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The Affordable Care Act (ACA) established the health insurance rate review program in order to protect consumers from unreasonable rate increases. [1] Through this program, proposed premium increases in the small group and individual markets that are above a threshold amount (ten percent or more, as of February 2014) are reviewed by states or the federal government to determine whether the ...
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
Administrative data are electronic records of services, including insurance claims and registration systems from hospitals, clinics, medical offices, pharmacies and labs. For example, a measure titled Childhood Immunization Status requires health plans to identify 2-year-old children who have been enrolled for at least a year.
Aug. 22—A watchdog group that reviews hospitals so consumers can make good choices for medical care has given an array of ratings to area facilities, ranging from 2 to 5 stars. The star rating ...
A report published Monday from the Rand Corporation found that in 2022, the prices hospitals charged to private insurance providers were 254% higher than what Medicare would have paid for the same ...
Reviews in 2008 and 2009 review of research on the effects of health care ratings found that there was evidence that public ratings drove hospitals to improve their performance, but there was limited evidence that they affected how consumers choose health care providers or insurance plans, or that they changed the performance of individual ...
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.
A number have deeming power for Medicare and Medicaid. American Association for Accreditation of Ambulatory Surgery Facilities [2] (AAAASF) Accreditation Association for Ambulatory Health Care (AAAHC) Accreditation Commission for Health Care (ACHC) American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC)