State Performance Standards System Evaluation and Subject Matter Expertise

Project Overview The Centers for Medicare & Medicaid Services’ (CMS) Quality Safety and Oversight Group (QSOG) provides oversight and ensures compliance for providers serving Medicare and Medicaid beneficiaries. State survey agencies support QSOG by conducting facility surveys to verify compliance with Conditions of Participation or Requirements for Participation, and they complete the certification process and[...]

Project Overview The Centers for Medicare & Medicaid Services (CMS) has established arrangements with Medicare Advantage Organizations (MAOs), Medicare Advantage Prescription Drug Plans (MA-PDs), Prescription Drug Plans (PDPs), and Medicare-Medicaid Plans (MMPs) to provide Medicare coverage. Organizations that provide Part C (medical coverage) and/or Part D (prescription drug) benefits, including MMPs, must meet certain standards[...]

Project Overview To address the significant problem of opioid use in pregnancy and associated high numbers of babies born with neonatal abstinence syndrome or neonatal opioid withdrawal syndrome, the Centers for Medicare & Medicaid Services (CMS) awarded cooperative agreements to 10 state Medicaid agencies to implement the Maternal Opioid Misuse (MOM) Model. By supporting the[...]

Project Overview The Centers for Medicare & Medicaid Services (CMS) relies on rigorous, rapid-cycle research to understand its target audiences and develop compelling communications that inspire beneficiaries to take action. Such research becomes essential as Medicare audiences continue to change, along with their information needs and preferences. Insight is supporting CMS’s Office of Communications in[...]

Overview The Centers for Medicare & Medicaid Services’ Integrated Care for Kids (InCK) is a child-centered local service delivery and state payment model. It aims to reduce expenditures and improve the quality of care for children under 21 covered by Medicaid through prevention, early identification, and treatment of behavioral and physical health needs. Model awardees[...]

Project Overview The Centers for Medicare & Medicaid Services has used the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) since 1998 to fulfill requirements of the 1997 Balanced Budget Act, the 2003 Medicare Modernization Act, and the 2010 Affordable Care Act. The survey provides measures of patient experience and quality of care provided[...]

Project Overview The Centers for Medicare & Medicaid Services (CMS) developed and tested a new long-term care survey process for nationwide use that will replace the Quality Indicator Survey (QIS), previously used by 27 states and the District of Columbia for nursing home inspections. This project provides support to CMS in the implementation of the[...]

Project Overview The Centers for Medicare & Medicaid Services (CMS) implemented the End-State Renal Disease (ESRD) Services Prospective Payment System (PPS) in 2011 and the ESRD Quality Incentive Program (QIP) in 2012 to improve the quality and efficiency of treatment for ESRD, a condition of permanent kidney failure. The most common treatment for ESRD is dialysis. In January[...]