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Guidance for spending and quality data for hospital referral regions (HRRs) and selected 12 HRRs that either had a combination of below-average costs and above-average quality, based on available measures, or the reverse – a combination of above-average costs and below-average quality.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: September 11, 2014

The use of health care services and program spending for Medicare beneficiaries varies substantially across the country.  To better understand the factors that influence this geographic variation, CMS analyzed spending and quality data for hospital referral regions (HRRs) and selected 12 HRRs that either had a combination of below-average costs and above-average quality, based on available measures, or the reverse – a combination of above-average costs and below-average quality.  CMS then conducted site visits to each HRR and interviewed a range of key stakeholders about the issues affecting the delivery of health care in their area.  The discussions focused on issues affecting care for two groups of Medicare beneficiaries: dual eligibles (beneficiaries who are eligible for both Medicare and Medicaid) and beneficiaries with serious chronic conditions.

CMS also conducted site visits to two HRRs that focused on the Program of All-Inclusive Care for the Elderly in an effort to better understand the factors that affect the establishment and sustainability of PACE programs.

This page has links to both reports.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.