REGIONAL
EDUCATION LABORATORY - APPALACHIA
U.S.
Department of Education
EVALUATION OF THE NATIONAL
PRACTITIONER DATA BANK (NPDB)/
HEALTHCARE INTEGRITY AND PROTECTION
DATA BANK (HIPDB)
Health
Resources and Services Administration
AN
EVALUATION OF THE IMPACT OF
CMS’S RECOVERY AUDIT
CONTRACT INITIATIVE ON THE
MEDICARE PROVIDER COMMUNITY
The
Centers for Medicare and Medicaid
Services
OPTIMIZING THE IMPACT OF THE
NATIONAL HEALTH SERVICE CORPS
Health
Resources and Services Administration
EVALUATION
OF HRSA’S NURSING EDUCATION
LOAN REPAYMENT PROGRAM AND
THE NURSING SCHOLARSHIP PROGRAM
Health
Resources and Services Administration
THE
2004 NATIONAL SAMPLE SURVEY
OF REGISTERED NURSES
Health
Resources and Services Administration
THE
NATIONAL ADVISORY COUNCIL
ON NURSING EDUCATION AND PRACTICE:
FOURTH REPORT TO THE SECRETARY
OF THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES AND THE
UNITED STATES CONGRESS
Health
Resources and Services Administration
ASSESSING
THE SOCIAL SECURITY ADMINISTRATION’S
EFFORT TO MEET THE NEEDS OF
PERSONS WITH LIMITED ENGLISH
PROFICIENCY
Social
Security Administration
TRAINING
PRIMARY CARE PROVIDERS IN
CULTURALLY COMPETENT, HIGH
QUALITY HEALTH CARE: THE ESSENTIAL
ROLE OF TITLE VII, SECTION
747, IN THE ELIMINATION OF
HEALTH CARE DISPARITIES
Health
Resources and Services Administration
DETERMINING
EFFECTIVE STRATEGIES FOR INFLUENCING
AND IMPROVING SCREENING AND
INTERVENTION FOR PRENATAL
SUBSTANCE ABUSE AND DOMESTIC
VIOLENCE
State
of Washington Department of
Health
THE
FUTURE OF PRIMARY CARE: THE
CRITICAL ROLE OF PRIMARY CARE
EDUCATION AND TRAINING
Health
Resources and Services Administration
EVALUATION
AND REDESIGN OF THE COMPREHENSIVE
PERFORMANCE MONITORING SYSTEM
Health
Resources and Services Administration
EVALUATION
OF THE MULTI-STATE NURSING
LICENSURE COMPACT
(in Partnership with the Gallup
Organization)
National
Council of the State Boards
of Nursing
CONSUMER
RESEARCH ON PERSONAL RESPONSIBILITY,
AND ITS’ RELATIONSHIP
TO CHOICE OF COVERAGE AND
WILLINGNESS TO NAVIGATE THE
HEALTH CARE SYSTEM
(in Partnership with Rolling-Thunder
Research)
Centers
for Medicare and Medicaid
Services
REGIONAL
EDUCATION LABORATORY-APPALACHIA
(In
partnership with the CNA Corporation)
U.S.
Department of Education
This
is a 5-year project to assess
the impact and effectiveness
of programs and initiatives
within the Regional Education
Laboratory-Appalachia (REL-Appalachia).
The goal of the REL-Appalachia
is to provide an effective
mechanism for serving the
educational research needs
of the state and local education
agencies, school districts,
and schools in the Appalachian
region (Virginia, West Virginia,
Kentucky, and Tennessee).
The REL-Appalachia, one
of a network of ten such
labs across the country,
is an important component
of the Department of Education's
efforts to conduct and disseminate
research that will support
continuous improvement in
student outcomes, help close
achievement gaps between
advantaged and disadvantaged
students, and achieve other
key goals of the No Child
Left Behind Act. Emphasis
is on long-term, rigorous
evaluations of public education
programs as well as short-term
research projects investigating
and analyzing education
policies and practices.
Insight serves as the primary
assessment consultant, providing
data collection, sampling,
analytical, and report writing
services to the CNA Corporation.
EVALUATION
OF THE NATIONAL PRACTITIONER
DATA BANK (NPDB)/ HEALTHCARE
INTEGRITY AND PROTECTION
DATA BANK (HIPDB)
(In
partnership with the Gallup
Organization)
Health
Resources and Services Administration
This
study is designed to evaluate
two national data banks
that are used to prevent
fraud and malpractice
within the health care
system. The HIPDB is a
system to alert health
care plans that a comprehensive
review of a practitioner's,
provider's, or supplier's
past actions may be prudent.
The HIPDB collects national
information on health
care-related adverse actions
from all kind of providers
and entities and makes
it available from a single
source. The NPDB is primarily
an alert system intended
to facilitate a comprehensive
review of health care
practitioners' professional
credentials. The intent
is to help State licensing
boards, hospitals, other
health care entities and
professional societies
to identify and discipline
practitioners who engage
in unprofessional behavior;
and to restrict the ability
of incompetent practitioners
to move from State to
State without disclosure
or discovery of previous
medical malpractice payment
and adverse actions. Insight
and the Gallup Organization
are conducting an analysis
focused on the goal of
making the two databanks
more useful, effective
and influential on decisions
made by hospitals, managed
care organizations and
other entities. Combined,
the data analysis will
evaluate the performance
and usefulness of the
NPDB and the HIPDB as
national repositories
that allow users to both
effectively report and
obtain the information
they need. The primary
purposes of the data analysis
among users are 1) to
assess the overall satisfaction
of NPDB and HIPDB users
with the reporting and
querying processes, 2)
to develop recommendations
for improving these processes,
3) to measure user perceptions
of the usefulness of the
information in licensing
and credentialing decisions.
Among non users the primary
purposes are 1) to determine
why eligible institutions
of the NPDB and HIPDB
did not use the databanks
2) how processes could
be improved, and 3) what
the perceived usefulness
of the information might
be.
AN
EVALUATION OF THE IMPACT
OF CMS’S RECOVERY
AUDIT CONTRACT INITIATIVE
ON THE MEDICARE PROVIDER
COMMUNITY
(in
Partnership with Econometrica,
Inc.)
The
Centers for Medicare and
Medicaid Services
The
purpose of this evaluation
is to assess the impact
of the Recovery Audit Contract
Demonstration on physicians,
providers and suppliers
who provide services paid
under Medicare. This demonstration
evaluates the cost effectiveness
of using Recovery Audit
Contractors (RACs) to ensure
that Medicare providers
received the correct payments
without incurring additional
burden on the provider community.
The states of California,
New York and Florida were
selected for this demonstration
based on their high per
capita Medicare expenditure
amounts. The evaluation
of this demonstration project
included discussion groups
with providers and suppliers
in New York and Florida,
and a baseline survey of
2,400 providers in each
of the three participating
states. The discussion groups
were designed to assess
the preliminary impact of
the RACs on Medicare providers
and inform the design of
the survey.The provider
survey is designed to collect
quantitative data on Medicare
providers’ awareness
of the demonstration project,
their attitudes towards
the RACs, and their satisfaction
with the RAC’s handling
of the claims investigation
process. The target population
for the survey includes
all health care providers
in the three states who
serve Medicare beneficiaries.
Insight conducted the discussion
group, designed the survey
and will analyze and write
the final report.
OPTIMIZING
THE IMPACT OF THE NATIONAL
HEALTH SERVICE CORPS
Health
Resources and Services Administration
The purpose of this evaluation
was to assist the NHSC in
determining how to achieve
the best possible outcomes
given: (a) recent changes
in program legislation, (b)
an increase in the program
funding level, and (c) and
the resultant increase in
the number of available awards.
The study focused on the determination
of the factors that are related
to positive NHSC outcomes,
the optimal mix of awardees
to achieve these outcomes,
and recommendations on how
the NHSC could improve program
performance. The research
involved analyses of qualitative
and quantitative data, and
developing simulations and
projections of the effect
of different mixes of awardees
on health professional shortage
areas over time. Factors influencing
the supply and demand of the
NHSC health professionals
were used to characterize
the future needs as they compare
with designation areas and
population characteristics.
Discussion groups were conducted
with site administrators,
NHSC clinicians, and alumni
to provide feedback on proposed
program improvements.
EVALUATION
OF HRSA’S NURSING EDUCATION
LOAN REPAYMENT PROGRAM (NELRP)
AND THE NURSING SCHOLARSHIP
PROGRAM (NSP)
Health
Resources and Services Administration
This
five year project involves
the comprehensive evaluation
of the impact of two key national
programs – the Nursing
Education Loan Repayment Program
and the Nursing Scholarship
Program. These programs are
designed to reduce the current
nursing shortage and address
the nation’s growing
need for nursing professionals,
particularly in critical shortage
facilities. The research design
contains both qualitative
and quantitative components.
Qualitative data is developed
through regional discussion
groups with both award recipients
and critical shortage facility
administrators. Quantitative
data is obtained from the
analysis of current program
databases (such as the number
of applicants, awards and
funds obligated by demographics
of program participants, school
and type of shortage facility)
and from nationally representative
surveys of program recipients
and their lenders. The evaluation
also includes the development
and implementation of annual
performance measures as well
as a cost-benefit analysis
of the program. At the end
of each year, Insight submits
an annual report detailing
the findings and resultant
recommendations to the Health
Resources and Services Administration
(HRSA) and the U.S. Congress.
The most recent report is
titled “HRSA Responds
to the Nursing Shortage: Results
from the Nursing Scholarship
Program and The Nursing Education
Loan Repayment Program, January,
2005.”
THE
2004 NATIONAL SAMPLE SURVEY
OF REGISTERED NURSES (in Partnership
with the Gallup Organization)
Health
Resources and Services Administration
The
National Sample Survey of
Registered Nurses is conducted
every four years to a) monitor
the number and characteristics
of the Registered Nurse (RN)
population and b) develop
supply and demand projections
needed to inform policymakers
about RN workforce needs.
Approximately 54,000 RNs are
selected across the U.S. to
participate in the study.
The survey is conducted primarily
by mail, with an Internet
reporting option available
and telephone follow-up for
nonrespondents. The descriptive
data on current nursing workforce
and the trend data that result
from this series of studies
provide critical information
used by researchers and policymakers
nationwide. The NSSRN report
provides key data needed to
analyze and evaluate the impact
of the Bureau of Health Professions’
support for nursing educational
programs on the RN workforce.
This information is used in
planning for future Federal
initiatives that might be
required to assist in assuring
that the appropriate nursing
workforce will be available
to serve the public’s
needs. The final report is
titled “The Registered
Nurse Population, March 2004”.
THE
NATIONAL ADVISORY COUNCIL
ON NURSING EDUCATION AND PRACTICE:
FOURTH REPORT TO THE SECRETARY
OF THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES AND THE
UNITED STATES CONGRESS
Health
Resources and Services Administration
The purpose of this project
was to analyze the current
state of geriatric health
care and the impact of the
aging population on the nurse
workforce and to develop detailed
recommendations and justifications
for direction and funding
of Title VIII Nursing programs.
The resulting report addressed
the future of nursing care
in the United States and the
implications of the growing
geriatric population on future
nursing workforce. The report
discussed the state of the
nursing workforce and geriatric
education, and made recommendations
to best meet the oncoming
geriatric care needs. Insight
worked in concordance with
the National Advisory Council
on Nursing Education and Practice,
providing literature reviews,
analyses, and assistance in
forming the final recommendations
to Congress. This report,
developed in concert with
HRSA and the National Advisory
Counsel on Nursing Education
and Practice was provided
to the Secretary of the U.S.
Department of Health and Human
Services and the United States
Congress.
ASSESSING
THE SOCIAL SECURITY ADMINISTRATION’S
EFFORT TO MEET THE NEEDS OF
PERSONS WITH LIMITED ENGLISH
PROFICIENCY
Social
Security Administration
The
purpose this study was to
determine the effectiveness
of the Social Security Administration’s
Multi-Language Gateway website
in meeting the public information
needs of Limited English Proficient
clients. Specifically, Insight
evaluated the effectiveness
of this website in meeting
the public information needs
of these populations, determined
which information/services
now offered on the English
SSA website should also be
offered in other languages
on the Multi-Language Gateway,
performed cost/benefit analyses
of proposed changes to the
Multi-Language Gateway, and
recommended ways in which
the SSA could maximize the
effectiveness of this important
resource. The final report
is titled “Ensuring
Meaningful Access to Services:
Assessing Social Security
Administration’s Efforts
to Serve Individuals with
Limited English Proficiency
in an Electronic Environment,
November 2004”.
TRAINING
PRIMARY CARE PROVIDERS IN
CULTURALLY COMPETENT, HIGH
QUALITY HEALTH CARE: THE ESSENTIAL
ROLE OF TITLE VII, SECTION
747, IN THE ELIMINATION OF
HEALTH CARE DISPARITIES
Health
Resources and Services Administration
The
purpose of this project was
to develop analyses and recommendations
with respect to the role of
Title VII, section 747 programs
in addressing health care
disparities. This report addressed
the current disparities in
health care, the projected
expansion of minorities in
the U.S. population, the increasing
need for high quality, culturally
competent patient care, and
the implications for primary
care education and training.
Insight reviewed all relevant
literature, analyzed data,
met with key staff from HRSA’s
Title VII programs, and worked
with HRSA’s Bureau of
Health Professions’
Advisory Committee on Training
in Primary Care Medicine and
Dentistry in developing this
report. As part of this report,
Insight designed and developed
state-level issue briefs for
distribution to members of
Congress describing current
health disparities and projected
demographic changes in each
state. The final report is
titled “Training Primary
Care Providers in Culturally
Competent, High Quality Health
Care: The Essential Role of
Title VII, Section 747 in
the Elimination of Healthcare
Disparities, November 2003”.
DETERMINING
EFFECTIVE STRATEGIES FOR INFLUENCING
AND IMPROVING SCREENING AND
INTERVENTION FOR PRENATAL
SUBSTANCE ABUSE AND DOMESTIC
VIOLENCE
State
of Washington Department of
Health
The
purpose of this project was
to evaluate the Maternal Substance
Abuse Screening Initiative
for Providers and the Washington
Perinatal Partnership Against
Domestic Violence Training
Program. These programs are
designed to train obstetric
providers to identify pregnant
women at risk of producing
a substance abuse-affected
baby or experiencing domestic
violence during pregnancy.
The Department of Health developed
screening criteria and intervention
guidelines to improve provider
ability to effectively screen
and identify women with tobacco,
alcohol, drug use or domestic
violence, and provided guidelines
for screening and follow-up,
provided sample screening
tools and referral resource
numbers to providers. Insight
analyzed the impact of these
initiatives on obstetric providers
and determined how the Department
of Health could help obstetricians
reduce substance abuse and
domestic violence during pregnancy.
To accomplish this, Insight
conducted: (a) literature
reviews of current research
involving prevalence of substance
abuse and domestic violence
during pregnancy, screening
techniques and tools used,
and physician attitudes toward
screening and intervention;
(b) semi-structured interviews
of providers distributed across
the state; and (c) focus groups
of obstetrics providers practicing
in the state. Research involved
behaviors/attitudes toward
screening and intervention,
current techniques used for
screening and intervention,
perceptions of importance
of screening, motivation for
screening, level of screening
that exists, methods for changing
the comfort level of screening,
effective informational strategies
that could influence a change
in practice, and effective
strategies for increasing/improving
provider screening during
pregnancy. The final report
is titled “Prenatal
Screening for Substance Abuse,
Tobacco, and Domestic Violence:
Assessing Effective Strategies
for Improving Screening and
Intervention, February 2004
THE
FUTURE OF PRIMARY CARE: THE
CRITICAL ROLE OF PRIMARY CARE
EDUCATION AND TRAINING
Health
Resources and Services Administration
The
purpose of this project was
to develop analyses and recommendations
with respect to the role of
Title VII, section 747 programs
in meeting the future health
care needs of the nation.
The 2004 report addressed
the future of primary care,
including recent changes in
the health care system that
impact primary care practice
and the implications for primary
care education. Insight reviewed
the literature on the future
of health services delivery,
analyzed data, met with key
staff from HRSA’s Title
VII programs, and worked with
HRSA’s Bureau of Health
Professions’ Advisory
Committee on Training in Primary
Care Medicine and Dentistry
in forming recommendations
and developing the final report.
The final report is titled
“Preparing Primary Health
Care Providers to Meet America’s
Future Health Care Needs:
The Critical Role of Title
VII, Section 747, November,
2004.
EVALUATION
AND REDESIGN OF THE COMPREHENSIVE
PERFORMANCE MONITORING SYSTEM
Health
Resources and Services Administration
The
purpose of this project was
to redesign the data collection
and reporting system used
to collect performance measurement
information from the Health
Resources and Services Administration’s
Bureau of Health Professions
grantees. The goal of this
reporting system was to assist
the Bureau in evaluating each
grantee’s progress toward
achieving the goals outlined
in their grant application
and to collect data on grantee
performance directly related
to the goals and performance
indicators that are common
to the Bureau’s programs.
This data is used to formulate
the GPRA Annual Performance
Report which is part of the
Bureau’s annual budget
request to Congress. The goal
of this research was to: (a)
evaluate the electronic data
collection instrument, in
terms of design, functionality,
ease-of-use, clarity of questions,
instructions, table presentation,
and definition lucidity and
sufficiency; (b) review data
for accuracy, consistency,
and completeness; and (c)
identify issues, perform cost-benefit
analyses, and develop recommendations
and strategies to increase
the compliance, completeness,
and accuracy of the data reported
by the grantees. To accomplish
this, Insight interviewed
grantees from academic institutions
nationwide. In addition, Insight
designed and developed an
informational web-based product
to help grantees identify
where underserved areas are
located, combining information
from many sources and government
agencies. Insight also wrote
an instructional manual that
grantees could download from
the website to locate these
underserved communities. The
resultant final reports include
“Medically Underserved
Communities, Recommendations
and Resources for Grantees,
November, 2002” and
“Recommendations for
the Redesign of the Electronic
Data Collection Instrument,
June, 2002.”
EVALUATION
OF THE MULTI-STATE NURSING LICENSURE
COMPACT
(in Partnership with the Gallup
Organization)
National
Council of the State Boards
of Nursing
This
project was designed to evaluate
the effectiveness and impact
of the Nurse Licensure Compact
(NLC) Agreement. The Compact
was passed into law in January,
2000 with the goal of removing
regulatory barriers to increase
access to safe nursing care
throughout the United States.
The NLC is an agreement between
participating State Boards
of Nursing to honor each others’
RN, LPN and LVN licenses as
their own, thereby allowing
nurses with a permanent residence
in a participating state (called
the “home state”)
to practice nursing in another
participating state (called
the “remote state”),
without having to obtain an
additional license in the
remote state. The purposes
of the NLC include promoting
protection of the public’s
health and safety, increasing
access to nursing care, facilitating
the exchange of information
between participating states
in the areas of nurse regulation,
investigation and adverse
actions, promoting compliance
with the laws governing the
practice of nursing in each
jurisdiction, and investing
all participating states with
the authority to hold a nurse
accountable for meeting all
state practice laws. The evaluation
assessed the NLC’s processes
and outcomes through in depth,
semi-structured interviews
with Nurse Licensure Compact
Administrators in participating
States and Executive Directors
of State Boards of Nursing
in non-participating States.
The interviews focused on
actual and perceived barriers
to joining the NLC, as well
as the NLC’s effectiveness
in meeting its goals with
respect to: (a) public health
and safety; (b) improved access
to nursing care; (c) better
collaboration and communication
between states, and: (d) prevention
of fraud. Further aspects
of the evaluation focused
on the NLC’s impact
on nurses and employers, in
addition to the State Boards
of Nursing, and, its effectiveness
in resolving problems and
removing regulatory barriers.
In addition to the semi-structured
interviews, this evaluation
includes a Computer Assisted
Telephone Interview of 2,000
nurses across the U.S. to
measure their awareness of
and attitudes about the NLC.
CONSUMER
RESEARCH ON PERSONAL RESPONSIBILITY,
AND ITS’ RELATIONSHIP
TO CHOICE OF COVERAGE AND
WILLINGNESS TO NAVIGATE THE
HEALTH CARE SYSTEM
(in Partnership with Rolling-Thunder
Research)
Centers
for Medicare and Medicaid
Services
The
purpose of this project was
to conduct an evaluation of
Medicare beneficiaries regarding
(a) the social psychological
factors underlying personal
responsibility as it relates
to decisions about Medicare
coverage and willingness to
actively participate in health
care decisions; (b) the meaning
of personal responsibility
to Medicare beneficiaries
with respect to their health
care decisions; (c) the relationship
between personal responsibility
and choice of coverage, behavior,
and decision efficacy; (d)
the relationship between personal
responsibility and willingness
to participate in, or express
dissatisfaction about, coverage
and payment decisions; and
(e) the belief system of beneficiaries
as it relates to responsibilities
for decision-making stages
within the health care system.
Evaluation tasks included
the development and implementation
of a cross-sectional survey
of beneficiaries and analyses
with respect to the above-stated
evaluation aspects.
