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To participate in the program, patients must meet the following inclusion criteria: be an adult greater than sixteen years of age with at least one valid ICD 9 CM diagnosis code, history of blunt or penetrating mechanisms of injury, or have an AIS score ≥ 3. Eligible patients also must have emergency department or hospital dispositions available.
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
Inclusion criteria may include factors such as type and stage of disease, the subject’s previous treatment history, age, sex, race, ethnicity. Exclusion criteria concern properties of the study sample, defining reasons for which patients from the target population are to be excluded from the current study sample. Typical exclusion criteria ...
The Medicare Prescription Drug, Improvement, and Modernization Act, [1] also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. [2] It produced the largest overhaul of Medicare in the public health program's 38-year history.
The transtheoretical model is also known by the abbreviation "TTM" [2] and sometimes by the term "stages of change", [3] although this latter term is a synecdoche since the stages of change are only one part of the model along with processes of change, levels of change, etc. [1] [4] Several self-help books—Changing for Good (1994), [5 ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform