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Care Management for High-Cost Beneficiaries Demonstration
News
Final Teleconference Agenda (.pdf 17 kb) Exhibits (.pdf 29 kb)
Frequently Asked Questions Document (updated 10/22/04) (.pdf 22 kb)
Applicant Teleconference Scheduled
Background
The Centers for Medicare & Medicaid Services (CMS) will conduct a demonstration to study various care management models for high-cost beneficiaries in the traditional Medicare fee-for-service program. CMS will assess how well each of these programs is able to reduce Medicare costs while improving the quality of care and quality of life for beneficiaries.
- Fact Sheet (.pdf 66 KB)
- Press Release (.pdf 61 KB)
How to submit an application to conduct a demonstration of care management for high-cost beneficiaries
Download and review the following materials:
- The Federal Register Notice (.pdf 23 KB)
- The Care Management for High-Cost Beneficiaries Demonstration Solicitation (.pdf 71 KB)
- The Medicare Waiver Demonstration Application (.pdf 57 KB)
Applicant Teleconference
CMS will conduct a teleconference on October 29, 2004, at 2:00 PM (Eastern Daylight Time) to address questions that have been posed by prospective applicants. To participate in the teleconference:
1. Dial into the conference at 877-357-7851.
2. When prompted enter the conference ID: 1591369.
Participants are strongly encouraged to submit questions to CMHCBDEMO@cms.hhs.gov in advance of the conference. These questions will form the basis of the agenda for the conference. An updated agenda will be posted on this website prior to the conference. If time permits, additional questions from conference participants will be addressed.
Conference agenda (.pdf 17 kb)Sample data set
Applicants may obtain and analyze a sample data set before submitting their
proposals. The data file is approximately 151 MB and contains 265 columns of
data for 282,521 beneficiaries. It includes summary claims data, Hierarchical
Coexisting Condition (HCC) risk data, and Diagnostic Related Group (DRG) data
for 1999, 2000, and 2001. The HCC assignment process allocates beneficiaries
to one or more of 70 HCC categories based on ICD-9 codes. The HCC categories
are used to calculate HCC risk scores. A risk score for one year is broadly
predictive of spending in the next.
To obtain a sample data set, download the Data Use Agreement and mail a signed
copy of the agreement to:
Care Management for High-Cost Beneficiaries
Centers for Medicare and Medicaid Services
C4-17-27
7500 Security Boulevard
Baltimore, MD 21244-1850
To get an understanding of the sample data set before submitting a Data Use
Agreement, please review the following materials:
- The Readme file for the sample data set (.pdf 13 KB)
- The Data Dictionary for the sample data set (.pdf 43 KB)
Once CMS receives the Data Use Agreement, a compact disk will be mailed to
the individual listed as a "point of contact" on the Agreement. The
compact disk will contain the sample data set, as well as documentation needed
to use the data (YOU SHOULD RECEIVE THE CD WITHIN A WEEK AFTER THE DATA USE
AGREEMENT IS RECEIVED BY CMS. PLEASE E-MAIL TO CMHCBDEMO@CMS.HHS.GOV IF YOU
DO NOT RECEIVE A CD IN THIS TIMEFRAME.)
Download the Data Use Agreement (.pdf
37 KB)
Questions regarding this demonstration may be sent to CMHCBDEMO@cms.hhs.gov
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