recommended)
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A special focus of this research area is the demonstration of
coordinated care models that integrate the range of services available
to persons who are dually eligible for Medicare and Medicaid.
Development of a risk adjustment system to support capitated payment
for dual eligibles is a key element of this activity. We are
implementing and evaluating demonstrations for the dually eligible
population, and exploring ways to improve coordination between the
Medicare and Medicaid programs.
Download project descriptions
(.pdf 66 KB:recommended)
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The CMS research, demonstration and evaluation agenda involves the
development and testing of improved information resources to enable
consumers to choose among health plans and providers based on their
relative value and quality. One part of this agenda seeks to better
understand how choices are made. The aim is to develop better tools
for measuring health care outcomes and quality, as well as the
performance of health plans and providers. Projects in this area
include; development and assessment of performance measures,
developing and testing approaches for selective contracting with
providers (institutions and Medicare contracting health plans) based
on quality, implementing and evaluating the Medicare lifestyle
modification program demonstration, and developing new quality
measures, especially for rehabilitation hospitals.
Download project descriptions
(.pdf 93 KB:recommended)
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CMS's research budget supports a variety of activities to increase
the efficiency of our research and demonstration program and to meet
the crosscutting research needs of the wider health research
community. These activities include assisting the infrastructure of
health services research and providing tools to support CMS's
research program. One example is the Medicare Current Beneficiary
Survey (MCBS) -- the only comprehensive source of information on the
health status, health care use and expenditures, health insurance
coverage, and socioeconomic and demographic characteristics of the
entire spectrum of Medicare beneficiaries.
Download project descriptions
(.pdf 149 KB:recommended)
Top of Page
Additional Indexes
The remaining sections of the print edition include topic indexes and other
finding aids. You may download a topical index, (.pdf
44 KB) the foreword
(.pdf 26 KB) to the report, and facts (.pdf 39 KB)
about CMS.
Complete Report
You may also download the entire report in one file (zipped .pdf, 723 KB)
through this link.
To request a single copy of the printed edition, contact the CMS Office of Research,
Development, and Information at 410-786-6501.
Top of Page
The researchers home page
on the CMS website offers additional information on research-related
activities at the Agency, and important links to new developments.
Note: Some of the files on this page are available only in Adobe Acrobat - Portable Document Format (PDF). To view PDF files, you must have the Adobe Acrobat Reader (minimum version 5, version 6 suggested). You can check here to see if you have the Acrobat Reader installed on your computer. If you do not already have the Acrobat Reader installed, please go to Adobe's Acrobat download page now.
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Last Modified on Friday, September 17, 2004
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