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Resource Utilization Groups (RUG) are part of this process, and provide the foundation upon which a resident's individual care plan is formulated. MDS assessment forms are completed for all residents in certified nursing homes, including SNFs, regardless of source of payment for the individual resident.
Utilization and Relative Resource Use; Health Plan Descriptive Information; Measures Collected Using Electronic Clinical Data Systems; Measures are added, deleted, and revised annually. For example, a measure for the length of stay after giving birth was deleted after legislation mandating minimum length of stay rendered this measure nearly ...
Data requirements can also be identified in the contract via special contract clauses (e.g., DFARS), which define special data provisions such as rights in data, warranty, etc. SOW guidance of MIL-HDBK-245D describes the desired relationship: "Work requirements should be specified in the SOW, and all data requirements for delivery, format, and ...
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 ...
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
[5] [6] Requirements quality can be improved through these and other methods: Visualization. Using tools that promote better understanding of the desired end-product such as visualization and simulation. Consistent use of templates. Producing a consistent set of models and templates to document the requirements. Documenting dependencies ...
The summary of the National Health Care Act as proposed in the 111th Congress (2009–2010) includes the following elements, among others: [10] Expands the Medicare program to provide all individuals residing in the 50 states, Washington, D.C., and territories of the United States with tax-funded health care that includes all medically necessary care.
Ascertaining requirements as expressed by health professionals, the public and other stakeholders; Identifying the most appropriate interventions; Considering the effect on resources for proposed interventions and assessing their cost-effectiveness; Supporting decision making in health care and planning health services including any necessary ...