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Introduction to Health Services Research : A Self-Study Course
Module 3: Selected Players (Federal and Private) (Page 4 of 27)
Centers for Medicare and Medicaid Services (formerly Health Care Financing Administration (HCFA)
 The Centers for Medicare and Medicaid Services (CMS) (https://www.cms.gov/) oversees the Medicare program, a federal health insurance program for persons over 65 years of age and certain disabled persons. The Medicaid program, supplies grants to states to provide medical services to the needy and related federal medical care quality control staffs. It also has responsibility for State Children's Health Insurance Program (SCHIP), Clinical Laboratory Improvements Act regulations and oversight, and for implementing various provisions of HIPAA such as health insurance reform and administrative simplification.
CMS also provides technical assistance to the Public Health Service and other agencies to coordinate delivery and funding of the Department of Health and Human Services' maternal and child health programs. Its Office of Research and Demonstrations (ORD) directs research, evaluation, and demonstration projects.
ORD Research Priorities
Some of ORDs research priorities include examining
- innovations in delivery of health care to Medicare and Medicaid recipients
- the impact of CMS programs on health, access to services, utilization, and personal expenditures of beneficiaries
- the behavior and economics of health care providers and the health care industry
Publications
The Agency publishes many of its studies in its quarterly journal, Health Care Financing Review, a key journal for health services researchers, especially those who are interested in peer reviewed research topics. The Medicare and Medicaid Statistical Supplement to the Health Care Financing Review contains over 100 tables of unique and detailed information on CMS programs and is an important source of statistics for librarians.
Data and Demonstration Projects
 Data is available for use in several formats from raw data to already processed tables from the site's Research, Statistics, Data and Systems page.
CMS conducts and sponsors a number of innovative demonstration projects to test and measure the effect of potential program changes.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) brought the most dramatic and innovative changes to the Medicare program since it began in 1965. It will bring "more affordable health care, prescription drug coverage to all people with Medicare, expanded health plan options, improved health care access for rural Americans, and preventive care services, such as flu shots and mammograms."
Notification Services
CMS keeps interested professionals and the public informed via RSS feeds. Instructions for using the feeds are available on the CMS site. You must use a feed reader or news aggregator to read the content. The following feeds are available:
You can also subscribe (or unsubscribe) to the CMS Press mailing list.
Additional historical information on CMS in Module 2.
Discussion Questions
- What content is available for researchers on the CMS site? For consumers?
- Besides consumers and researchers, who are the other audiences for which CMS provides information? Would exploring the site's content make you come back?
- Given the amount of the content that CMS has made available on its site, where would you go for a glossary of terms, data, a manual, or forms?
- Oral health is an important component of Medicaid, Medicare and SCHIP. Are there any reports on the site of use to researchers?
- What are the "Open Door Forums" The "New Freedom" and "PRIT?"
- Speculate on how the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) will/has affected health services research. Is it worth tracking research initiated as a result of this law? Why or why not?
- Why are the demonstration projects of such interest to researchers, public health and state agencies?
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