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The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver. Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs.
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
No person or place is immune from disasters or disaster-related losses. Infectious disease outbreaks, acts of terrorism, social unrest, or financial disasters in addition to natural hazards can all lead to large-scale consequences for the nation and its communities. Communities and the nation thus face difficult fiscal, social, cultural, and environmental choices about the best ways to ensure basic security and quality of life against hazards, deliberate attacks, and disasters. Beyond the unquantifiable costs of injury and loss of life from disasters, statistics for 2011 alone indicate economic damages from natural disasters in the United States exceeded $55 billion, with 14 events costing more than a billion dollars in damages each. One way to reduce the impacts of disasters on the nation and its communities is to invest in enhancing resilience-the ability to prepare and plan for, absorb, recover from and more successfully adapt to adverse events. Disaster Resilience: A National Imperative addresses the broad issue of increasing the nation's resilience to disasters. This book defines "national resilience", describes the state of knowledge about resilience to hazards and disasters, and frames the main issues related to increasing resilience in the United States. It also provide goals, baseline conditions, or performance metrics for national resilience and outlines additional information, data, gaps, and/or obstacles that need to be addressed to increase the nation's resilience to disasters. Additionally, the book's authoring committee makes recommendations about the necessary approaches to elevate national resilience to disasters in the United States. Enhanced resilience allows better anticipation of disasters and better planning to reduce disaster losses-rather than waiting for an event to occur and paying for it afterward. Disaster Resilience confronts the topic of how to increase the nation's resilience to disasters through a vision of the characteristics of a resilient nation in the year 2030. Increasing disaster resilience is an imperative that requires the collective will of the nation and its communities. Although disasters will continue to occur, actions that move the nation from reactive approaches to disasters to a proactive stance where communities actively engage in enhancing resilience will reduce many of the broad societal and economic burdens that disasters can cause.
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.