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  1. Sandia National Laboratories: Working with Sandia: Procurement:

    Science.gov (United States)

    ; Technology Defense Systems & Assessments About Defense Systems & Assessments Program Areas Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios Contract Audit Working with Sandia Construction and Facilities Sandia establishes contracts to support

  2. Sandia National Laboratories: Working with Sandia

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios /Facilities Contract Audit Technology Partnerships Sandia collaborates with industry, small businesses

  3. Controlling prescription drug costs: regulation and the role of interest groups in Medicare and the Veterans Health Administration.

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D; Hendricks, Ann M

    2008-12-01

    Medicare and the Veterans Health Administration (VA) both finance large outpatient prescription drug programs, though in very different ways. In the ongoing debate on how to control Medicare spending, some suggest that Medicare should negotiate directly with drug manufacturers, as the VA does. In this article we relate the role of interest groups to policy differences between Medicare and the VA and, in doing so, explain why such a large change to the Medicare drug program is unlikely. We argue that key policy differences are attributable to stable differences in interest group involvement. While this stability makes major changes in Medicare unlikely, it suggests the possibility of leveraging VA drug purchasing to achieve savings in Medicare. This could be done through a VA-administered drug-only benefit for Medicare-enrolled veterans. Such a partnership could incorporate key elements of both programs: capacity to accept large numbers of enrollees (like Medicare) and leverage to negotiate prescription drug prices (like the VA). Moreover, it could be implemented at no cost to the VA while achieving savings for Medicare and beneficiaries.

  4. Feasibility of Economic Analysis of Radiation Therapy Oncology Group (RTOG) 91-11 Using Medicare Data

    International Nuclear Information System (INIS)

    Konski, Andre; Bhargavan, Mythreyi; Owen, Jean; Paulus, Rebecca; Cooper, Jay; Forastiere, Arlene; Ang, K. Kian; Watkins-Bruner, Deborah

    2011-01-01

    Purpose: The specific aim of this analysis was to evaluate the feasibility of performing a cost-effectiveness analysis using Medicare data from patients treated on a randomized Phase III clinical trial. Methods and Materials: Cost data included Medicare Part A and Part B costs from all providers-inpatient, outpatient, skilled nursing facility, home health, hospice, and physicians-and were obtained from the Centers for Medicare and Medicaid Services for patients eligible for Medicare, treated on Radiation Therapy Oncology Group (RTOG) 9111 between 1992 and 1996. The 47-month expected discounted (annual discount rate of 3%) cost for each arm of the trial was calculated in 1996 dollars, with Kaplan-Meier sampling average estimates of survival probabilities for each month and mean monthly costs. Overall and disease-free survival was also discounted 3%/year. The analysis was performed from a payer's perspective. Incremental cost-effectiveness ratios were calculated comparing the chemotherapy arms to the radiation alone arm. Results: Of the 547 patients entered, Medicare cost data and clinical outcomes were available for 66 patients. Reasons for exclusion included no RTOG follow-up, Medicare HMO enrollment, no Medicare claims since trial entry, and trial entry after 1996. Differences existed between groups in tumor characteristics, toxicity, and survival, all which could affect resource utilization. Conclusions: Although we were able to test the methodology of economic analysis alongside a clinical trial using Medicare data, the results may be difficult to translate to the entire trial population because of non-random missing data. Methods to improve Medicare data capture and matching to clinical trial samples are required.

  5. Sandia National Laboratories: Sandia National Laboratories: Missions:

    Science.gov (United States)

    Defense Systems & Assessments: About Us Sandia National Laboratories Exceptional service in ; Security Weapons Science & Technology Defense Systems & Assessments About Defense Systems & Information Construction & Facilities Contract Audit Sandia's Economic Impact Licensing & Technology

  6. Partnering with Sandia National Laboratories through alliances or consortia

    Energy Technology Data Exchange (ETDEWEB)

    Winchell, B.M.

    1994-12-01

    To better facilitate working with industry, groups of industrial participants, and partners in alliances or consortia, Sandia National Laboratories presents information helpful to those outside groups as to the forms of arrangements that may be used to better facilitate partnering relationships between Sandia National Laboratories and consortia or alliances of outside parties. It is expected that these alliances and consortia will include both large and small for-profit industrial concerns, as well as not-for-profit entities such as universities, institutes, other research facilities, and other nonprofit institutions or consortia containing institutions. The intent of this report is to provide such outside groups with information that will facilitate rapid interactions with Sandia National Laboratories through some of these forms of business which will be discussed in this report. These are not the only approaches to facilitating business interactions with Sandia National Laboratories and it is not intended that this report be legal advice or required approaches to doing business with Sandia National Laboratories. The intent of this report is merely to suggest ways in which Sandia National Laboratories can work with outside parties in the most expeditious manner.

  7. Partnering with Sandia National Laboratories through alliances or consortia

    Energy Technology Data Exchange (ETDEWEB)

    Winchell, B.M.

    1994-04-01

    To better facilitate working with industry, groups of industrial participants, and partners in alliances or consortia, Sandia National laboratories presents information helpful to those outside groups as to the forms of arrangements that may be used to better facilitate partnering relationships between Sandia National Laboratories and consortia or alliances of outside parties. It is expected that these alliances and consortia will include both large and small for-profit industrial concerns, as well as not-for-profit entities such as universities, institutes, other research facilities, and other nonprofit institutions or consortia containing institutions. The intent of this report is to provide such outside groups with information that will facilitate rapid interactions with Sandia National Laboratories through some of these forms of business which will be discussed in this report. These are not the only approaches to facilitating business interactions with Sandia National Laboratories and it is not intended that this report be legal advice or required approaches to doing business with Sandia National Laboratories. The intent of this report is merely to suggest ways in which Sandia National Laboratories can work with outside parties in the most expeditious manner.

  8. Sandia National Laboratories: Sandia Enabled Communications and

    Science.gov (United States)

    Locator Search Menu About Leadership Mission Social Media Community Involvement Contribution Programs Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Hiring Process Life at New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia Science & Technology

  9. Committee to evaluate Sandia`s risk expertise: Final report. Volume 1: Presentations

    Energy Technology Data Exchange (ETDEWEB)

    Dudley, E.C.

    1998-05-01

    On July 1--2, 1997, Sandia National Laboratories hosted the External Committee to Evaluate Sandia`s Risk Expertise. Under the auspices of SIISRS (Sandia`s International Institute for Systematic Risk Studies), Sandia assembled a blue-ribbon panel of experts in the field of risk management to assess their risk programs labs-wide. Panelists were chosen not only for their own expertise, but also for their ability to add balance to the panel as a whole. Presentations were made to the committee on the risk activities at Sandia. In addition, a tour of Sandia`s research and development programs in support of the US Nuclear Regulatory Commission was arranged. The panel attended a poster session featuring eight presentations and demonstrations for selected projects. Overviews and viewgraphs from the presentations are included in Volume 1 of this report. Presentations are related to weapons, nuclear power plants, transportation systems, architectural surety, environmental programs, and information systems.

  10. Sandia National Laboratories: Sandia National Laboratories: Missions:

    Science.gov (United States)

    Responsibility History Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Technology Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia interest Menu Search Icon Locations Contact Us Employee Locator Search Menu About Leadership Mission Social

  11. Sandia National Laboratories: Working with Sandia: Accounts Payable

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios and Facilities Contract Audit Working with Sandia Accounts Payable Invoice processing Electronic

  12. Sandia National Laboratories: Working with Sandia: Small Business

    Science.gov (United States)

    Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for Mexico Small Business Assistance Program Sandia Science & Technology Park Careers Community

  13. Sandia National Laboratories

    Data.gov (United States)

    Federal Laboratory Consortium — For more than 60 years, Sandia has delivered essential science and technology to resolve the nation's most challenging security issues.Sandia National Laboratories...

  14. Sandia Technology engineering and science accomplishments

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    This report briefly discusses the following research being conducted at Sandia Laboratories: Advanced Manufacturing -- Sandia technology helps keep US industry in the lead; Microelectronics-Sandia`s unique facilities transform research advances into manufacturable products; Energy -- Sandia`s energy programs focus on strengthening industrial growth and political decisionmaking; Environment -- Sandia is a leader in environmentally conscious manufacturing and hazardous waste reduction; Health Care -- New biomedical technologies help reduce cost and improve quality of health care; Information & Computation -- Sandia aims to help make the information age a reality; Transportation -- This new initiative at the Labs will help improve transportation, safety,l efficiency, and economy; Nonproliferation -- Dismantlement and arms control are major areas of emphasis at Sandia; and Awards and Patents -- Talented, dedicated employees are the backbone of Sandia`s success.

  15. Pre-Medicare Eligible Individuals’ Decision-Making In Medicare Part D: An Interview Study

    Directory of Open Access Journals (Sweden)

    Tao Jin, B.S. Pharm, Ph.D. Candidate

    2010-01-01

    Full Text Available ObjectivesThe objective of this study was to elicit salient beliefs among pre-Medicare eligible individuals regarding (1 the outcomes associated with enrolling in the Medicare Part D program; (2 those referents who might influence participants’ decisions about enrolling in the Part D program; and (3 the perceived barriers and facilitators facing those considering enrolling in the Part D program.MethodsFocused interviews were used for collecting data. A sample of 10 persons between 62 and 64 years of age not otherwise enrolled in the Medicare program was recruited. Interviews were audio taped and field notes were taken concurrently. Audio recordings were reviewed to amend field notes until obtaining a thorough reflection of interviews. Field notes were analyzed to elicit a group of beliefs, which were coded into perceived outcomes, the relevant others who might influence Medicare Part D enrollment decisions and perceived facilitators and impediments. By extracting those most frequently mentioned beliefs, modal salient sets of behavioral beliefs, relevant referents, and control beliefs were identified.ResultsAnalyses showed that (1 most pre-Medicare eligible believed that Medicare Part D could “provide drug coverage”, “save money on medications”, and “provide financial and health security in later life”. However, “monthly premiums”, “the formulary with limited drug coverage” and “the complexity of Medicare Part D” were perceived as major disadvantages; (2 immediate family members are most likely to influence pre-Medicare eligible’s decisions about Medicare Part D enrollment; and (3 internet and mailing educational brochures are considered to be most useful resources for Medicare Part D enrollment. Major barriers to enrollment included the complexity and inadequacy of insurance plan information.ConclusionThere are multiple factors related to decision-making surrounding the Medicare Part D enrollment. These factors

  16. Pre-Medicare Eligible Individuals' Decision-Making In Medicare Part D: An Interview Study

    Directory of Open Access Journals (Sweden)

    Tao Jin

    2010-01-01

    Full Text Available Objectives: The objective of this study was to elicit salient beliefs among pre-Medicare eligible individuals regarding (1 the outcomes associated with enrolling in the Medicare Part D program; (2 those referents who might influence participants' decisions about enrolling in the Part D program; and (3 the perceived barriers and facilitators facing those considering enrolling in the Part D program. Methods: Focused interviews were used for collecting data. A sample of 10 persons between 62 and 64 years of age not otherwise enrolled in the Medicare program was recruited. Interviews were audio taped and field notes were taken concurrently. Audio recordings were reviewed to amend field notes until obtaining a thorough reflection of interviews. Field notes were analyzed to elicit a group of beliefs, which were coded into perceived outcomes, the relevant others who might influence Medicare Part D enrollment decisions and perceived facilitators and impediments. By extracting those most frequently mentioned beliefs, modal salient sets of behavioral beliefs, relevant referents, and control beliefs were identified. Results: Analyses showed that (1 most pre-Medicare eligible believed that Medicare Part D could "provide drug coverage", "save money on medications", and "provide financial and health security in later life". However, "monthly premiums", "the formulary with limited drug coverage" and "the complexity of Medicare Part D" were perceived as major disadvantages; (2 immediate family members are most likely to influence pre-Medicare eligible's decisions about Medicare Part D enrollment; and (3 internet and mailing educational brochures are considered to be most useful resources for Medicare Part D enrollment. Major barriers to enrollment included the complexity and inadequacy of insurance plan information. Conclusion: There are multiple factors related to decision-making surrounding the Medicare Part D enrollment. These factors include the advantages

  17. Sandia QIS Capabilities.

    Energy Technology Data Exchange (ETDEWEB)

    Muller, Richard P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-07-01

    Sandia National Laboratories has developed a broad set of capabilities in quantum information science (QIS), including elements of quantum computing, quantum communications, and quantum sensing. The Sandia QIS program is built atop unique DOE investments at the laboratories, including the MESA microelectronics fabrication facility, the Center for Integrated Nanotechnologies (CINT) facilities (joint with LANL), the Ion Beam Laboratory, and ASC High Performance Computing (HPC) facilities. Sandia has invested $75 M of LDRD funding over 12 years to develop unique, differentiating capabilities that leverage these DOE infrastructure investments.

  18. Charter of the Sandia National Laboratories Sandia Postdoctoral Development (SPD) Association.

    Energy Technology Data Exchange (ETDEWEB)

    McBride, Amber Alane Fisher; McBride, Amber Alane Fisher; Rodgers, Theron; Dong, Wen; Juan, Pierre-Alexandre; Barkholtz, Heather; Alley, William Morgan; Wolk, Benjamin Matthew; Vane, Zachary Phillips; Priye, Aashish; Ball, Cameron Scott; McBride, Amber Alane Fisher

    2017-03-01

    The SNL SPD Association represents all personnel that are classified as Postdoctoral Appointees at Sandia National Laboratories. The purpose of the SNL SPD Association is to address the needs and concerns of Postdoctoral Appointees within Sandia National Laboratories.

  19. Sandia National Laboratories: Working with Sandia: What Does Sandia Buy?

    Science.gov (United States)

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  20. Sandia National Laboratories

    Science.gov (United States)

    Gilliom, Laura R.

    1992-01-01

    Sandia National Laboratories has identified technology transfer to U.S. industry as a laboratory mission which complements our national security mission and as a key component of the Laboratory's future. A number of technology transfer mechanisms - such as CRADA's, licenses, work-for-others, and consortia - are identified and specific examples are given. Sandia's experience with the Specialty Metals Processing Consortium is highlighted with a focus on the elements which have made it successful. A brief discussion of Sandia's potential interactions with NASA under the Space Exploration Initiative was included as an example of laboratory-to-NASA technology transfer. Viewgraphs are provided.

  1. Experiences implementing the MPI standard on Sandia`s lightweight kernels

    Energy Technology Data Exchange (ETDEWEB)

    Brightwell, R.; Greenberg, D.S.

    1997-10-01

    This technical report describes some lessons learned from implementing the Message Passing Interface (MPI) standard, and some proposed extentions to MPI, at Sandia. The implementations were developed using Sandia-developed lightweight kernels running on the Intel Paragon and Intel TeraFLOPS platforms. The motivations for this research are discussed, and a detailed analysis of several implementation issues is presented.

  2. Sandia`s network for Supercomputing `94: Linking the Los Alamos, Lawrence Livermore, and Sandia National Laboratories using switched multimegabit data service

    Energy Technology Data Exchange (ETDEWEB)

    Vahle, M.O.; Gossage, S.A.; Brenkosh, J.P. [Sandia National Labs., Albuquerque, NM (United States). Advanced Networking Integration Dept.

    1995-01-01

    Supercomputing `94, a high-performance computing and communications conference, was held November 14th through 18th, 1994 in Washington DC. For the past four years, Sandia National Laboratories has used this conference to showcase and focus its communications and networking endeavors. At the 1994 conference, Sandia built a Switched Multimegabit Data Service (SMDS) network running at 44.736 megabits per second linking its private SMDS network between its facilities in Albuquerque, New Mexico and Livermore, California to the convention center in Washington, D.C. For the show, the network was also extended from Sandia, New Mexico to Los Alamos National Laboratory and from Sandia, California to Lawrence Livermore National Laboratory. This paper documents and describes this network and how it was used at the conference.

  3. Medicare

    Science.gov (United States)

    ... Mariana Islands, Guam, American Samoa, or the U.S. Virgin Islands, we’ll automatically enroll you in Medicare ... enrollment period for people covered under an employer group health plan If you’re 65 or older ...

  4. Sandia National Laboratories, California Environmental Management System Program Manual.

    Energy Technology Data Exchange (ETDEWEB)

    2009-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004 and Department of Energy (DOE) Order 450.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a set of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site received ISO 14001 certification in September 2006. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy Management and Fleet Services Environmental programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has several groups operating at Sandia

  5. Sandia National Laboratories, California Environmental Management System program manual.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2012-03-01

    several groups operating at Sandia National Laboratories, New Mexico (SNL/NM). Although these groups, from an organizational perspective, are part of Division 8000, they are managed locally and fall under the environmental requirements specific to their New Mexico location. The New Mexico groups in Division 8000 follow the corporate EMS Program for New Mexico operations.

  6. Sandia National Laboratories, California Environmental Management System Program Manual.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2011-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 450.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a set of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site received ISO 14001 certification in September 2006. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has several groups operating at Sandia National Laboratories

  7. A user`s guide to LHS: Sandia`s Latin Hypercube Sampling Software

    Energy Technology Data Exchange (ETDEWEB)

    Wyss, G.D.; Jorgensen, K.H. [Sandia National Labs., Albuquerque, NM (United States). Risk Assessment and Systems Modeling Dept.

    1998-02-01

    This document is a reference guide for LHS, Sandia`s Latin Hypercube Sampling Software. This software has been developed to generate either Latin hypercube or random multivariate samples. The Latin hypercube technique employs a constrained sampling scheme, whereas random sampling corresponds to a simple Monte Carlo technique. The present program replaces the previous Latin hypercube sampling program developed at Sandia National Laboratories (SAND83-2365). This manual covers the theory behind stratified sampling as well as use of the LHS code both with the Windows graphical user interface and in the stand-alone mode.

  8. The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans

    Science.gov (United States)

    Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P

    2004-01-01

    Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective

  9. Sandia National Laboratories: Feedback

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Responsibility History Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Technology Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia

  10. Sandia National Laboratories embraces ISDN

    Energy Technology Data Exchange (ETDEWEB)

    Tolendino, L.F.; Eldridge, J.M.

    1994-08-01

    Sandia National Laboratories (Sandia), a multidisciplinary research and development laboratory located on Kirtland Air Force Base, has embraced Integrated Services Digital Network technology as an integral part of its communication network. Sandia and the Department of Energy`s Albuquerque Operations Office have recently completed the installation of a modernized and expanded telephone system based, on the AT&T 5ESS telephone switch. Sandia is committed to ISDN as an integral part of data communication services, and it views ISDN as one part of a continuum of services -- services that range from ISDN`s asynchronous and limited bandwidth Ethernet (250--1000 Kbps) through full bandwidth Ethernet, FDDI, and ATM at Sonet rates. Sandia has demonstrated this commitment through its use of ISDN data features to support critical progmmmatic services such as access to corporate data base systems. In the future, ISDN will provide enhanced voice, data communication, and video services.

  11. Simulation and off-line programming at Sandia`s Intelligent Systems and Robotics Center

    Energy Technology Data Exchange (ETDEWEB)

    Xavier, P.G.; Fahrenholtz, J.C.; McDonald, M. [Sandia National Labs., Albuquerque, NM (United States). Intelligent Systems and Robotics Center] [and others

    1997-11-01

    One role of the Intelligent Robotics and System Center (ISRC) at Sandia National Laboratories is to address certain aspects of Sandia`s mission to design, manufacture, maintain, and dismantle nuclear weapon components. Hazardous materials, devices, and environments are often involved. Because of shrinking resources, these tasks must be accomplished with a minimum of prototyping, while maintaining high reliability. In this paper, the authors describe simulation, off-line programming/planning, and related tools which are in use, under development, and being researched to solve these problems at the ISRC.

  12. SANDIA-ORIGEN user's manual

    International Nuclear Information System (INIS)

    Bennett, D.E.

    1979-10-01

    The SANDIA-ORIGEN code calculates the detailed isotopic composition as a function of time in nuclear reactor fuel irradiation and radioactive decay problems. This code was developed specifically for Control Data Corporation computers from the original Oak Ridge National Laboratory ORIGEN code. The nuclear data file used with the code at Sandia Laboratories contains 1063 isotopes (254 structural materials, 101 actinides, and 708 fission products). SANDIA-ORIGEN is oriented toward simple, easy use and includes NAMELIST input, convenient control of the output, and versatile options for the blending and reprocessing of reactor fuel. System operating instructions and the input decks for numerous sample problems are also presented. 13 references, 14 figures

  13. 77 FR 22071 - Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit...

    Science.gov (United States)

    2012-04-12

    ... Outcome Survey HPMS Health Plan Management System ICD-9-CM Internal Classification of Disease, 9th..., Improvement, and Modernization Act of 2003 (Pub. L. 108-173) MS-DRG Medicare Severity Diagnosis Related Group...

  14. Sandia Pulse Reactor-IV Project

    International Nuclear Information System (INIS)

    Reuscher, J.A.

    1983-01-01

    Sandia National Laboratories has developed, designed and operated fast burst reactors for over 20 years. These reactors have been used for a variety of radiation effects programs. During this period, programs have required larger irradiation volumes primarily to expose complex electronic systems to postulated threat environments. As experiment volumes increased, a new reactor was built so that these components could be tested. The Sandia Pulse Reactor-IV is a logical evolution of the two decades of fast burst reactor development at Sandia

  15. Medicare

    Science.gov (United States)

    ... get about Medicare Lost/incorrect Medicare card Report fraud & abuse File a complaint Identity theft: protect yourself ... the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 Sign Up / Change Plans ...

  16. Sandia National Laboratories: News: Publications

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Community Involvement Leadership Mission Environmental Responsibility History Diversity Social Media Careers Small Business Assistance Program Sandia's Economic Impact Sandia Science & Technology Park © 2018

  17. Sandia National Laboratories: Working with Sandia: Current Suppliers

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios Suppliers iSupplier Account Accounts Payable Contract Information Construction and Facilities Contract Audit

  18. Sandia National Laboratories: Working with Sandia: Contract Audit

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios Audit iSupplier Account Accounts Payable Contract Information Construction and Facilities Contract Audit

  19. Sandia National Laboratories: Search Results

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Hiring Process Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia Science &

  20. Sandia National Laboratories: Working with Sandia: Prospective Suppliers

    Science.gov (United States)

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  1. Sandia National Laboratories Institutional Plan: FY 1996--2001

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    Sandia`s Institutional Plan is by necessity a large document. As their missions have grown and diversified over the past decades, the variety of technical and site activities has increased. The programs and activities described here cover an enormous breadth of scientific and technological effort--from the creation of new materials to the development of a Sandia-wide electronic communications system. Today, there are three major themes that greatly influence this work. First, every federally funded institution is being challenged to find ways to become more cost effective, as the US seeks to reduce the deficit and achieve a balanced federal spending plan. Sandia is evaluating its business and operational processes to reduce the overall costs. Second, in response to the Galvin Task Force`s report ``Alternative Futures for the Department of Energy National Laboratories``, Sandia and the Department of Energy are working jointly to reduce the burden of administrative and compliance activities in order to devote more of the total effort to their principal research and development missions. Third, they are reevaluating the match between their missions and the programs they will emphasize in the future. They must demonstrate that Sandia`s roles--in national security, energy security, environmental integrity, and national scientific and technology agenda support--fit their special capabilities and skills and thus ensure their place in these missions for the longer planning horizon. The following areas are covered here: Sandia`s mission; laboratory directives; programmatic activities; technology partnerships and commercialization; Sandia`s resources; and protecting resources and the community.

  2. Sandia National Laboratories: About Sandia: Community Involvement:

    Science.gov (United States)

    Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current . In the 1960s, employees initiated the Shoes for Kids Program. Rather than giving each other gifts holidays, New Mexico employees enjoy the opportunity to provide gifts for more than 600 children who are

  3. Sandia National Laboratories: The First Fifty Years

    Energy Technology Data Exchange (ETDEWEB)

    MORA,CARL J.

    1999-11-03

    On Nov. 1, 1999, Sandia National Laboratories celebrates its 50th birthday. Although Sandia has its roots in the World War II-era Manhattan Project, Sandia began operating as a separate nuclear weapons engineering laboratory under the management of AT&T on Nov. 1, 1949. Today the lab employs more than 7,000 people at its two sites in Albuquerque and Livermore, California, and has research and development missions in national security, energy and environmental technologies, and U.S. economic competitiveness. Lockheed Martin Corporation operates Sandia for the US. Department of Energy.

  4. Sandia Technology: Engineering and science accomplishments, February 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-02-01

    Sandia National Laboratories is one of the Department of Energy`s primary research and development laboratories. Our essential mission is to support the national interests of the US in defense, energy, and the environment. Managed by Martin Marietta Corporation for DOE, Sandia focuses its resources on problems of national interest that require the integration of science and technology for their solution. We all hope that this period of sweeping alterations in international affairs will result in a successful transition from the Cold War to a period of sustainable global security and prosperity. In the meantime, our nation`s interests are best served by continued commitment to Sandia`s traditional responsibilities. Nonetheless, as momentous developments are reshaping the world, Sandia is also changing from its beginning as a closed operation concentrating on classified defense programs, Sandia has become a more accessible resource that focuses on research and development partnerships with industry and universities as a way to ensure continued success in DOE`s evolving core mission area of nuclear weapons, energy, environment, and the basis sciences. Through these collaborative efforts, Sandia and its partners are also benefiting the economic competitiveness of our nation. Sandia places a special emphasis on working with small businesses as both technology transfer partners and suppliers of goods and services. We are also reaching out the the larger community surrounding Sandia, striving to provide technological solution and accurate information to meet community needs. We believe that the dialogue we are creating will benefit Sandia, the community, and the nation. Our goal is to render `` exceptional service in the national interest`` by returning maximum value on the investment in the labs. As you review this document, look for new ways in which Sandia can contribute to the solution of problems facing our nation.

  5. Development of the Sandia Cooler

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Terry Alan [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Koplow, Jeffrey P. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Staats, Wayne Lawrence [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Curgus, Dita Brigitte [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Leick, Michael Thomas. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Matthew, Ned Daniel [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Zimmerman, Mark D. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Arienti, Marco [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Gharagozloo, Patricia E. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Hecht, Ethan S. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Spencer, Nathan A. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Vanness, Justin William. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Gorman, Ryan [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2013-12-01

    This report describes an FY13 effort to develop the latest version of the Sandia Cooler, a breakthrough technology for air-cooled heat exchangers that was developed at Sandia National Laboratories. The project was focused on fabrication, assembly and demonstration of ten prototype systems for the cooling of high power density electronics, specifically high performance desktop computers (CPUs). In addition, computational simulation and experimentation was carried out to fully understand the performance characteristics of each of the key design aspects. This work culminated in a parameter and scaling study that now provides a design framework, including a number of design and analysis tools, for Sandia Cooler development for applications beyond CPU cooling.

  6. 78 FR 16614 - Medicare Program; Medicare Hospital Insurance (Part A) and Medicare Supplementary Medical...

    Science.gov (United States)

    2013-03-18

    ... policy to address the issues raised by the Administrative Law Judge and Medicare Appeals Council... issued by the ALJs and the Medicare Appeals Council do not establish Medicare payment policy, we are... Council decisions previously described, this Ruling establishes a policy that revises the current policy...

  7. Individualizing Medicare.

    Science.gov (United States)

    Chollet, D J

    1999-05-01

    Despite the enactment of significant changes to the Medicare program in 1997, Medicare's Hospital Insurance trust fund is projected to be exhausted just as the baby boom enters retirement. To address Medicare's financial difficulties, a number of reform proposals have been offered, including several to individualize Medicare financing and benefits. These proposals would attempt to increase Medicare revenues and reduce Medicare expenditures by having individuals bear risk--investment market risk before retirement and insurance market risk after retirement. Many fundamental aspects of these proposals have yet to be worked out, including how to guarantee a baseline level of saving for health insurance after retirement, how retirees might finance unanticipated health insurance price increases after retirement, the potential implications for Medicaid of inadequate individual saving, and whether the administrative cost of making the system fair and adequate ultimately would eliminate any rate-of-return advantages from allowing workers to invest their Medicare contributions in corporate stocks and bonds.

  8. The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.

    Science.gov (United States)

    Coulam, Robert; Kralewski, John; Dowd, Bryan; Gans, David

    2016-01-01

    Although there are numerous studies of the factors influencing the adoption of quality assurance (QA) programs by medical group practices, few have focused on the role of group practice administrators. To gain insights into the role these administrators play in QA programs, we analyzed how medical practices adopted and implemented the Medicare Physician Quality Reporting System (PQRS), the largest physician quality reporting system in the United States. We conducted focus group interviews in 2011 with a national convenience sample of 76 medical group practice administrators. Responses were organized and analyzed using the innovation decision framework of Van de Ven and colleagues. Administrators conducted due diligence on PQRS, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations. Virtually, all who attempted it agreed that PQRS was straightforward to implement. However, the complexities of Medicare's PQRS reports impeded use of the data by administrators to support quality management. Group practice administrators are playing a prominent role in activities related to the quality of patient care--they are not limited to the business side of the practice. Especially, as PQRS becomes more nearly universal after 2014, Medicare should take account of the role that administrators play, by more actively engaging administrators in shaping these programs and making it easier for administrators to use the results. More research is needed on the rapidly evolving role of nonphysician administration in medical group practices. Practice administrators have a larger role than commonly understood in how quality reporting initiatives are adopted and used and are in an exceptional position to influence the more appropriate use of these resources if

  9. Sandia National Laboratories analysis code data base

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1994-11-01

    Sandia National Laboratories, mission is to solve important problems in the areas of national defense, energy security, environmental integrity, and industrial technology. The Laboratories` strategy for accomplishing this mission is to conduct research to provide an understanding of the important physical phenomena underlying any problem, and then to construct validated computational models of the phenomena which can be used as tools to solve the problem. In the course of implementing this strategy, Sandia`s technical staff has produced a wide variety of numerical problem-solving tools which they use regularly in the design, analysis, performance prediction, and optimization of Sandia components, systems and manufacturing processes. This report provides the relevant technical and accessibility data on the numerical codes used at Sandia, including information on the technical competency or capability area that each code addresses, code ``ownership`` and release status, and references describing the physical models and numerical implementation.

  10. Sandia National Laboratories: News: Economic Impact

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Involvement Leadership Mission Environmental Responsibility History Diversity Social Media Careers View All Small Business Assistance Program Sandia's Economic Impact Sandia Science & Technology Park © 2018

  11. Sandia National Laboratories: News: Image Gallery

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Hiring Process Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia Science &

  12. How Successful Is Medicare Advantage?

    Science.gov (United States)

    Newhouse, Joseph P; McGuire, Thomas G

    2014-01-01

    Context Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. Methods This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Findings Beneficiaries make “mistakes” in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of “zero-premium” plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Conclusions Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan

  13. Sandia Combustion Research Program

    Energy Technology Data Exchange (ETDEWEB)

    Johnston, S.C.; Palmer, R.E.; Montana, C.A. (eds.)

    1988-01-01

    During the late 1970s, in response to a national energy crisis, Sandia proposed to the US Department of Energy (DOE) a new, ambitious program in combustion research. Shortly thereafter, the Combustion Research Facility (CRF) was established at Sandia's Livermore location. Designated a ''user facility,'' the charter of the CRF was to develop and maintain special-purpose resources to support a nationwide initiative-involving US inventories, industry, and national laboratories--to improve our understanding and control of combustion. This report includes descriptions several research projects which have been simulated by working groups and involve the on-site participation of industry scientists. DOE's Industry Technology Fellowship program, supported through the Office of Energy Research, has been instrumental in the success of some of these joint efforts. The remainder of this report presents results of calendar year 1988, separated thematically into eleven categories. Referred journal articles appearing in print during 1988 and selected other publications are included at the end of Section 11. Our traditional'' research activities--combustion chemistry, reacting flows, diagnostics, engine and coal combustion--have been supplemented by a new effort aimed at understanding combustion-related issues in the management of toxic and hazardous materials.

  14. Sandia software guidelines: Volume 5, Tools, techniques, and methodologies

    Energy Technology Data Exchange (ETDEWEB)

    1989-07-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. This volume describes software tools and methodologies available to Sandia personnel for the development of software, and outlines techniques that have proven useful within the Laboratories and elsewhere. References and evaluations by Sandia personnel are included. 6 figs.

  15. Mobile robotics research at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Morse, W.D.

    1998-09-01

    Sandia is a National Security Laboratory providing scientific and engineering solutions to meet national needs for both government and industry. As part of this mission, the Intelligent Systems and Robotics Center conducts research and development in robotics and intelligent machine technologies. An overview of Sandia`s mobile robotics research is provided. Recent achievements and future directions in the areas of coordinated mobile manipulation, small smart machines, world modeling, and special application robots are presented.

  16. Sandia National Laboratories: What Sandia Looks For In Our Suppliers

    Science.gov (United States)

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  17. Sandia Agile MEMS Prototyping, Layout Tools, Education and Services Program

    Energy Technology Data Exchange (ETDEWEB)

    Schriner, H.; Davies, B.; Sniegowski, J.; Rodgers, M.S.; Allen, J.; Shepard, C.

    1998-05-01

    Research and development in the design and manufacture of Microelectromechanical Systems (MEMS) is growing at an enormous rate. Advances in MEMS design tools and fabrication processes at Sandia National Laboratories` Microelectronics Development Laboratory (MDL) have broadened the scope of MEMS applications that can be designed and manufactured for both military and commercial use. As improvements in micromachining fabrication technologies continue to be made, MEMS designs can become more complex, thus opening the door to an even broader set of MEMS applications. In an effort to further research and development in MEMS design, fabrication, and application, Sandia National Laboratories has launched the Sandia Agile MEMS Prototyping, Layout Tools, Education and Services Program or SAMPLES program. The SAMPLES program offers potential partners interested in MEMS the opportunity to prototype an idea and produce hardware that can be used to sell a concept. The SAMPLES program provides education and training on Sandia`s design tools, analysis tools and fabrication process. New designers can participate in the SAMPLES program and design MEMS devices using Sandia`s design and analysis tools. As part of the SAMPLES program, participants` designs are fabricated using Sandia`s 4 level polycrystalline silicon surface micromachine technology fabrication process known as SUMMiT (Sandia Ultra-planar, Multi-level MEMS Technology). Furthermore, SAMPLES participants can also opt to obtain state of the art, post-fabrication services provided at Sandia such as release, packaging, reliability characterization, and failure analysis. This paper discusses the components of the SAMPLES program.

  18. Sandia Laboratories environment and safety programs

    International Nuclear Information System (INIS)

    Zak, B.D.; McGrath, P.E.; Trauth, C.A. Jr.

    1975-01-01

    Sandia, one of ERDA's largest laboratories, is primarily known for its extensive work in the nuclear weapons field. In recent years, however, Sandia's role has expanded to embrace sizeable programs in the energy, resource recovery, and the environment and safety fields. In this latter area, Sandia has programs which address nuclear, fossil fuel, and general environment and safety issues. Here we survey ongoing activities and describe in more detail aa few projects of particular interest. These range from a study of the impact of sealed disposal of radioactive wastes, through reactor safety and fossil fuel plume chemistry, to investigations of the composition and dynamics of the stratosphere

  19. A History of Building 828, Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, Rebecca

    1999-08-01

    This report documents the history of Building 828 in Sandia National Laboratories' Technical Area I. Building 828 was constructed in 1946 as a mechanical test laboratory for Los Alamos' Z-Division (later Sandia) as it moved to Sandia Base. The building has undergone significant remodeling over the years and has had a variety of occupants. The building was evaluated in compliance with the National Historic Preservation Act, but was not eligible for the National Register of Historic Places. Nevertheless, for many Labs employees, it was a symbol of Sandia's roots in World War II and the Manhattan Project.

  20. Tonopah test range - outpost of Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.

    1996-03-01

    Tonopah Test Range is a unique historic site. Established in 1957 by Sandia Corporation, Tonopah Test Range in Nevada provided an isolated place for the Atomic Energy Commission to test ballistics and non-nuclear features of atomic weapons. It served this and allied purposes well for nearly forty years, contributing immeasurably to a peaceful conclusion to the long arms race remembered as the Cold War. This report is a brief review of historical highlights at Tonopah Test Range. Sandia`s Los Lunas, Salton Sea, Kauai, and Edgewood testing ranges also receive abridged mention. Although Sandia`s test ranges are the subject, the central focus is on the people who managed and operated the range. Comments from historical figures are interspersed through the narrative to establish this perspective, and at the end a few observations concerning the range`s future are provided.

  1. Medicare Modernization Act (MMA) IRS Medicare Part D

    Data.gov (United States)

    Social Security Administration — SSA uses the Internal Revenue Service (IRS) information in determing the eligibility of Medicare recipients to receive subsidy payments for Medicare premiums. SSA...

  2. Building business from technology: The Sandia experience

    Energy Technology Data Exchange (ETDEWEB)

    Traylor, L.B.

    1995-07-01

    This paper describes New Ventures, a new initiative at Sandia National Laboratories that encourages the creation of new businesses based on laboratory technology as a timely, efficient means of technology transfer. Sandia`s New Ventures program has shown that a dedicated effort can produce significant results. In the three years prior to this program`s launch, just two ventures per year on average were created based on laboratory technology. By comparison, the New Ventures program has enabled 20 new ventures in its first nine months of full operation.

  3. Sandia National Laboratories: Locations: Kauai Test Facility

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community History Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Hiring Technology Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia

  4. Sandia National Laboratories: News: Publications: Annual Report

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Hiring Process Life at New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia Science & Technology

  5. Sandia National Laboratories: News: Publications: Strategic Plan

    Science.gov (United States)

    Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Involvement Leadership Mission Environmental Responsibility History Diversity Social Media Careers View All Small Business Assistance Program Sandia's Economic Impact Sandia Science & Technology Park © 2018

  6. Sandia National Laboratories: Employee & Retiree Resources: Emergency

    Science.gov (United States)

    Media Community Involvement Contribution Programs Volunteer Programs Education Programs Environmental & Figures Programs Nuclear Weapons About Nuclear Weapons Safety & Security Weapons Science & , twitter.com/SandiaLabs Sandia Kirtland Radio at 1640 AM Information regarding road conditions can be found at

  7. Results of the Medicare Health Support disease-management pilot program.

    Science.gov (United States)

    McCall, Nancy; Cromwell, Jerry

    2011-11-03

    In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

  8. Medicare Hospice Benefits

    Science.gov (United States)

    CENTERS for MEDICARE & MEDICAID SERVICES Medicare Hospice Benefits This official government booklet includes information about Medicare hospice benefits: Who’s eligible for hospice care What services are included in hospice care How ...

  9. Sandia National Laboratories analysis code data base

    Science.gov (United States)

    Peterson, C. W.

    1994-11-01

    Sandia National Laboratories' mission is to solve important problems in the areas of national defense, energy security, environmental integrity, and industrial technology. The laboratories' strategy for accomplishing this mission is to conduct research to provide an understanding of the important physical phenomena underlying any problem, and then to construct validated computational models of the phenomena which can be used as tools to solve the problem. In the course of implementing this strategy, Sandia's technical staff has produced a wide variety of numerical problem-solving tools which they use regularly in the design, analysis, performance prediction, and optimization of Sandia components, systems, and manufacturing processes. This report provides the relevant technical and accessibility data on the numerical codes used at Sandia, including information on the technical competency or capability area that each code addresses, code 'ownership' and release status, and references describing the physical models and numerical implementation.

  10. Sandia National Laboratories Institutional Plan: FY 1999-2004

    Energy Technology Data Exchange (ETDEWEB)

    Garber, D.P.

    1999-01-06

    This Institutional Plan is the most comprehensive yearly "snapshot" available of Sandia National Laboratories' major programs, facilities, human resources, and budget. The document also includes overviews of our missions, organization, capabilities, planning functions, milestones, and accomplishments. The document's purpose is to provide the above information to the US Department of Energy, key congressional committees, Sandia management, and other present and potential customers. Chapter 2 presents information about Sandia's mission and summarizes our recent revision of Sandia's Strategic Plan. Chapter 3 presents an overview of Sandia's strategic objectives, chapter 4 lists laboratory goals and milestones for FY 1999, and chapter 5 presents our accomplishments during FY 1998. Chapters 3 through 5 are organized around our eight strategic objectives. The four primary objectives cover nuclear weapons responsibilities, nonproliferation and materials control, energy and critical infrastructures, and emerging national security threats. The major programmatic initiatives are presented in chapter 7. However, the programmatic descriptions in chapter 6 and the Associated funding tables in chapter 9 continue to be presented by DOE Budget and Reporting Code, as in previous Sandia institutional plans. As an aid to the reader, the four primary strategic objectives in chapter 3 are cross-referenced to the program information in chapter 6.

  11. Sandia software guidelines: Software quality planning

    Energy Technology Data Exchange (ETDEWEB)

    1987-08-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. In consonance with the IEEE Standard for Software Quality Assurance Plans, this volume identifies procedures to follow in producing a Software Quality Assurance Plan for an organization or a project, and provides an example project SQA plan. 2 figs., 4 tabs.

  12. Connecting the physical and psychosocial space to Sandia's mission

    Energy Technology Data Exchange (ETDEWEB)

    Emmanuel, Glory Ruth [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Silva, Austin Ray [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-07-01

    Sandia Labs has corporate, lab-wide efforts to enhance the research environment as well as improve physical space. However, these two efforts are usually done in isolation. The integration of physical space design with the nurturing of what we call psychosocial space can foster more efficient and effective creativity, innovation, collaboration, and performance. This paper presents a brief literature review on how academia and industry are studying the integration of physical and psychosocial space and focuses on the efforts that we, the authors, have made to improve the research environment in the Cyber Engineering Research Lab (CERL), home to Group 1460. Interviews with subject matter experts from Silicon Valley and the University of New Mexico plus changes to actual spaces in CERL provided us with six lessons learned when integrating physical and psychosocial space. We describe these six key takeaways in hopes that Sandia will see this area as an evolving research capability that Sandia can both contribute to and benefit from.

  13. A brief history of Sandia's National security missions.

    Energy Technology Data Exchange (ETDEWEB)

    Drewien, Celeste A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); O' Canna, Myra Lynn [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Stikar, John Anthony. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-09-01

    To help members of the workforce understand what factors contribute to Sandia National Laboratories national security mission, the authors describe the evolution of Sandias core mission and its other mission components. The mission of Sandia first as a division of Los Alamos and later as Sandia Corporation underlies our core nuclear weapon mission of today. Sandias mission changed in 1963 and twice more in the 1970s. This report should help staff and management appreciate the need for mission evolution. A clear definition and communication of a consistent corporate mission statement is still needed.

  14. Medicare hospital spending per patient (Medicare Spending per Beneficiary) – Additional Decimal Places

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  15. Site environmental report for 2004 Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L. (Sandia National Laboratories, Livermore, CA)

    2005-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's (DOE) National Nuclear Security Administration. The DOE Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2004 was prepared in accordance with DOE Order 231.1A. The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2004. General site and environmental program information is also included.

  16. Site Environmental Report for 2007: Sandia National Laboratories, California

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L. [Sandia National Lab. (SNL-CA), Livermore, CA (United States). Environmental Management Dept.

    2008-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy’s National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2007 was prepared in accordance with DOE Order 231.1A (DOE 2004a). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2007. General site and environmental program information is also included.

  17. Site environmental report for 2008 Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2009-04-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2008 was prepared in accordance with DOE Order 231.1A (DOE 2004a). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2008. General site and environmental program information is also included.

  18. Site environmental report for 2006 Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2007-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2006 was prepared in accordance with DOE Order 231.1A (DOE 2004a). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2006. General site and environmental program information is also included.

  19. Site environmental report for 2005 Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2006-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's (DOE) National Nuclear Security Administration (NNSA). The DOE/NNSA Sandia Site Office (SSO) oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2005 was prepared in accordance with DOE Order 231.1A. The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2005. General site and environmental program information is also included.

  20. Site environmental report for 2003 Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2004-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's (DOE) National Nuclear Security Administration. The DOE Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2003 was prepared in accordance with DOE Order 231.1A. The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2003. General site and environmental program information is also included.

  1. Critical experiments at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Harms, G.A.; Ford, J.T.; Barber, A.D.

    2011-01-01

    Sandia National Laboratories (SNL) has conducted radiation effects testing for the Department of Energy (DOE) and other contractors supporting the DOE since the 1960's. Over this period, the research reactor facilities at Sandia have had a primary mission to provide appropriate nuclear radiation environments for radiation testing and qualification of electronic components and other devices. The current generation of reactors includes the Annular Core Research Reactor (ACRR), a water-moderated pool-type reactor, fueled by elements constructed from UO2-BeO ceramic fuel pellets, and the Sandia Pulse Reactor III (SPR-III), a bare metal fast burst reactor utilizing a uranium-molybdenum alloy fuel. The SPR-III is currently defueled. The SPR Facility (SPRF) has hosted a series of critical experiments. A purpose-built critical experiment was first operated at the SPRF in the late 1980's. This experiment, called the Space Nuclear Thermal Propulsion Critical Experiment (CX), was designed to explore the reactor physics of a nuclear thermal rocket motor. This experiment was fueled with highly-enriched uranium carbide fuel in annular water-moderated fuel elements. The experiment program was completed and the fuel for the experiment was moved off-site. A second critical experiment, the Burnup Credit Critical Experiment (BUCCX) was operated at Sandia in 2002. The critical assembly for this experiment was based on the assembly used in the CX modified to accommodate low-enriched pin-type fuel in water moderator. This experiment was designed as a platform in which the reactivity effects of specific fission product poisons could be measured. Experiments were carried out on rhodium, an important fission product poison. The fuel and assembly hardware for the BUCCX remains at Sandia and is available for future experimentation. The critical experiment currently in operation at the SPRF is the Seven Percent Critical Experiment (7uPCX). This experiment is designed to provide benchmark

  2. Critical experiments at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Harms, G.A.; Ford, J.T.; Barber, A.D., E-mail: gaharms@sandia.gov [Sandia National Laboratories, Albuquerque, NM (United States)

    2011-07-01

    Sandia National Laboratories (SNL) has conducted radiation effects testing for the Department of Energy (DOE) and other contractors supporting the DOE since the 1960's. Over this period, the research reactor facilities at Sandia have had a primary mission to provide appropriate nuclear radiation environments for radiation testing and qualification of electronic components and other devices. The current generation of reactors includes the Annular Core Research Reactor (ACRR), a water-moderated pool-type reactor, fueled by elements constructed from UO2-BeO ceramic fuel pellets, and the Sandia Pulse Reactor III (SPR-III), a bare metal fast burst reactor utilizing a uranium-molybdenum alloy fuel. The SPR-III is currently defueled. The SPR Facility (SPRF) has hosted a series of critical experiments. A purpose-built critical experiment was first operated at the SPRF in the late 1980's. This experiment, called the Space Nuclear Thermal Propulsion Critical Experiment (CX), was designed to explore the reactor physics of a nuclear thermal rocket motor. This experiment was fueled with highly-enriched uranium carbide fuel in annular water-moderated fuel elements. The experiment program was completed and the fuel for the experiment was moved off-site. A second critical experiment, the Burnup Credit Critical Experiment (BUCCX) was operated at Sandia in 2002. The critical assembly for this experiment was based on the assembly used in the CX modified to accommodate low-enriched pin-type fuel in water moderator. This experiment was designed as a platform in which the reactivity effects of specific fission product poisons could be measured. Experiments were carried out on rhodium, an important fission product poison. The fuel and assembly hardware for the BUCCX remains at Sandia and is available for future experimentation. The critical experiment currently in operation at the SPRF is the Seven Percent Critical Experiment (7uPCX). This experiment is designed to provide

  3. Your Medicare Benefits

    Science.gov (United States)

    ... schedule a lung cancer screening counseling and shared decision making visit with your doctor to discuss the benefits ... when they’re available in your MyMedicare.gov account. 58 Section 3: For more information Visit Medicare. gov for general information about Medicare ...

  4. Energy technologies at Sandia National Laboratories: Past, Present, Future

    Energy Technology Data Exchange (ETDEWEB)

    1989-08-01

    We at Sandia first became involved with developing energy technology when the nation initiated its push toward energy independence in the early 1970s. That involvement continues to be strong. In shaping Sandia's energy programs for the 1990s, we will build on our track record from the 70s and 80s, a record outlined in this publication. It contains reprints of three issues of Sandia's Lab News that were devoted to our non-nuclear energy programs. Together, they summarize the history, current activities, and future of Sandia's diverse energy concerns; hence my desire to see them in one volume. Written in the fall of 1988, the articles cover Sandia's extremely broad range of energy technologies -- coal, oil and gas, geothermal, solar thermal, photovoltaics, wind, rechargeable batteries, and combustion.

  5. Sandia National Laboratories: News: Media Resources: Media Contacts

    Science.gov (United States)

    Foundations Bioscience Computing & Information Science Electromagnetics Engineering Science Geoscience computing, modeling and simulation and nanotechnology. Contact: (505) 845-7078; nsinger@sandia.gov Kristen specialist at Sandia/California. She covers biological and engineering sciences, homeland security and

  6. Teamwork and diversity: A survey at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Apodaca, T.; Berman, M.; Griego, C.; Jansma, R.; Leatherwood, M.; Lovato, L.; Sanchez, A.

    1995-11-01

    In September, 1994, Sandia`s Diversity Leadership and Education Outreach Center arid the Corporate Diversity Team commissioned a Diversity Action Team (DAT-Phase II) to address the area of team- work. The goal of this DAT was to identify ways to capitalize on the diversity of people to enhance team success at Sandia. Given a six- month lifetime and funding levels of 12 hours per person per month, we chose to accomplish our goal by gathering and analyzing data on the performance and diversity of Sandia teams and publishing this report of our findings. The work presented herein builds on earlier work of this team.

  7. SAPLE: Sandia Advanced Personnel Locator Engine.

    Energy Technology Data Exchange (ETDEWEB)

    Procopio, Michael J.

    2010-04-01

    We present the Sandia Advanced Personnel Locator Engine (SAPLE) web application, a directory search application for use by Sandia National Laboratories personnel. SAPLE's purpose is to return Sandia personnel 'results' as a function of user search queries, with its mission to make it easier and faster to find people at Sandia. To accomplish this, SAPLE breaks from more traditional directory application approaches by aiming to return the correct set of results while placing minimal constraints on the user's query. Two key features form the core of SAPLE: advanced search query interpretation and inexact string matching. SAPLE's query interpretation permits the user to perform compound queries when typing into a single search field; where able, SAPLE infers the type of field that the user intends to search on based on the value of the search term. SAPLE's inexact string matching feature yields a high-quality ranking of personnel search results even when there are no exact matches to the user's query. This paper explores these two key features, describing in detail the architecture and operation of SAPLE. Finally, an extensive analysis on logged search query data taken from an 11-week sample period is presented.

  8. Cognition, Health Literacy, and Actual and Perceived Medicare Knowledge Among Inner-City Medicare Beneficiaries.

    Science.gov (United States)

    Sivakumar, Haran; Hanoch, Yaniv; Barnes, Andrew J; Federman, Alex D

    2016-01-01

    Poor Medicare knowledge is associated with worse health outcomes, especially in low-income patients. We examined the association of health literacy and cognition with actual and perceived Medicare knowledge in a sample of inner-city older adults. We conducted a cross-sectional analysis of data on 336 adults ages 65 years and older with Medicare coverage recruited from senior centers and low-income housing facilities in Manhattan, New York. Actual Medicare knowledge was determined by a summary score of 9 true/false questions about the Medicare program and perceived Medicare knowledge with a single item. Validated measures were used to assess health literacy and general cognition. Among respondents, 63.1% had high actual Medicare knowledge, and 36.0% believed that they knew what they needed to know about Medicare. Actual and perceived Medicare knowledge were poorly correlated (r = -.01, p > .05). In multivariable models, low health literacy was significantly associated with actual Medicare knowledge (β = -8.30, SE = 2.71, p information about the Medicare program and diminish their ability to make fully informed choices.

  9. Sandia WIPP calibration traceability

    Energy Technology Data Exchange (ETDEWEB)

    Schuhen, M.D. [Sandia National Labs., Albuquerque, NM (United States); Dean, T.A. [RE/SPEC, Inc., Albuquerque, NM (United States)

    1996-05-01

    This report summarizes the work performed to establish calibration traceability for the instrumentation used by Sandia National Laboratories at the Waste Isolation Pilot Plant (WIPP) during testing from 1980-1985. Identifying the calibration traceability is an important part of establishing a pedigree for the data and is part of the qualification of existing data. In general, the requirement states that the calibration of Measuring and Test equipment must have a valid relationship to nationally recognized standards or the basis for the calibration must be documented. Sandia recognized that just establishing calibration traceability would not necessarily mean that all QA requirements were met during the certification of test instrumentation. To address this concern, the assessment was expanded to include various activities.

  10. Sandia WIPP calibration traceability

    International Nuclear Information System (INIS)

    Schuhen, M.D.; Dean, T.A.

    1996-05-01

    This report summarizes the work performed to establish calibration traceability for the instrumentation used by Sandia National Laboratories at the Waste Isolation Pilot Plant (WIPP) during testing from 1980-1985. Identifying the calibration traceability is an important part of establishing a pedigree for the data and is part of the qualification of existing data. In general, the requirement states that the calibration of Measuring and Test equipment must have a valid relationship to nationally recognized standards or the basis for the calibration must be documented. Sandia recognized that just establishing calibration traceability would not necessarily mean that all QA requirements were met during the certification of test instrumentation. To address this concern, the assessment was expanded to include various activities

  11. Medicare and Medicaid fraud and abuse regulations.

    Science.gov (United States)

    Liang, F Z; Black, B L

    1991-11-01

    Specific business arrangements that are protected under legislation and regulations governing parties doing business with Medicare or Medicaid are discussed. Regulations implementing the Medicare and Medicaid Patient Protection Act of 1987 specify practices and activities that are not subject to criminal penalties under the antikickback provisions of the Social Security Act or to exclusion from Medicare or state health-care programs. As of July 29, 1991, all organized health-care settings that receive payments from either Medicare or state health-care programs must comply with these regulations. The final rule sets forth "safe harbors"--exceptions to prohibitions against (1) kickbacks, bribes, rebates, and other illegal activities involving remunerations for patient referrals and (2) inducements to purchase or lease goods paid for by Medicare or state health-care programs. The safe harbors comprise 11 broad categories--investment interests, space rental, equipment rental, personal services and management contracts, purchase of a medical practice, referral services, warranties, discounts, employees, group purchasing organizations, and waiver of deductibles and coinsurance. Implications for pharmacy are discussed. These regulations will affect the purchase of pharmaceuticals by institutional pharmacies. Each institution should review its current practices to determine whether they are within the safe harbors.

  12. Sandia National Laboratories: Strategic Partnership Projects, Non-Federal

    Science.gov (United States)

    Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Hiring Process Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia Science & interest Menu Search Icon Locations Contact Us Employee Locator Search Menu About Leadership Mission Social

  13. Medicare Appeals Council Decisions

    Data.gov (United States)

    U.S. Department of Health & Human Services — Decisions of the Departmental Appeals Board's Medicare Appeals Council involving claims for entitlement to Medicare and individual claims for Medicare coverage and...

  14. Sandia software guidelines, Volume 4: Configuration management

    Energy Technology Data Exchange (ETDEWEB)

    1992-06-01

    This volume is one in a series of Sandia Software Guidelines for use in producing quality software within Sandia National Laboratories. This volume is based on the IEEE standard and guide for software configuration management. The basic concepts and detailed guidance on implementation of these concepts are discussed for several software project types. Example planning documents for both projects and organizations are included.

  15. Programmable SAW development :Sandia/NASA project final report.

    Energy Technology Data Exchange (ETDEWEB)

    Brocato, Robert Wesley

    2004-10-01

    This report describes a project to develop both fixed and programmable surface acoustic wave (SAW) correlators for use in a low power space communication network. This work was funded by NASA at Sandia National Laboratories for fiscal years 2004, 2003, and the final part of 2002. The role of Sandia was to develop the SAW correlator component, although additional work pertaining to use of the component in a system and system optimization was also done at Sandia. The potential of SAW correlator-based communication systems, the design and fabrication of SAW correlators, and general system utilization of those correlators are discussed here.

  16. Sandia National Laboratories: Agreements

    Science.gov (United States)

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  17. Power supplies for space systems quality assurance by Sandia Laboratories

    International Nuclear Information System (INIS)

    Hannigan, R.L.; Harnar, R.R.

    1976-07-01

    The Sandia Laboratories' participation in Quality Assurance programs for Radioisotopic Thermoelectric Generators which have been used in space systems over the past 10 years is summarized. Basic elements of this QA program are briefly described and recognition of assistance from other Sandia organizations is included. Descriptions of the various systems for which Sandia has had the QA responsibility are presented, including SNAP 19 (Nimbus, Pioneer, Viking), SNAP 27 (Apollo), Transit, Multi-Hundred Watt (LES 8/9 and MJS), and a new program, High-Performance Generator Mod 3. The outlook for Sandia participation in RTG programs for the next several years is noted

  18. Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs

    Science.gov (United States)

    Eggers, Paul W.; Prihoda, Ronald

    1982-01-01

    The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre

  19. Lessons learned from early microelectronics production at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, H.T.

    1998-02-01

    During the 1980s Sandia designed, developed, fabricated, tested, and delivered hundreds of thousands of radiation hardened Integrated Circuits (IC) for use in weapons and satellites. Initially, Sandia carried out all phases, design through delivery, so that development of next generation ICs and production of current generation circuits were carried out simultaneously. All this changed in the mid-eighties when an outside contractor was brought in to produce ICs that Sandia developed, in effect creating a crisp separation between development and production. This partnership had a severe impact on operations, but its more damaging effect was the degradation of Sandia`s microelectronics capabilities. This report outlines microelectronics development and production in the early eighties and summarizes the impact of changing to a separate contractor for production. This record suggests that low volume production be best accomplished within the development organization.

  20. A Sandia telephone database system

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, S.D.; Tolendino, L.F.

    1991-08-01

    Sandia National Laboratories, Albuquerque, may soon have more responsibility for the operation of its own telephone system. The processes that constitute providing telephone service can all be improved through the use of a central data information system. We studied these processes, determined the requirements for a database system, then designed the first stages of a system that meets our needs for work order handling, trouble reporting, and ISDN hardware assignments. The design was based on an extensive set of applications that have been used for five years to manage the Sandia secure data network. The system utilizes an Ingres database management system and is programmed using the Application-By-Forms tools.

  1. Medicare Provider Analysis and Review (MEDPAR)

    Data.gov (United States)

    U.S. Department of Health & Human Services — MEDPAR files contain information on Medicare beneficiaries using hospital inpatient services. The data is provided by the state and the Diagnosis Related Groups...

  2. Sandia National Laboratories: Pathfinder Radar ISR and Synthetic Aperture

    Science.gov (United States)

    Radar (SAR) Systems Sandia National Laboratories Exceptional service in the national interest ; Technology Defense Systems & Assessments About Defense Systems & Assessments Program Areas Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios

  3. MediCaring: development and test marketing of a supportive care benefit for older people.

    Science.gov (United States)

    Lynn, J; O'Connor, M A; Dulac, J D; Roach, M J; Ross, C S; Wasson, J H

    1999-09-01

    To develop an alternative healthcare benefit (called MediCaring) and to assess the preferences of older Medicare beneficiaries concerning this benefit, which emphasizes more home-based and supportive health care and discourages use of hospitalization and aggressive treatment. To evaluate the beneficiaries' ability to understand and make a choice regarding health insurance benefits; to measure their likelihood to change from traditional Medicare to the new MediCaring benefit; and to determine the short-term stability of that choice. Focus groups of persons aged 65+ and family members shaped the potential MediCaring benefit. A panel of 50 national experts critiqued three iterations of the benefit. The final version was test marketed by discussing it with 382 older people (men > or = 75 years and women > or = 80 years) in their homes. Telephone surveys a few days later, and again 1 month after the home interview, assessed the potential beneficiaries' understanding and preferences concerning MediCaring and the stability of their responses. Focus groups were held in community settings in New Hampshire, Washington, DC, Cleveland, OH, and Columbia, SC. Test marketing occurred in New Hampshire, Cleveland, OH; Columbia, SC, and Los Angeles, CA. Focus group participants were persons more than 65 years old (11 focus groups), healthcare providers (9 focus groups), and family decision-makers (3 focus groups). Participants in the in-home informing (test marketing group) were persons older than 75 years who were identified through contact with a variety of services. Demographics, health characteristics, understanding, and preferences. Focus group beneficiaries between the ages of 65 and 74 generally wanted access to all possible medical treatment and saw MediCaring as a need of persons older than themselves. Those older than age 80 were mostly in favor of it. Test marketing participants understood the key points of the new benefit: 74% generally liked it, and 34% said they would

  4. Sandia Software Guidelines, Volume 2. Documentation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    This volume is one in a series of Sandia Software Guidelines intended for use in producing quality software within Sandia National Laboratories. In consonance with the IEEE Standards for software documentation, this volume provides guidance in the selection of an adequate document set for a software project and example formats for many types of software documentation. A tutorial on life cycle documentation is also provided. Extended document thematic outlines and working examples of software documents are available on electronic media as an extension of this volume.

  5. Site Environmental Report for 2016 Sandia National Laboratories California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2017-06-01

    Sandia National Laboratories, California (SNL/CA) is a Department of Energy (DOE) facility. The management and operations of the facility are under a contract with the DOE’s National Nuclear Security Administration (NNSA). On May 1, 2017, the name of the management and operating contractor changed from Sandia Corporation to National Technology and Engineering Solutions of Sandia, LLC (NTESS). The DOE, NNSA, Sandia Field Office administers the contract and oversees contractor operations at the site. This Site Environmental Report for 2016 was prepared in accordance with DOE Order 231.1B, Environment, Safety and Health Reporting (DOE 2012). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2016, unless noted otherwise. General site and environmental program information is also included.

  6. Sandia capabilities for the measurement, characterization, and analysis of heliostats for CSP.

    Energy Technology Data Exchange (ETDEWEB)

    Andraka, Charles E.; Christian, Joshua Mark; Ghanbari, Cheryl M.; Gill, David Dennis; Ho, Clifford Kuofei; Kolb, William J.; Moss, Timothy A.; Smith, Edward J.; Yellowhair, Julius

    2013-07-01

    The Concentrating Solar Technologies Organization at Sandia National Laboratories has a long history of performing important research, development, and testing that has enabled the Concentrating Solar Power Industry to deploy full-scale power plants. Sandia continues to pursue innovative CSP concepts with the goal of reducing the cost of CSP while improving efficiency and performance. In this pursuit, Sandia has developed many tools for the analysis of CSP performance. The following capabilities document highlights Sandias extensive experience in the design, construction, and utilization of large-scale testing facilities for CSP and the tools that Sandia has created for the full characterization of heliostats. Sandia has extensive experience in using these tools to evaluate the performance of novel heliostat designs.

  7. 76 FR 21372 - Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions...

    Science.gov (United States)

    2011-04-15

    ...] Medicare Program; Solicitation for Proposals for the Medicare Community-Based Care Transitions Program... interested parties of an opportunity to apply to participate in the Medicare Community-based Care Transitions.... 111-148, enacted on March 23, 2010) (Affordable Care Act) authorized the Medicare Community-based Care...

  8. Medicare 1144 Outreach

    Data.gov (United States)

    Social Security Administration — The purpose of this exchange is to identify any Medicare beneficiary who may be eligible for Medicare cost sharing under the Medicaid program, notify these potential...

  9. Medicare Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. The cost report contains provider...

  10. Medicare program; Medicare depreciation, useful life guidelines--HCFA. Final rule.

    Science.gov (United States)

    1983-08-18

    These final rules amend Medicare regulations to clarify which useful life guidelines may be used by providers of health care services to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize the Departmental useful life guidelines or, if none have been published by the Department, either the American Hospital Association (AHA) useful life guidelines of 1973 of IRS guidelines. We are eliminating the reference to IRS guidelines because these are now outdated for Medicare purposes since they have been rendered obsolete either by the IRS or by statutory change. We are also deleting the specific reference to the 1973 AHA guidelines since these guidelines are updated by the AHA periodically. In addition, we are clarifying that certain tax legislation on accelerated depreciation, passed by Congress, does not apply to the Medicare program.

  11. Sandia National Laboratories: Hydrogen Risk Assessment Models toolkit now

    Science.gov (United States)

    Icon Locations Contact Us Employee Locator Search Menu About Leadership Mission Social Media Community Responsibility History Diversity Social Media Careers View All Jobs Students & Postdocs Benefits & Perks Technology Deployment Centers New Mexico Small Business Assistance Program Sandia's Economic Impact Sandia

  12. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.

    Science.gov (United States)

    2016-11-15

    This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.

  13. Sandia Strehl Calculator Version 1.0

    Energy Technology Data Exchange (ETDEWEB)

    2017-12-05

    The Sandia Strehl Calculator is designed to calculate the Gibson and Lanni point spread function (PSF), Strehl ratio, and ensquared energy, allowing non-design immersion, coverslip, and sample layers. It also uses Abbe number calculations to determine the refractive index at specific wavelengths when given the refractive index at a different wavelength and the dispersion. The primary application of Sandia Strehl Calculator is to determine the theoretical impacts of using an optical microscope beyond its normal design parameters. Examples of non-design microscope usage include: a) using coverslips of non-design material b) coverslips of different thicknesses c) imaging deep into an aqueous sample with an immersion objective d) imaging a sample at 37 degrees. All of these changes can affect the imaging quality, sometimes profoundly, but are at the same time non-design conditions employed not infrequently. Rather than having to experimentally determine whether the changes will result in unacceptable image quality, Sandia Strehl Calculator uses existing optical theory to determine the approximate effect of the change, saving the need to perform experiments.

  14. Critical experiments at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Harms, Gary A.; Ford, John T.; Barber, Allison Delo

    2010-01-01

    Sandia National Laboratories (SNL) has conducted radiation effects testing for the Department of Energy (DOE) and other contractors supporting the DOE since the 1960's. Over this period, the research reactor facilities at Sandia have had a primary mission to provide appropriate nuclear radiation environments for radiation testing and qualification of electronic components and other devices. The current generation of reactors includes the Annular Core Research Reactor (ACRR), a water-moderated pool-type reactor, fueled by elements constructed from UO2-BeO ceramic fuel pellets, and the Sandia Pulse Reactor III (SPR-III), a bare metal fast burst reactor utilizing a uranium-molybdenum alloy fuel. The SPR-III is currently defueled. The SPR Facility (SPRF) has hosted a series of critical experiments. A purpose-built critical experiment was first operated at the SPRF in the late 1980's. This experiment, called the Space Nuclear Thermal Propulsion Critical Experiment (CX), was designed to explore the reactor physics of a nuclear thermal rocket motor. This experiment was fueled with highly-enriched uranium carbide fuel in annular water-moderated fuel elements. The experiment program was completed and the fuel for the experiment was moved off-site. A second critical experiment, the Burnup Credit Critical Experiment (BUCCX) was operated at Sandia in 2002. The critical assembly for this experiment was based on the assembly used in the CX modified to accommodate low-enriched pin-type fuel in water moderator. This experiment was designed as a platform in which the reactivity effects of specific fission product poisons could be measured. Experiments were carried out on rhodium, an important fission product poison. The fuel and assembly hardware for the BUCCX remains at Sandia and is available for future experimentation. The critical experiment currently in operation at the SPRF is the Seven Percent Critical Experiment (7uPCX). This experiment is designed to provide benchmark

  15. Transportation Energy - Sandia Energy

    Science.gov (United States)

    Energy Energy Secure & Sustainable Energy Future Search Icon Sandia Home Locations Contact Us Employee Locator Menu Stationary Power solar Energy Conversion Efficiency Increasing the amount of electricity produced from a given thermal energy input. Solar Energy Wind Energy Water Power Supercritical CO2

  16. Energy Research - Sandia Energy

    Science.gov (United States)

    Energy Energy Secure & Sustainable Energy Future Search Icon Sandia Home Locations Contact Us Employee Locator Menu Stationary Power solar Energy Conversion Efficiency Increasing the amount of electricity produced from a given thermal energy input. Solar Energy Wind Energy Water Power Supercritical CO2

  17. Energy - Sandia National Laboratories

    Science.gov (United States)

    Energy Energy Secure & Sustainable Energy Future Search Icon Sandia Home Locations Contact Us Employee Locator Menu Stationary Power solar Energy Conversion Efficiency Increasing the amount of electricity produced from a given thermal energy input. Solar Energy Wind Energy Water Power Supercritical CO2

  18. Functional and operational requirements document : building 1012, Battery and Energy Storage Device Test Facility, Sandia National Laboratories, New Mexico.

    Energy Technology Data Exchange (ETDEWEB)

    Johns, William H. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2013-11-01

    This report provides an overview of information, prior studies, and analyses relevant to the development of functional and operational requirements for electrochemical testing of batteries and energy storage devices carried out by Sandia Organization 2546, Advanced Power Sources R&D. Electrochemical operations for this group are scheduled to transition from Sandia Building 894 to a new Building located in Sandia TA-II referred to as Building 1012. This report also provides background on select design considerations and identifies the Safety Goals, Stakeholder Objectives, and Design Objectives required by the Sandia Design Team to develop the Performance Criteria necessary to the design of Building 1012. This document recognizes the Architecture-Engineering (A-E) Team as the primary design entity. Where safety considerations are identified, suggestions are provided to provide context for the corresponding operational requirement(s).

  19. 78 FR 43820 - Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare...

    Science.gov (United States)

    2013-07-22

    ... and 423 [CMS-4173-CN] RIN 0938-AR69 Medicare Program; Medical Loss Ratio Requirements for the Medicare... number of technical, typographical, and cross-referencing errors that are identified and corrected in the... Minimum Medical Loss Ratio, we made a typographical error in a section number. On page 31311, in Sec. 423...

  20. User's guide to the Sandia Mathematical Program Library at Livermore

    Energy Technology Data Exchange (ETDEWEB)

    Huddleston, R.E.; Jefferson, T.H.

    1976-03-01

    The Sandia Mathematical Program Library is a collection of general-purpose mathematical subroutines which are maintained within Sandia on a quick service basis. This document is intended to be a reference guide for using the library at Sandia Laboratories, Livermore. (auth)

  1. Sandia Laboratories technical capabilities: testing

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    The testing capabilities at Sandia Laboratories are characterized. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  2. New model for public participation at Sandia National Laboratories: What comes after environmental restoration?

    International Nuclear Information System (INIS)

    KEENER R, WILLIAM; BACA, STEPHEN S.; BACA, MAUREEN R.; STOTTS, AL; TOOPS, TAMI; WOLFF, THEODORE A.

    2000-01-01

    As the Sandia National Laboratories' Environmental Restoration (ER) project moves toward closure, the project's experiences--including a number of successes in the public participation arena--suggest it is time for a new, more interactive model for future government-citizen involvement. This model would strive to improve the quality of public interaction with the Department of Energy (DOE) and Sandia, by using subject-specific working groups and aiming for long-term trustful relationships with the community. It would make use of interactive techniques, fewer formal public forums, and a variety of polling and communication technologies to improve information gathering and exchange

  3. Assessments of the probabilities of aircraft impact with the Sandia Pulsed Reactor and Building 836, Sandia Laboratories, Albuquerque

    International Nuclear Information System (INIS)

    Biringer, B.E.

    1976-11-01

    This report documents a study of the annual probabilities of aircraft impact with the Sandia Pulsed Reactor (SPR) and Bldg. 836 at Sandia Laboratories, Albuquerque. The probability of aircraft impact into each structure was estimated using total yearly operations, effective structure area, structure location relative to air activity, and accident rate per kilometer. The estimated probability for an aircraft impact with SPR is 1.1 x 10 -4 per year; the estimated probability for impact with Bldg. 836 is 1.0 x 10 -3 per year

  4. PACE and the Medicare+Choice risk-adjusted payment model.

    Science.gov (United States)

    Temkin-Greener, H; Meiners, M R; Gruenberg, L

    2001-01-01

    This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.

  5. Medicare Hospital Spending Per Patient - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  6. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  7. Medicare Hospital Spending Per Patient - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  8. Sandia Laboratories technical capabilities: electronics

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    This report characterizes the electronics capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  9. 75 FR 78246 - Medicare Program; Re-Chartering of the Advisory Panel on Ambulatory Payment Classification (APC...

    Science.gov (United States)

    2010-12-15

    ...] Medicare Program; Re-Chartering of the Advisory Panel on Ambulatory Payment Classification (APC) Groups... announces the re-chartering of the Advisory Panel on Ambulatory Payment Classification (APC) Groups (the... (APC) groups and their associated weights established under the Medicare hospital Outpatient...

  10. Inside Sandia

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    Articles in this issue include ``Molten salt corrosion testing,`` ``Pulsed ion beams for thermal surface treatment: Improved corrosion, wear, and hardness properties at low cost,`` ``Unmasking hidden armaments: Superconducting gravity sensor could find underground weapons, bunkers,`` ``Charbroiled burgers, heterocyclic amines, and cancer: Molecular modeling identifies dangerous mutagens,`` ``Revolutionary airbag offers increased safety options,`` ``EcoSys{sup TM}: an expert system for `Green Design` ``, ``Sandia, salt, and oil: Labs` diagnostics and analysis help maintain vital US oil reserve,`` and ``Automated fixture design speeds development for prototypes and production``.

  11. 77 FR 29647 - Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education...

    Science.gov (United States)

    2012-05-18

    ...] Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education Demonstration... participate in the Medicare Graduate Nurse Education (GNE) Demonstration. DATES: Proposals will be considered...--(A) 1 or more applicable schools of nursing; and (B) 2 or more applicable non- hospital community...

  12. High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare.

    Science.gov (United States)

    Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N; Mor, Vincent

    2015-10-01

    Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Site environmental report for 2011. Sandia National Laboratories, California

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2012-05-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractoroperated laboratory. Sandia Corporation, a wholly-owned subsidiary of Lockheed Martin Corporation, manages and operates the laboratory for the Department of Energy’s National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office administers the contract and oversees contractor operations at the site. This Site Environmental Report for 2011 was prepared in accordance with DOE Order 231.1B, Environment, Safety and Health Reporting (DOE 2011d). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2011. General site and environmental program information is also included.

  14. Vibration control for precision manufacturing at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Hinnerichs, T.; Martinez, D.

    1995-01-01

    Sandia National Laboratories performs R and D in structural dynamics and vibration suppression for precision applications in weapon systems, space, underwater, transportation and civil structures. Over the last decade these efforts have expanded into the areas of active vibration control and ''smart'' structures and material systems. In addition, Sandia has focused major resources towards technology to support weapon product development and agile manufacturing capability for defense and industrial applications. This paper will briefly describe the structural dynamics modeling and verification process currently in place at Sandia that supports vibration control and some specific applications of these techniques to manufacturing in the areas of lithography, machine tools and flexible robotics

  15. Vibration control for precision manufacturing at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Hinnerichs, T.; Martinez, D. [Sandia National Labs., Albuquerque, NM (United States). Structural Dynamics and Vibration Control Dept.

    1995-04-01

    Sandia National Laboratories performs R and D in structural dynamics and vibration suppression for precision applications in weapon systems, space, underwater, transportation and civil structures. Over the last decade these efforts have expanded into the areas of active vibration control and ``smart`` structures and material systems. In addition, Sandia has focused major resources towards technology to support weapon product development and agile manufacturing capability for defense and industrial applications. This paper will briefly describe the structural dynamics modeling and verification process currently in place at Sandia that supports vibration control and some specific applications of these techniques to manufacturing in the areas of lithography, machine tools and flexible robotics.

  16. Site Environmental Report for 2012 Sandia National Laboratories California

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2013-05-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, manages and operates the laboratory for the Department of Energy’s National Nuclear Security Administration (NNSA). The NNSA Sandia Field Office administers the contract and oversees contractor operations at the site. This Site Environmental Report for 2012 was prepared in accordance with DOE Order 231.1B, Environment, Safety and Health Reporting (DOE 2011d). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2012. General site and environmental program information is also included.

  17. Market Assessment and Commercialization Strategy for the Radial Sandia Cooler

    Energy Technology Data Exchange (ETDEWEB)

    Goetzler, William [Navigant Consulting, Inc., Burlington, MA (United States); Shandross, Richard [Navigant Consulting, Inc., Burlington, MA (United States); Weintraub, Daniel [Navigant Consulting, Inc., Burlington, MA (United States); Young, Jim [Navigant Consulting, Inc., Burlington, MA (United States)

    2014-02-01

    This market assessment and commercialization report characterizes and assesses the market potential of the rotating heat exchanger technology developed at Sandia National Laboratories (SNL), known as the Radial Sandia Cooler. The RSC is a novel, motor-driven, rotating, finned heat exchanger technology. The RSC was evaluated for the residential, commercial, industrial, and transportation markets. Recommendations for commercialization were made based on assessments of the prototype RSC and the Sandia Cooler technology in general, as well as an in-depth analysis of the six most promising products for initial RSC commercialization.

  18. Sandia technology, Winter 1975--1976

    International Nuclear Information System (INIS)

    Weber, J.P.; Marcrum, L.S.

    1976-06-01

    Unclassified development activities at Sandia Laboratories are described. Information is included on rocket-powered aerial trolleys, material evaluation using a plasmajet, metal-hydride models, glass-ceramic tube insulators, ferroelectric ceramics, and systems to communicate with earth penetrators

  19. Pulsed power driven hohlraum research at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Leeper, R.J.; Alberts, T.E.; Allshouse, G.A.

    1996-01-01

    Three pulsed power driven hohlraum concepts are being investigated at Sandia for application to inertial fusion research. These hohlraums are driven by intense proton and Li ion beams as well as by two different types of z-pinch x-ray sources. Research on these hohlraum systems will continue on Sandia's PBFA II-Z facility

  20. Sandia Data Archive (SDA) file specifications

    Energy Technology Data Exchange (ETDEWEB)

    Dolan, Daniel H. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ao, Tommy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-02-01

    The Sandia Data Archive (SDA) format is a specific implementation of the HDF5 (Hierarchal Data Format version 5) standard. The format was developed for storing data in a universally accessible manner. SDA files may contain one or more data records, each associated with a distinct text label. Primitive records provide basic data storage, while compound records support more elaborate grouping. External records allow text/binary files to be carried inside an archive and later recovered. This report documents version 1.0 of the SDA standard. The information provided here is sufficient for reading from and writing to an archive. Although the format was original designed for use in MATLAB, broader use is encouraged.

  1. 1987 environmental monitoring report, Sandia National Laboratories, Livermore, California

    International Nuclear Information System (INIS)

    Devlin, T.K.

    1988-04-01

    Sandia National Labortories conduct various research activities related to Department of Energy interests which have the potential for release of hazardous materials or radionuclides to the environment. A strict environmental control program places maximum emphasis on limiting releases. The environmental monitoring program conducted by Lawrence Livermore National Laboratory and augmented by Sandia is designed to measure the performance of the environmental controls. The program includes analysis of air, water, soil, vegetation, sewer effluent, ground water, and foodstuffs for various toxic, hazardous, or radioactive materials. Based on these studies, the releases of materials of concern at Sandia during 1987 were well below applicable Department of Energy standards. 8 refs., 3 figs., 12 tabs

  2. Environmental monitoring report: Sandia Laboratories, 1976

    International Nuclear Information System (INIS)

    Simmons, T.N.

    1977-04-01

    Water and vegetation are monitored to determine Sandia Laboratories impact on the surrounding environment. Nonradioactive pollutants released are reported. Radioactive effluents are also reported and their person-rem contribution to the Albuquerque population is calculated. The environmental monitoring for calendar year 1976 shows that concentrations of radioactive materials in the Albuquerque area are typical of natural background for the area. An exception is a single onsite location where slightly abnormal uranium concentrations are expected. An estimated 0.044 person-rem Albuquerque area (80 km radius) population dose commitment results from calculated Sandia Laboratories releases. Over the same area 57,000 person-rem is accumulated from natural background. There were no measurable offsite radioactive effluent releases in CY 1976

  3. Technical review of the Sandia Laboratories' Particle Beam Fusion Program

    International Nuclear Information System (INIS)

    1979-01-01

    This report considers the technical aspects of Sandia Laboratories' Particle Beam Fusion Program and examines the program's initial goals, the progress made to date towards reaching those goals, and the future plans or methods of reaching those original or modified goals. A summary of Sandia Laboratories' effort, which seeks to demonstrate that high voltage pulsed power generated high-current electron or light ion beams can be used to ignite a deuterium or tritium pellet, is provided. A brief review and assessment of the Sandia Pulse Power Program is given. Several critical issues and summaries of the committee members' opinions are discussed

  4. Diagnosis-Based Risk Adjustment for Medicare Capitation Payments

    Science.gov (United States)

    Ellis, Randall P.; Pope, Gregory C.; Iezzoni, Lisa I.; Ayanian, John Z.; Bates, David W.; Burstin, Helen; Ash, Arlene S.

    1996-01-01

    Using 1991-92 data for a 5-percent Medicare sample, we develop, estimate, and evaluate risk-adjustment models that utilize diagnostic information from both inpatient and ambulatory claims to adjust payments for aged and disabled Medicare enrollees. Hierarchical coexisting conditions (HCC) models achieve greater explanatory power than diagnostic cost group (DCG) models by taking account of multiple coexisting medical conditions. Prospective models predict average costs of individuals with chronic conditions nearly as well as concurrent models. All models predict medical costs far more accurately than the current health maintenance organization (HMO) payment formula. PMID:10172666

  5. Nuclear energy related capabilities at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Pickering, Susan Y. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-02-01

    Sandia National Laboratories' technology solutions are depended on to solve national and global threats to peace and freedom. Through science and technology, people, infrastructure, and partnerships, part of Sandia's mission is to meet the national needs in the areas of energy, climate and infrastructure security. Within this mission to ensure clean, abundant, and affordable energy and water is the Nuclear Energy and Fuel Cycle Programs. The Nuclear Energy and Fuel Cycle Programs have a broad range of capabilities, with both physical facilities and intellectual expertise. These resources are brought to bear upon the key scientific and engineering challenges facing the nation and can be made available to address the research needs of others. Sandia can support the safe, secure, reliable, and sustainable use of nuclear power worldwide by incorporating state-of-the-art technologies in safety, security, nonproliferation, transportation, modeling, repository science, and system demonstrations.

  6. Energy Fact Sheets - Sandia Energy

    Science.gov (United States)

    Energy Energy Secure & Sustainable Energy Future Search Icon Sandia Home Locations Contact Us Employee Locator Menu Stationary Power solar Energy Conversion Efficiency Increasing the amount of electricity produced from a given thermal energy input. Solar Energy Wind Energy Water Power Supercritical CO2

  7. Sandia National Laboratories: Research: Biodefense

    Science.gov (United States)

    Energy Stationary Power Earth Science Transportation Energy Energy Research Global Security WMD knowledge to counter disease Sandia conducts research into how pathogens interact and subvert a host's immune response to develop the knowledge base needed to create new novel environmental detectors, medical

  8. Medicare Current Beneficiary Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Characteristics and Perceptions of the Medicare Population Data from the 2010 Medicare Current Beneficiary Survey is a series of source books based on the...

  9. Remediating the past and preparing for the future at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Sanders, T.L.

    1996-01-01

    Sandia National Laboratories is one of the nation's largest multiprogram research, development, test, and evaluation (RDT ampersand E) facilities, with headquarters in Albuquerque, New Mexico, a laboratory in Livermore, California, and a test range near Tonopah, Nevada. Smaller testing facilities are also operated at other locations. Established in 1945, Sandia is currently operated for the U.S. Department of Energy by Lockheed-Martin's energy and environment sector. Sandia's responsibility is research and development for national security programs in defense, energy, and environment, with primary emphasis on nuclear weapons research and development. This article describes Sandia's program of remedial action which aims to use technology to reduce costs of decommissioning and decontamination, positioning itself for future opportunities

  10. Sandia National Laboratories: Integrated Military Systems

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios ; Culture Work-Life Balance Special Programs Integrated Military Systems (IMS) Capabilities Facilities

  11. Sandia Laboratories technical capabilities: engineering analysis

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    This report characterizes the engineering analysis capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  12. The evolution of Interior Intrusion Detection Technology at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Graham, R.H.; Workhoven, R.M.

    1987-07-01

    Interior Intrusion Detection Technology began at Sandia National Laboratories (SNL) in 1975 as part of the Fixed Facilities Physical Protection Research and Development program sponsored by the US Department of Energy in connection with their nuclear safeguards effort. This paper describes the evolution of Interior Intrusion Detection Technology at Sandia National Laboratories from the beginning of the Interior Sensor Laboratory to the present. This Laboratory was established in 1976 to evaluate commercial interior intrusion sensors and to assist in site-specific intrusion detection system designs. Examples of special test techniques and new test equipment that were developed at the Lab are presented, including the Sandia Intruder Motion Simulator (SIMS), the Sensor and Environment Monitor (SEM), and the Sandia Interior Robot (SIR). We also discuss new sensors and unique sensor combinations developed when commercial sensors were unavailable and the future application of expert systems

  13. Medicare payment changes and physicians' incomes.

    Science.gov (United States)

    Weeks, William B; Wallace, Amy E

    2002-01-01

    An effort to control the physician portion of Medicare expenditures and to narrow the income gap between primary care and procedure-based physicians was effected through t he enactment of the Medicare Fee Schedule (MFS). To determine whether academic and private sector physicians' incomes had demonstrated changes consistent with payment changes, we collected income information from surveys of private sector physicians and academic physicians in six specialties: (1) family practice; (2) general internal medicine; (3) psychiatry; (4) general surgery; (5) radiology; and (6) anesthesiology. With the exception of general internal medicine, the anticipated changes in Medicare revenue were not closely associated with income changes in either the academic or private sector group. Academic physicians were underpaid, relative to their private sector counterparts, but modestly less so at the end of the period examined. Our findings suggest that using changes in payment schedules to change incomes in order to influence the attractiveness of different specialties, even with a very large payer, may be ineffective. Should academic incomes remain uncompetitive with private sector incomes, it may be increasingly difficult to persuade physicians to enter academic careers.

  14. Medicare and Rural Health

    Science.gov (United States)

    ... community has a significant impact on the local economy. In rural areas, Medicare reimbursement is a critical source of that healthcare spending, particularly since the higher percentage of elderly population in rural areas mean that Medicare accounts for ...

  15. Sandia Laboratories technical capabilities: systems analysis

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-06-01

    The systems analysis capabilities at Sandia Laboratories are summarized. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs. (U.S.)

  16. Sandia National Laboratories: Contact Us

    Science.gov (United States)

    Employment (VOE) - New Mexico and California Please submit your requests by fax OR email - not both. Fax Number: (505) 845-0097, ATTN: HR Records Email Address: HR-Records@sandia.gov HR Records' Hotline: (505 in Writing Requester's Contact Information: Requester's name, company name (if applicable), phone

  17. Statement of Work Electrical Energy Storage System Installation at Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Schenkman, Benjamin L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    Sandia is seeking to procure a 1 MWh energy storage system. It will be installed at the existing Energy Storage Test Pad, which is located at Sandia National Laboratories in Albuquerque, New Mexico. This energy storage system will be a daily operational system, but will also be used as a tool in our Research and development work. The system will be part of a showcase of Sandia distributed energy technologies viewed by many distinguished delegates.

  18. Sandia National Laboratories/New Mexico 1994 site environmental report. Summary pamphlet

    International Nuclear Information System (INIS)

    1995-01-01

    This document presents details of the environmental activities that occurred during 1994 at Sandia National Laboratories. Topics include: Background about Sandia; radiation facts; sources of radiation; environmental monitoring; discussion of radiation detectors; radioactive waste management; environmental restoration; and quality assurance

  19. Sandia National Laboratories/New Mexico 1994 site environmental report. Summary pamphlet

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This document presents details of the environmental activities that occurred during 1994 at Sandia National Laboratories. Topics include: Background about Sandia; radiation facts; sources of radiation; environmental monitoring; discussion of radiation detectors; radioactive waste management; environmental restoration; and quality assurance.

  20. HyMARC (Sandia) Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    Allendorf, Mark D. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Stavila, Vitalie [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Klebanoff, Leonard E. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Kolasinski, Robert [Sandia National Lab. (SNL-CA), Livermore, CA (United States); El Gabaly Marquez, Farid [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Zhou, Xiaowang [Sandia National Lab. (SNL-CA), Livermore, CA (United States); White, James Lawrence [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2017-07-01

    The Sandia HyMARC team continued its development of new synthetic, modeling, and diagnostic tools that are providing new insights into all major classes of storage materials, ranging from relatively simple systems such as PdHx and MgH2, to exceptionally complex ones, such as the metal borohydrides, as well as materials thought to be very well-understood, such as Ti-doped NaAlH4. This unprecedented suite of capabilities, capable of probing all relevant length scales within storage materials, is already having a significant impact, as they are now being used by both Seedling projects and collaborators at other laboratories within HyMARC. We expect this impact to grow as new Seedling projects begin and through collaborations with other scientists outside HyMARC. In the coming year, Sandia efforts will focus on the highest impact problems, in coordination with the other HyMARC National Laboratory partners, to provide the foundational science necessary to accelerate the discovery of new hydrogen storage materials.

  1. Sandia National Laboratories 1979 environmental monitoring report

    International Nuclear Information System (INIS)

    Simmons, T.N.

    1980-04-01

    Sandia National Laboratories in Albuquerque is located south of the city on two broad mesas. The local climate is arid continental. Radionuclides are released from five technical areas from the Laboratories' resarch activities. Sandia's environmental monitoring program searches for cesium-137, tritium, uranium, alpha emitters, and beta emitters in water, soil, air, and vegetation. No activity was found in public areas in excess of local background in 1979. The Albuquerque population receives only 0.076 person-rem (estimated) from airborne radioactive releases. While national security research is the laboratories' major responsibility, energy research is a major area of activity. Both these research areas cause radioactive releases

  2. Transuranic waste management at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Humphrey, Betty [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bland, Jesse John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2018-01-01

    This paper documents the history of the TRU program at Sandia, previous and current activities associated with TRU material and waste, interfaces with other TRU waste generator sites and the Waste Isolation Pilot Plan (WIPP), and paths forward for TRU material and waste. This document is a snapshot in time of the TRU program and should be updated as necessary, or when significant changes have occurred in the Sandia TRU program or in the TRU regulatory environment. This paper should serve as a roadmap to capture past TRU work so that efforts are not repeated and ground is not lost due to future inactivity and personnel changes.

  3. Sandia National Laboratories: Business Opportunities Website

    Science.gov (United States)

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  4. Environmental monitoring report, Sandia Laboratories 1975

    International Nuclear Information System (INIS)

    Holley, W.L.; Simmons, T.N.

    1976-04-01

    Water and vegetation are monitored to determine Sandia Laboratories impact on the surrounding environment. Nonradioactive pollutants released are reported. Radioactive effluents are also reported and their person-rem contribution to the population is calculated

  5. 1992 Environmental monitoring report, Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Culp, T.; Cox, W.; Hwang, H.; Irwin, M.; Jones, A.; Matz, B.; Molley, K.; Rhodes, W.; Stermer, D.; Wolff, T.

    1993-09-01

    This 1992 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, envirorunental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque, New Mexico, are included. The maximum offsite dose impact was calculated to be 0.0034 millirem. The total population within a 50-mile radius of Sandia National Laboratories/New Mexico received an estimated collective dose of 0.019 person-rem during 1992 from the laboratories' operations. As in the previous year, the 1992 operations at Sandia National Laboratories/New Mexico had no discernible impact on the general public or on the environment

  6. Installation and Testing Instructions for the Sandia Automatic Report Generator (ARG).

    Energy Technology Data Exchange (ETDEWEB)

    Clay, Robert L.

    2018-04-01

    Robert L. CLAY Sandia National Laboratories P.O. Box 969 Livermore, CA 94551, U.S.A. rlclay@sandia.gov In this report, we provide detailed and reproducible installation instructions of the Automatic Report Generator (ARG), for both Linux and macOS target platforms.

  7. Medicare program; clarification of Medicare's accrual basis of accounting policy--HCFA. Final rule.

    Science.gov (United States)

    1995-06-27

    This final rule revises the Medicare regulations to clarify the concept of "accrual basis of accounting" to indicate that expenses must be incurred by a provider of health care services before Medicare will pay its share of those expenses. This rule does not signify a change in policy but, rather, incorporates into the regulations Medicare's longstanding policy regarding the circumstances under which we recognize, for the purposes of program payment, a provider's claim for costs for which it has not actually expended funds during the current cost reporting period.

  8. An analysis of microsystems development at Sandia National Laboratories

    Science.gov (United States)

    Herrera, Gilbert V.; Myers, David R.

    2011-06-01

    While Sandia initially was motivated to investigate emergent microsystem technology to miniaturize existing macroscale structures, present designs embody innovative approaches that directly exploit the fundamentally different material properties of a new technology at the micro- and nano-scale. Direct, hands-on experience with the emerging technology gave Sandia engineers insights that not only guided the evolution of the technology but also enabled them to address new applications that enlarged the customer base for the new technology. Sandia's early commitment to develop complex microsystems demonstrated the advantages that early adopters gain by developing an extensive design and process tool kit and a shared awareness of multiple approaches to achieve the multiple goals. As with any emergent technology, Sandia's program benefited from interactions with the larger technical community. However, custom development followed a spiral path of direct trial-and-error experience, analysis, quantification of materials properties at the micro- and nano-scale, evolution of design tools and process recipes, and an understanding of reliability factors and failure mechanisms even in extreme environments. The microsystems capability at Sandia relied on three key elements. The first was people: a mix of mechanical and semiconductor engineers, chemists, physical scientists, designers, and numerical analysts. The second was a unique facility that enabled the development of custom technologies without contaminating mainline product deliveries. The third was the arrival of specialized equipment as part of a Cooperative Research And Development Agreement (CRADA) enabled by the National Competitiveness Technology Transfer Act of 1989. Underpinning all these, the program was guided and sustained through the research and development phases by accomplishing intermediate milestones addressing direct mission needs.

  9. Isotopic power supplies for space and terrestrial systems: quality assurance by Sandia National Laboratories

    International Nuclear Information System (INIS)

    Hannigan, R.L.; Harnar, R.R.

    1981-09-01

    The Sandia National Laboratories participation in Quality Assurance (QA) programs for Radioisotopic Thermoelectric Generators which have been used in space and terrestrial systems over the past 15 years is summarized. Basic elements of the program are briefly described and recognition of assistance from other Sandia organizations is included. Descriptions of the various systems for which Sandia has had the QA responsibility are also presented. In addition, the outlook for Sandia participation in RTG programs for the next several years is noted

  10. The evolution of interior intrusion detection technology at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Graham, R.H.; Workhoven, R.M.

    1987-07-01

    Interior Intrusion Detection Technology began at Sandia National Laboratories (SNL) in 1975 as part of the Fixed Facilities Physical Protection Research and Development program sponsored by the US Department of Energy in connection with their nuclear safeguards effort. This paper describes the evolution of Interior Intrusion Detection Technology at Sandia National Laboratories from the beginning of the Interior Sensor Laboratory to the present. This Laboratory was established in 1976 to evaluate commercial interior intrusion sensors and to assist in site-specific intrusion detection system designs. Examples of special test techniques and new test equipment that were developed at the Lab are presented, including the Sandia Intruder Motion Simulator (SIMS), the Sensor and Environment Monitor (SEM), and the Sandia Interior Robot (SIR). We also discuss new sensors and unique sensor combination developed when commercial sensors were unavailable and the future application of expert systems. 5 refs

  11. The evolution of interior intrusion detection technology at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Graham, R.H.; Workhoven, R.M.

    1987-01-01

    Interior Intrusion Detection Technology began at Sandia National Laboratories (SNL) in 1975 as part of the Fixed Facilities Physical Protection Research and Development program sponsored by the U.S. Department of Energy in connection with their nuclear safeguards effort. This paper describes the evolution of Interior Intrusion Detection Technology at Sandia National Laboratories from the beginning of the Interior Sensor Laboratory to the present. This Laboratory was established in 1976 to evaluate commercial interior intrusion sensors and to assist in site-specific intrusion detection system designs. Examples of special test techniques and new test equipment that were developed at the Lab are presented, including the Sandia Intruder Motion Simulator (SIMS), the Sensor and Environment Monitor (SEM), and the Sandia Interior Robot (SIR). The authors also discuss new sensors and unique sensor combinations developed when commercial sensors were unavailable and the future application of expert systems

  12. Site environmental report for 2009 : Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2010-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2009 was prepared in accordance with DOE Order 231.1A (DOE 2004a). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2009. General site and environmental program information is also included. The Site Environmental Report is divided into ten chapters. Chapter 1, the Executive Summary, highlights compliance and monitoring results obtained in 2009. Chapter 2 provides a brief introduction to SNL/CA and the existing environment found on site. Chapter 3 summarizes SNL/CA's compliance activities with the major environmental requirements applicable to site operations. Chapter 4 presents information on environmental management, performance measures, and environmental programs. Chapter 5 presents the results of monitoring and surveillance activities in 2009. Chapter 6 discusses quality assurance. Chapters 7 through 9 provide supporting information for the report and Chapter 10 is the report distribution list.

  13. Micromachined sensor and actuator research at Sandia`s Microelectronics Development Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J.H.

    1996-11-01

    An overview of the surface micromachining program at the Microelectronics Development Laboratory of Sandia National Laboratories is presented. Development efforts are underway for a variety of surface micromachined sensors and actuators for both defense and commercial applications. A technology that embeds micromechanical devices below the surface of the wafer prior to microelectronics fabrication has been developed for integrating microelectronics with surface-micromachined micromechanical devices. The application of chemical-mechanical polishing to increase the manufacturability of micromechanical devices is also presented.

  14. 42 CFR 422.2276 - Employer group retiree marketing.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Employer group retiree marketing. 422.2276 Section 422.2276 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Medicare Advantage Marketing Requirements § 422.2276 Employer group retiree marketing. M...

  15. Patient casemix classification for medicare psychiatric prospective payment.

    Science.gov (United States)

    Drozd, Edward M; Cromwell, Jerry; Gage, Barbara; Maier, Jan; Greenwald, Leslie M; Goldman, Howard H

    2006-04-01

    For a proposed Medicare prospective payment system for inpatient psychiatric facility treatment, the authors developed a casemix classification to capture differences in patients' real daily resource use. Primary data on patient characteristics and daily time spent in various activities were collected in a survey of 696 patients from 40 inpatient psychiatric facilities. Survey data were combined with Medicare claims data to estimate intensity-adjusted daily cost. Classification and Regression Trees (CART) analysis of average daily routine and ancillary costs yielded several hierarchical classification groupings. Regression analysis was used to control for facility and day-of-stay effects in order to compare hierarchical models with models based on the recently proposed payment system of the Centers for Medicare & Medicaid Services. CART analysis identified a small set of patient characteristics strongly associated with higher daily costs, including age, psychiatric diagnosis, deficits in daily living activities, and detox or ECT use. A parsimonious, 16-group, fully interactive model that used five major DSM-IV categories and stratified by age, illness severity, deficits in daily living activities, dangerousness, and use of ECT explained 40% (out of a possible 76%) of daily cost variation not attributable to idiosyncratic daily changes within patients. A noninteractive model based on diagnosis-related groups, age, and medical comorbidity had explanatory power of only 32%. A regression model with 16 casemix groups restricted to using "appropriate" payment variables (i.e., those with clinical face validity and low administrative burden that are easily validated and provide proper care incentives) produced more efficient and equitable payments than did a noninteractive system based on diagnosis-related groups.

  16. State Policies Influence Medicare Telemedicine Utilization.

    Science.gov (United States)

    Neufeld, Jonathan D; Doarn, Charles R; Aly, Reem

    2016-01-01

    Medicare policy regarding telemedicine reimbursement has changed little since 2000. Many individual states, however, have added telemedicine reimbursement for either Medicaid and/or commercial payers over the same period. Because telemedicine programs must serve patients from all or most payers, it is likely that these state-level policy changes have significant impacts on telemedicine program viability and utilization of services from all payers, not just those services and payers affected directly by state policy. This report explores the impact of two significant state-level policy changes-one expanding Medicaid telemedicine coverage and the other introducing telemedicine parity for commercial payers-on Medicare utilization in the affected states. Medicare claims data from 2011-2013 were examined for states in the Great Lakes region. All valid claims for live interactive telemedicine professional fees were extracted and linked to their states of origin. Allowed encounters and expenditures were calculated in total and on a per 1,000 members per year basis to standardize against changes in the Medicare population by state and year. Medicare telemedicine encounters and professional fee expenditures grew sharply following changes in state Medicaid and commercial payer policy in the examined states. Medicare utilization in Illinois grew by 173% in 2012 (over 2011) following Medicaid coverage expansion, and Medicare utilization in Michigan grew by 118% in 2013 (over 2012) following adoption of telemedicine parity for commercial payers. By contrast, annual Medicare telemedicine utilization growth in surrounding states (in which there were no significant policy changes during these years) varied somewhat but showed no discernible pattern. Although Medicare telemedicine policy has changed little since its inception, changes in state policies with regard to telemedicine reimbursement appear to have significant impacts on the practical viability of telemedicine programs

  17. Summary of Sandia Laboratories technical capabilities

    International Nuclear Information System (INIS)

    1977-05-01

    The technical capabilities of Sandia Laboratories are detailed in a series of companion reports. In this summary the use of the capabilities in technical programs is outlined and the capabilities are summarized. 25 figures, 3 tables

  18. Annual Site Environmental Report Sandia National Laboratories, Albuquerque, New Mexico, Calendar year 2007

    Energy Technology Data Exchange (ETDEWEB)

    Agogino, Karen [National Nuclear Security Administration (NNSA), Washington, DC (United States); Sanchez, Rebecca [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2008-09-30

    Sandia National Laboratories, New Mexico (SNL/NM) is a government-owned/contractor-operated facility. Sandia Corporation (Sandia), a wholly owned subsidiary of Lockheed Martin Corporation, manages and operates the laboratory for the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA). The DOE/NNSA Sandia Site Office (SSO) administers the contract and oversees contractor operations at the site. This annual report summarizes data and the compliance status of Sandia Corporation’s environmental protection and monitoring programs through December 31, 2007. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention (P2), environmental restoration (ER), oil and chemical spill prevention, and implementation of the National Environmental Policy Act (NEPA). Environmental monitoring and surveillance programs are required by DOE Order 450.1, Environmental Protection Program (DOE 2007a) and DOE Manual 231.1-1A, Environment, Safety, and Health Reporting (DOE 2007).

  19. Sandia Combustion Research: Technical review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    This report contains reports from research programs conducted at the Sandia Combustion Research Facility. Research is presented under the following topics: laser based diagnostics; combustion chemistry; reacting flow; combustion in engines and commercial burners; coal combustion; and industrial processing. Individual projects were processed separately for entry onto the DOE databases.

  20. A case for Sandia investment in complex adaptive systems science and technology.

    Energy Technology Data Exchange (ETDEWEB)

    Colbaugh, Richard; Tsao, Jeffrey Yeenien; Johnson, Curtis Martin; Backus, George A.; Brown, Theresa Jean; Jones, Katherine A.

    2012-05-01

    This white paper makes a case for Sandia National Laboratories investments in complex adaptive systems science and technology (S&T) -- investments that could enable higher-value-added and more-robustly-engineered solutions to challenges of importance to Sandia's national security mission and to the nation. Complex adaptive systems are ubiquitous in Sandia's national security mission areas. We often ignore the adaptive complexity of these systems by narrowing our 'aperture of concern' to systems or subsystems with a limited range of function exposed to a limited range of environments over limited periods of time. But by widening our aperture of concern we could increase our impact considerably. To do so, the science and technology of complex adaptive systems must mature considerably. Despite an explosion of interest outside of Sandia, however, that science and technology is still in its youth. What has been missing is contact with real (rather than model) systems and real domain-area detail. With its center-of-gravity as an engineering laboratory, Sandia's has made considerable progress applying existing science and technology to real complex adaptive systems. It has focused much less, however, on advancing the science and technology itself. But its close contact with real systems and real domain-area detail represents a powerful strength with which to help complex adaptive systems science and technology mature. Sandia is thus both a prime beneficiary of, as well as potentially a prime contributor to, complex adaptive systems science and technology. Building a productive program in complex adaptive systems science and technology at Sandia will not be trivial, but a credible path can be envisioned: in the short run, continue to apply existing science and technology to real domain-area complex adaptive systems; in the medium run, jump-start the creation of new science and technology capability through Sandia's Laboratory Directed Research

  1. Medicare program; offset of Medicare payments to individuals to collect past-due obligations arising from breach of scholarship and loan contracts--HCFA. Final rule.

    Science.gov (United States)

    1992-05-04

    This final rule sets forth the procedures to be followed for collection of past-due amounts owed by individuals who breached contracts under certain scholarship and loan programs. The programs that would be affected are the National Health Service Corps Scholarship, the Physician Shortage Area Scholarship, and the Health Education Assistance Loan. These procedures would apply to those individuals who breached contracts under the scholarship and loan programs and who-- Accept Medicare assignment for services; Are employed by or affiliated with a provider, Health Maintenance Organization, or Competitive Medical Plan that receives Medicare payment for services; or Are members of a group practice that receives Medicare payment for services. This regulation implements section 1892 of the Social Security Act, as added by section 4052 of the Omnibus Budget Reconciliation Act of 1987.

  2. Sandia National Laboratories ASCI Applications Software Quality Engineering Practices; TOPICAL

    International Nuclear Information System (INIS)

    ZEPPER, JOHN D.; ARAGON, KATHRYN MARY; ELLIS, MOLLY A.; BYLE, KATHLEEN A.; EATON, DONNA SUE

    2002-01-01

    This document provides a guide to the deployment of the software verification activities, software engineering practices, and project management principles that guide the development of Accelerated Strategic Computing Initiative (ASCI) applications software at Sandia National Laboratories (Sandia). The goal of this document is to identify practices and activities that will foster the development of reliable and trusted products produced by the ASCI Applications program. Document contents include an explanation of the structure and purpose of the ASCI Quality Management Council, an overview of the software development lifecycle, an outline of the practices and activities that should be followed, and an assessment tool. These sections map practices and activities at Sandia to the ASCI Software Quality Engineering: Goals, Principles, and Guidelines, a Department of Energy document

  3. Calendar Year 2009 Annual Site Environmental Report for Sandia National Laboratories, New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Armstrong, Karen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bailey-White, Brenda [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bonaguidi, Joseph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brown, Mendy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Byrd, Caroline [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cabble, Kevin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Castillo, Dave [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Coplen, Amy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Curran, Kelsey [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Deola, Regina [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Duran, Leroy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Eckstein, Joanna [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Evelo, Stacie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Fitzgerald, Tanja [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); French, Chris [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gerard, Morgan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gonzales, Linda [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Gorman, Susan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jackson, Timothy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jarry, Jeff [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jones, Adrian [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lauffer, Franz [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mauser, Joseph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mayeux, Lucie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); McCord, Samuel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Miller, Mark [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Oborny, Stephanie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Perini, Robin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Puissant, Pamela [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reiser, Anita [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Roma, Charles [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Salinas, Stephanie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Skelly, Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ullrich, Rebecca [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wagner, Katrina [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wrons, Ralph [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2010-09-30

    Sandia National Laboratories, New Mexico (SNL/NM) is a government-owned/contractor operated facility. Sandia Corporation (Sandia), a wholly owned subsidiary of Lockheed Martin Corporation (LMC), manages and operates the laboratory for the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA). The DOE/NNSA, Sandia Site O ffice (SSO) administers the contract and oversees contractor operations at the site. This annual report summarizes data and the compliance status of Sandia Corporation’s environmental protection and monitoring programs through December 31, 2009. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention (P2), environmental restoration (ER), oil and chemical spill prevention, and implementation of the National Environmental Policy Act (NEPA). Environmental monitoring and surveillance programs are required by DOE Order 450.1A, Environmental Protection Program (DOE 2008a) and DOE Manual 231.1-1A, Environment, Safety, and Health Reporting (DOE 2007).

  4. Medicare Non-Utilization Project (MNUP)

    Data.gov (United States)

    Social Security Administration — A program integrity initiative using a data exchange between SSA and the Centers for Medicare and Medicaid Services (CMS).CMS will identify Medicare Part B enrollees...

  5. Medicare Administrative Contractor Performance Evaluation

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) has compiled a summary of overall Medicare Administrative Contractor (MAC) performance information as measured...

  6. Sandia National Laboratories Institutional Plan FY1994--1999

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    This report presents a five year plan for the laboratory. This plan takes advantage of the technical strengths of the lab and its staff to address issues of concern to the nation on a scope much broader than Sandia`s original mission, while maintaining the general integrity of the laboratory. The plan proposes initiatives in a number of technologies which overlap the needs of its customers and the strengths of its staff. They include: advanced manufacturing technology; electronics; information and computational technology; transportation energy technology and infrastructure; environmental technology; energy research and technology development; biomedical systems engineering; and post-cold war defense imperatives.

  7. Sandia National Laboratories: Careers: Special Programs

    Science.gov (United States)

    Program Master's Fellowship Program Wounded Warrior Career Development Program Careers Special Programs Special career opportunities for select individuals Join Sandia's workforce while receiving support and Laboratories' Affirmative Action Plan. Learn more about MFP. Wounded Warrior Career Development Program U.S

  8. Is expanding Medicare coverage cost-effective?

    Directory of Open Access Journals (Sweden)

    Muennig Peter

    2005-03-01

    Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

  9. Medicare and Medicaid Linked Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) has been developed to allow for the examination of all Medicare and Medicaid enrollment and...

  10. Medicare and Medicaid Research Review

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS), Office of Information Products and Data Analysis (OIPDA), is pleased to present our journal, Medicare and...

  11. NNSA Master Asset Map - Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Billie, Gepetta S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-01-01

    This report gives information on the following topics related to Sandia National Laboratories: site leadership's vision, condition, footprint management, major gaps and risks, and proposed investment plan.

  12. Medicare Managed Care plan Performance, A Comparison...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The study evaluates the performance of Medicare managed care, Medicare Advantage, Plans in comparison to Medicare fee-for-service Plans in three states with...

  13. Medicare Utilization for Part B

    Data.gov (United States)

    U.S. Department of Health & Human Services — This link takes you to the Medicare utilization statistics for Part B (Supplementary Medical Insurance SMI) which includes the Medicare Part B Physician and Supplier...

  14. 78 FR 75304 - Medicare Program; Medicare Secondary Payer and Certain Civil Money Penalties

    Science.gov (United States)

    2013-12-11

    ... [CMS-6061-ANPRM] RIN 0938-AR88 Medicare Program; Medicare Secondary Payer and Certain Civil Money... practices for which civil money penalties (CMPs) may or may not be imposed for failure to comply with...-3951. I. Background A. Imposition of Civil Money Penalties (CMPs) In 1981, the Congress added section...

  15. Medicare Utilization for Part A

    Data.gov (United States)

    U.S. Department of Health & Human Services — This link takes you to the Medicare utilization statistics for Part A (Hospital Insurance HI) which include the Medicare Ranking for all Short-Stay Hospitals by...

  16. Understanding Trends in Medicare Spending, 2007-2014.

    Science.gov (United States)

    Keohane, Laura M; Gambrel, Robert J; Freed, Salama S; Stevenson, David; Buntin, Melinda B

    2018-03-06

    To analyze the sources of per-beneficiary Medicare spending growth between 2007 and 2014, including the role of demographic characteristics, attributes of Medicare coverage, and chronic conditions. Individual-level Medicare spending and enrollment data. Using an Oaxaca-Blinder decomposition model, we analyzed whether changes in price-standardized, per-beneficiary Medicare Part A and B spending reflected changes in the composition of the Medicare population or changes in relative spending levels per person. We identified a 5 percent sample of fee-for-service Medicare beneficiaries age 65 and above from years 2007 to 2014. Mean payment-adjusted Medicare per-beneficiary spending decreased by $180 between the 2007-2010 and 2011-2014 time periods. This decline was almost entirely attributable to lower spending levels for beneficiaries. Notably, declines in marginal spending levels for beneficiaries with chronic conditions were associated with a $175 reduction in per-beneficiary spending. The decline was partially offset by the increasing prevalence of certain chronic diseases. Still, we are unable to attribute a large share of the decline in spending levels to observable beneficiary characteristics or chronic conditions. Declines in spending levels for Medicare beneficiaries with chronic conditions suggest that changing patterns of care use may be moderating spending growth. © Health Research and Educational Trust.

  17. Sandia National Laboratories: Research: Research Foundations: Engineering

    Science.gov (United States)

    Foundations Bioscience Computing & Information Science Electromagnetics Engineering Science Geoscience Mexico Small Business Assistance Program Sandia Science & Technology Park Careers Community Library Events Careers View All Jobs Students & Postdocs Internships & Co-ops Fellowships

  18. 77 FR 16841 - Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education...

    Science.gov (United States)

    2012-03-22

    ...] Medicare Program; Solicitation for Proposals for the Medicare Graduate Nurse Education Demonstration... Education (GNE) Demonstration. The primary goal of the GNE Demonstration is to increase the number of... schools of nursing; and (B) 2 or more applicable non-hospital community-based care settings. The written...

  19. Reductions in mortality among Medicare beneficiaries following the implementation of Medicare Part D.

    Science.gov (United States)

    Semilla, April P; Chen, Fang; Dall, Timothy M

    2015-07-01

    Medicare Part D is a prescription drug program that provides seniors and disabled individuals enrolled in Medicare with outpatient drug coverage benefits. Part D has been shown to increase access to medicines and improve medication adherence; however, the effect of Part D on health outcomes has not yet been extensively studied. In this study, we used a published and validated Markov-based microsimulation model to quantify the relationships among medication use, disease incidence and severity, and mortality. Based on the simulation results, we estimate that since the implementation of Part D in 2006, nearly 200,000 Medicare beneficiaries have lived at least 1 year longer. Reductions in mortality have occurred because of fewer deaths associated with medication-sensitive conditions such as diabetes, congestive heart failure, stroke, and myocardial infarction. Improved access to medication through Medicare Part D helps patients improve blood pressure, cholesterol, and blood glucose levels, which in turn can prevent or delay the onset of disease and the incidence of adverse health events, thus reducing mortality.

  20. Sandia's severe human body Electrostatic Discharge Tester (SSET)

    International Nuclear Information System (INIS)

    Barnum, J.R.

    1991-01-01

    This paper reports that the Electromagnetic Testing Division at Sandia National Laboratories (SNL) has developed a simulator to replicate a severe human body electrostatic discharge event. This simulator is referred to as Sandia's Severe Human Body Electrostatic Discharge Tester (SSET). The SSET is configured as a coaxial transmission line, which allows control of parasitic inductance and capacitance to achieve the desired waveform signature, and operates reliably at voltages up to 35 kV. It is constructed from off-the-shelf or easily fabricated components and costs approximately $750 for materials, not including the power supply. The output is very repeatable and provides good simulation fidelity of a severe human body discharge

  1. Evaluation of Strontium Selectivity by Sandia Octahedral Molecular Sieves (SOMS).

    Energy Technology Data Exchange (ETDEWEB)

    Rigali, Mark J.; Stewart, Thomas Austin

    2016-01-01

    Sandia National Laboratories has collaborated with Pleasanton Ridge Research Company (PRRC) to determine whether Sandia Octahedral Molecular Sieves (SOMS) and modified SOMs materials can be synthesized in large batches and produced in granular form. Sandia National Laboratories tested these SOMS and its variants based in aqueous chemical environments for an application-based evaluation of material performance as a sorbent. Testing focused primarily on determining the distribution coefficients (K d ) and chemical selectivity SOMs for alkali earth (Sr) ions in aqueous and dilute seawater solutions. In general the well-crystallized SOMS materials tested exhibited very high K d values (>10 6 ) in distilled water but K d values dropped substantially (%7E10 2 -10 3 ) in the dilute seawater (3%). However, one set of SOMS samples (1.4.2 and 1.4.6) provided by PRRC yielded relatively high K d (approaching 10 4 ) in dilute seawater. Further examination of these samples by scanning electron microscopy (SEM) revealed the presence of at least two phases at least one of which may be accounting for the improved K d values in dilute seawater. Evaluation of Strontium Selectivity by Sandia Octahedral Molecular Sieves (SOMS) January 20, 2016

  2. Trends in Medicare Service Volume for Cataract Surgery and the Impact of the Medicare Physician Fee Schedule.

    Science.gov (United States)

    Gong, Dan; Jun, Lin; Tsai, James C

    2017-08-01

    To calculate the associations between Medicare payment and service volume for complex and noncomplex cataract surgeries. The 2005-2009 CMS Part B National Summary Data Files, CMS Part B Carrier Summary Data Files, and the Medicare Physician Fee Schedule. Conducting a retrospective, longitudinal analysis using a fixed-effects model of Medicare Part B carriers representing all 50 states and the District of Columbia from 2005 to 2009, we calculated the Medicare payment-service volume elasticities for noncomplex (CPT 66984) and complex (CPT 66982) cataract surgeries. Service volume data were extracted from the CMS Part B National Summary and Carrier Summary Data Files. Payment data were extracted from the Medicare Physician Fee Schedule. From 2005 to 2009, the proportion of total cataract services billed as complex increased from 3.2 to 6.7 percent. Every 1 percent decrease in Medicare payment was associated with a nonsignificant change in noncomplex cataract service volume (elasticity = 0.15, 95 percent CI [-0.09, 0.38]) but a statistically significant increase in complex cataract service volume (elasticity = -1.12, 95 percent CI [-1.60, -0.63]). Reduced Medicare payment was associated with a significant increase in complex cataract service volume but not in noncomplex cataract service volume, resulting in a shift toward performing a greater proportion of complex cataract surgeries from 2005 to 2009. © Health Research and Educational Trust.

  3. This is Sandia

    Energy Technology Data Exchange (ETDEWEB)

    1995-02-01

    Sandia is a multiprogram engineering and science laboratory operated for the Department of Energy with major facilities at Albuquerque, New Mexico, and Livermore, California, and a test range near Tonapah, Nevada. It has major research and development responsibilities for nuclear weapons, arms control, energy, the environment, economic competitiveness, and other areas of importance to the needs of the nation. The principal mission is to support national defense policies by ensuring that the nuclear weapon stockpile meets the highest standards of safety, reliability, security, use control, and military performance. This publication gives a brief overview of the multifaceted research programs conducted by the laboratory.

  4. 2016 Annual Site Environmental Report Sandia National Laboratories/New Mexico.

    Energy Technology Data Exchange (ETDEWEB)

    Salas, Angela Maria [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Griffith, Stacy R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-07-01

    Sandia National Laboratories (SNL) is a multimission laboratory managed and operated by National Technology & Engineering Solutions of Sandia, LLC, a wholly owned subsidiary of Honeywell International Inc., for the U.S. Department of Energy’s (DOE’s), National Nuclear Security Administration (NNSA). The DOE/NNSA Sandia Field Office administers the contract and oversees contractor operations at SNL, New Mexico. This Annual Site Environmental Report (ASER) summarizes data and the compliance status of sustainability, environmental protection, and monitoring programs at SNL/NM during calendar year 2016. Major environmental programs include air quality, water quality, groundwater protection, terrestrial and ecological surveillance, waste management, pollution prevention, environmental restoration, oil and chemical spill prevention, and implementation of the National Environmental Policy Act. This ASER is prepared in accordance with and required by DOE O 231.1B, Admin Change 1, Environment, Safety, and Health Reporting.

  5. 1993 Site environmental report Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Culp, T.A.; Cheng, C.F.; Cox, W.; Durand, N.; Irwin, M.; Jones, A.; Lauffer, F.; Lincoln, M.; McClellan, Y.; Molley, K.

    1994-11-01

    This 1993 report contains monitoring data from routine radiological and nonradiological environmental surveillance activities. Summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, environmental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque, New Mexico, are included. The maximum offsite dose impact was calculated to be 0.0016 millirem. The total population within a 50-mile (80 kilometer) radius of Sandia National Laboratories/New Mexico received an estimated collective dose of 0.027 person-rem during 1993 from the laboratories operations, As in the previous year, the 1993 operations at Sandia National Laboratories/New Mexico had no discernible impact on the general public or on the environment. This report is prepared for the U.S. Department of Energy in compliance with DOE Order 5400.1

  6. Financial Performance of Rural Medicare ACOs.

    Science.gov (United States)

    Nattinger, Matthew C; Mueller, Keith; Ullrich, Fred; Zhu, Xi

    2018-12-01

    The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan. Of the ACOs reporting performance data, we identified 97 ACOs with a measurable rural presence. We found that successful rural ACO financial performance is associated with the ACO's organizational type (eg, physician-based) and that 8 of the 11 rural ACOs participating in the Advanced Payment Program (APP) garnered savings for Medicare. Unlike previous work, we did not find an association between ACO size or experience and rural ACO financial performance. Our findings suggest that rural ACO financial success is likely associated with factors unique to rural environments. Given the emphasis CMS has placed on rural ACO development, further research to identify these factors is warranted. © 2016 National Rural Health Association.

  7. Fusion by 1990: the Sandia ion beam program can do it

    International Nuclear Information System (INIS)

    Stevens, C.B.

    1985-01-01

    Recent experimental results at Sandia National Laboratories demonstrate that light ion beam accelerator devices can deliver considerably more than the power necessary for achieving high-gain fusion energy - millions of joules at power densities of 10,000 trillion watts/cm 2 . This means that commercial fusion energy with an inertial-confinement fusion device can be realized by the 1990s, despite the general curtailment of the US fusion research budget over the past eight years. Dr. J. Pace VanDevender, pulsed power sciences director at Sandia, and Professor Ravindra N. Sudan, director of the Cornell University Laboratory of Plasma Studies, discussed the experimental and theoretical advances underlying this happy prognosis at the April 17-19 conference at the Rochester University for Laser Energetics. Sudan showed that experiments with high-current ion beam pulses over the past decade have demonstrated that such pulses, instead of diffusing, tend to self-focus nonlinearly to higher power densities. Second, weak magnetic fields do not interact and change the trajectory of such high-current beam pulses. At the Rochester meeting, VanDevender reviewed experiments on Sandia's Proto I device in which 1.5 trillion watts per square centimeter were delivered to a target in May 1984. This spring, Sandia's Particle Beam Fusion Accelerator I, PBFA I, delivered an 8-trillion watt pulse onto a spot 4.0 to 4.5 millimeters in diameter. This demonstrated that the Sandia light ion beam focusing process maintains itself as the current is increased. 3 figures

  8. Sandia National Laboratories: News: Publications: Fact Sheets

    Science.gov (United States)

    Environmental Management System Pollution Prevention History 60 impacts Diversity Locations Facts & Figures Does Sandia Buy? Opportunities Small Business Procurement Technical Assistance Program (PTAP) Current Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for

  9. Improving Refill Adherence in Medicare Patients With Tailored and Interactive Mobile Text Messaging: Pilot Study

    Science.gov (United States)

    Jeong, Erwin W; Feger, Erin; Noble, Harmony K; Kmiec, Magdalen; Prayaga, Ram S

    2018-01-01

    Background Nonadherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a variety of reasons. Text message reminders have been used to improve adherence. However, few programs or studies have explored the benefits of text messaging with older populations and at scale. In this paper, we present a program design using tailored and interactive text messaging to improve refill rates of partially adherent or nonadherent Medicare members of a large integrated health plan. Objective The aim of this 3-month program was to gain an understanding of whether tailored interactive text message dialogues could be used to improve medication refills in Medicare patients with one or more chronic diseases. Methods We used the mPulse Mobile interactive text messaging solution with partially adherent and nonadherent Medicare patients (ie, over age 65 years or younger with disabilities) of Kaiser Permanente Southern California (KP), a large integrated health plan, and compared refill rates of the text messaging group (n=12,272) to a group of partially adherent or nonadherent Medicare patients at KP who did not receive text messages (nontext messaging group, n=76,068). Both groups were exposed to other forms of refill and adherence outreach including phone calls, secure emails, and robo-calls from December 2016 to February 2017. Results The text messaging group and nontext messaging group were compared using an independent samples t test to test difference in group average of refill rates. There was a significant difference in medication refill rates between the 2 groups, with a 14.07 percentage points higher refill rate in the text messaging group (Pimprove medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement

  10. Targets development at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Smith, M.L.; Hebron, D.; Derzon, M.; Olson, R.; Alberts, T.

    1997-01-01

    For many years, Sandia National Laboratories under contract to the Department of Energy has produced targets designed to understand complex ion beam and z-pinch plasma physics. This poster focuses on the features of target designs that make them suitable for Z-pinch plasma physics applications. Precision diagnostic targets will prove critical in understanding the plasma physics model needed for future ion beam and z-pinch design. Targets are designed to meet specific physics needs; in this case the authors have fabricated targets to maximize information about the end-on versus side-on x-ray emission and z-pinch hohlraum development. In this poster, they describe the fabrication and characterization techniques. They include discussion of current targets under development as well as target fabrication capabilities. Advanced target designs are fabricated by Sandia National Laboratories in cooperation with General Atomics of San Diego, CA and W.J. Schafer Associates, Inc. of Livermore, CA

  11. Sandia National Laboratories: Research: Research Foundations: Nanodevices

    Science.gov (United States)

    Technology Partnerships Business, Industry, & Non-Profits Government Universities Center for Mexico Small Business Assistance Program Sandia Science & Technology Park Careers Community support for research; technology advancement and maturation; and small-lot, fast-turn prototyping Our

  12. Medicare program; requirements for the Medicare incentive reward program and provider enrollment. Final rule.

    Science.gov (United States)

    2014-12-05

    This final rule implements various provider enrollment requirements. These include: Expanding the instances in which a felony conviction can serve as a basis for denial or revocation of a provider or supplier's enrollment; if certain criteria are met, enabling us to deny enrollment if the enrolling provider, supplier, or owner thereof had an ownership relationship with a previously enrolled provider or supplier that had a Medicare debt; enabling us to revoke Medicare billing privileges if we determine that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements; and limiting the ability of ambulance suppliers to "backbill" for services performed prior to enrollment.

  13. Access to Care for Medicare-Medicaid Dually Eligible Beneficiaries: The Role of State Medicaid Payment Policies.

    Science.gov (United States)

    Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian

    2017-12-01

    Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.

  14. Changes in initial expenditures for benign prostatic hyperplasia evaluation in the Medicare population: a comparison to overall Medicare inflation.

    Science.gov (United States)

    Bellinger, Adam S; Elliott, Sean P; Yang, Liu; Wei, John T; Saigal, Christopher S; Smith, Alexandria; Wilt, Timothy J; Strope, Seth A

    2012-05-01

    Benign prostatic hyperplasia creates significant expenses for the Medicare program. We determined expenditure trends for benign prostatic hyperplasia evaluative testing after urologist consultation and placed these trends in the context of overall Medicare expenditures. Using a 5% national sample of Medicare beneficiaries from 2000 to 2007 we developed a cohort of 40,253 with claims for new visits to urologists for diagnoses consistent with symptomatic benign prostatic hyperplasia. We assessed trends in initial inflation and geography adjusted expenditures within 12 months of diagnosis by evaluative test categories derived from the 2003 American Urological Association guideline on the management of benign prostatic hyperplasia. Using governmental reports on Medicare expenditure trends for benign prostatic hyperplasia we compared expenditures to overall and imaging specific Medicare expenditures. Comparisons were assessed by the Z-test and regression analysis for linear trends, as appropriate. Between 2000 and 2007 inflation adjusted total Medicare expenditures per patient for the initial evaluation of patients with benign prostatic hyperplasia seen by urologists increased from $255.44 to $343.98 (p inflation adjusted expenditures increased for benign prostatic hyperplasia related evaluations. This growth was slower than the overall growth in Medicare expenditures. The increase in BPH related imaging expenditures was restrained compared to that of the Medicare program as a whole. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Calendar year 2004 annual site environmental report:Sandia National Laboratories, Albuquerque, New Mexico.

    Energy Technology Data Exchange (ETDEWEB)

    Montoya, Amber L.; Goering, Teresa Lynn; Wagner, Katrina; Koss, Susan I.; Salinas, Stephanie A.

    2005-09-01

    Sandia National Laboratories, New Mexico (SNL/NM) is a government-owned, contractor-operated facility owned by the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA) and managed by the Sandia Site Office (SSO), Albuquerque, New Mexico. Sandia Corporation, a wholly-owned subsidiary of Lockheed Martin Corporation, operates SNL/NM. This annual report summarizes data and the compliance status of Sandia Corporation's environmental protection and monitoring programs through December 31, 2004. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention (P2), environmental restoration (ER), oil and chemical spill prevention, and the National Environmental Policy Act (NEPA). Environmental monitoring and surveillance programs are required by DOE Order 450.1, Environmental Protection Program (DOE 2005) and DOE Order 231.1A, Environment, Safety, and Health Reporting (DOE 2004a). (DOE 2004a).

  16. 42 CFR 423.2276 - Employer group retiree marketing.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Employer group retiree marketing. 423.2276 Section 423.2276 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Part D Marketing Requirements § 423.2276 Employer group retiree...

  17. Renewable energy technology development at Sandia National Laboratories

    Science.gov (United States)

    Klimas, P. C.

    1994-02-01

    The use of renewable energy technologies is typically thought of as an integral part of creating and sustaining an environment that maximizes the overall quality of life of the Earth's present inhabitants and does not leave an undue burden on future generations. Sandia National Laboratories has been a leader in developing many of these technologies over the last two decades. This paper describes innovative solar, wind and geothermal energy systems and components that Sandia is helping to bring to the marketplace. A common but special aspect of all of these activities is that they are conducted in partnership with non-federal government entities. A number of these partners are from New Mexico.

  18. Practice arrangement and medicare physician payment in otolaryngology.

    Science.gov (United States)

    Cracchiolo, Jennifer; Ridge, John A; Egleston, Brian; Lango, Miriam

    2015-06-01

    Medicare Part B physician payment indicates a cost to Medicare beneficiaries for a physician service and connotes physician clinical productivity. The objective of this study was to determine whether there was an association between practice arrangement and Medicare physician payment. Cross-sectional study. Medicare provider utilization and payment data. Otolaryngologists from 1 metropolitan area were included as part of a pilot study. A generalized linear model was used to determine the effect of practice-specific variables including patient volumes on physician payment. Of 67 otolaryngologists included, 23 (34%) provided services through an independent practice, while others were employed by 1 of 3 local academic centers. Median payment was $58,895 per physician for the year, although some physicians received substantially higher payments. Reimbursements to faculty at 1 academic department were higher than to those at other institutions or to independent practitioners. After adjustments were made for patient volumes, physician subspecialty, and gender, payments to each faculty at Hospital C were 2 times higher than to those at Hospital A (relative ratio [RR] 2.03; 95% CI, 1.27-3.27; P = .003); 2 times higher than to faculty at Hospital B (RR 2.04; 95% CI, 1.4-2.7; P = .0001); and 1.6 times higher than to independent practitioners (RR 1.6; 95% CI, 1.04-2.7; P = .03). Payments to physicians in the other groups were not significantly different. Differences in reimbursement corresponded to an emphasis on procedures over office visits but not Medicare case mix adjustments for patient discharges from associated institutions. Variation in the cost of academic otolaryngology care may be subject in part to institutional factors. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  19. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program. Final rule.

    Science.gov (United States)

    2017-11-15

    This major final rule addresses changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies such as changes to the Medicare Shared Savings Program, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. In addition, this final rule includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model.

  20. Long conduction time plasma opening switch experiments at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Savage, M.E.; Simpson, W.W.; Cooper, G.W.; Usher, M.A.

    1993-01-01

    Sandia National Laboratories has undertaken an ambitious program to reduce the size and cost of large pulsed power drivers. The program basis is inductive energy storage and Plasma Opening Switches (POS). Inductive energy storage has well known advantages, including increased efficiency and reduced stress on the vacuum interface. The Sandia approach is to retain the reliable and efficient Marx generator and the temporal pulse compression of the water dielectric capacitor. A triggered closing switch, developed at Sandia, transfers the capacitor charge into the energy storage inductor. This approach has several advantages, including relaxed requirements on Marx jitter and inductance, and much faster current risetime in the energy storage inductor. The POS itself is the key to the Sandia program. The switch design uses an auxiliary magnetic field to inject the plasma and hold it in place during conduction. After opening begins, the self magnetic field of the power pulse pushes on the plasma to increase the opened gap. The authors use magnetic pressure because they desire POS gaps of several cm. Typical plasma opening switches do not achieve large gaps. Improved opening allows more efficient transfer to loads. They present results from recent experiments at Sandia. Their driver presently supplies 650 kA with a 240 ns risetime to the input of the POS. The storage inductor is a 17 Ohm magnetically insulated transmission line (MITL) that is five meters long. They discuss the ways in which magnetic field influences the POS, and the ways in which they control the magnetic fields

  1. DESALINATION AND WATER TREATMENT RESEARCH AT SANDIA NATIONAL LABORATORIES.

    Energy Technology Data Exchange (ETDEWEB)

    Rigali, Mark J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Miller, James E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Altman, Susan J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Biedermann, Laura [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brady, Patrick Vane. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kuzio, Stephanie P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Nenoff, Tina M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rempe, Susan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-11-01

    Water is the backbone of our economy - safe and adequate supplies of water are vital for agriculture, industry, recreation, and human consumption. While our supply of water today is largely safe and adequate, we as a nation face increasing water supply challenges in the form of extended droughts, demand growth due to population increase, more stringent health-based regulation, and competing demands from a variety of users. To meet these challenges in the coming decades, water treatment technologies, including desalination, will contribute substantially to ensuring a safe, sustainable, affordable, and adequate water supply for the United States. This overview documents Sandia National Laboratories' (SNL, or Sandia) Water Treatment Program which focused on the development and demonstration of advanced water purification technologies as part of the larger Sandia Water Initiative. Projects under the Water Treatment Program include: (1) the development of desalination research roadmaps (2) our efforts to accelerate the commercialization of new desalination and water treatment technologies (known as the 'Jump-Start Program),' (3) long range (high risk, early stage) desalination research (known as the 'Long Range Research Program'), (4) treatment research projects under the Joint Water Reuse & Desalination Task Force, (5) the Arsenic Water Technology Partnership Program, (6) water treatment projects funded under the New Mexico Small Business Administration, (7) water treatment projects for the National Energy Technology Laboratory (NETL) and the National Renewable Energy Laboratory (NREL), (8) Sandia- developed contaminant-selective treatment technologies, and finally (9) current Laboratory Directed Research and Development (LDRD) funded desalination projects.

  2. Assessing Measurement Error in Medicare Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey Using linked administrative data, to validate Medicare coverage estimates...

  3. Competitive bidding in Medicare: who benefits from competition?

    Science.gov (United States)

    Song, Zirui; Landrum, Mary Beth; Chernew, Michael E

    2012-09-01

    To conduct the first empirical study of competitive bidding in Medicare. We analyzed 2006-2010 Medicare Advantage data from the Centers for Medicare and Medicaid Services using longitudinal models adjusted for market and plan characteristics. A $1 increase in Medicare's payment to health maintenance organization (HMO) plans led to a $0.49 (P service plans included, higher Medicare payments increased bids less ($0.33 per dollar), suggesting more competition among these latter plans. As a market-based alternative to cost control through administrative pricing, competitive bidding relies on private insurance plans proposing prices they are willing to accept for insuring a beneficiary. However, competition is imperfect in the Medicare bidding market. As much as half of every dollar in increased plan payment went to higher bids rather than to beneficiaries. While having more insurers in a market lowered bids, the design of any bidding system for Medicare should recognize this shortcoming of competition.

  4. Medicares Physician Quality Reporting System (PQRS)...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicares Physician Quality Reporting System (PQRS) allows providers to report measures of process quality and health outcomes. The authors of Medicares Physician...

  5. Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance.

    Science.gov (United States)

    Trish, Erin; Ginsburg, Paul; Gascue, Laura; Joyce, Geoffrey

    2017-09-01

    Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans. Retrospective analysis of claims data evaluating MA prices paid to physicians and for laboratory services and durable medical equipment between 2007 and 2012 in 348 US core-based statistical areas. The study population included all MA and commercial enrollees with a large national health insurer operating in both markets, as well as a 20% sample of TM beneficiaries. Enrollment in an MA plan. Mean reimbursement paid to physicians, laboratories, and durable medical equipment suppliers for MA and commercial enrollees relative to TM rates for 11 Healthcare Common Procedure Coding Systems (HCPCS) codes spanning 7 sites of care. The sample consisted of 144 million claims. Physician reimbursement in MA was more strongly tied to TM rates than commercial prices, although MA plans tended to pay physicians less than TM. For a mid-level office visit with an established patient (Current Procedural Terminology [CPT] code 99213), the mean MA price was 96.9% (95% CI, 96.7%-97.2%) of TM. Across the common physician services we evaluated, mean MA reimbursement ranged from 91.3% of TM for cataract removal in an ambulatory surgery center (CPT 66984; 95% CI, 90.7%-91.9%) to 102.3% of TM for complex evaluation and management of a patient in the emergency department (CPT 99285; 95% CI, 102.1%-102.6%). However, for laboratory services and durable medical equipment, where commercial prices are lower than TM rates, MA plans take advantage of these lower commercial prices, ranging from 67.4% for a walker

  6. Calendar year 2003 annual site environmental report for Sandia National Laboratories, New Mexico.

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Katrina; Sanchez, Rebecca V.; Mayeux, Lucie; Koss, Susan I.; Salinas, Stephanie A.

    2004-09-01

    Sandia National Laboratories, New Mexico (SNL/NM) is a government-owned, contractor-operated facility owned by the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA) and managed by the Sandia Site Office (SSO), Albuquerque, New Mexico. Sandia Corporation, a wholly-owned subsidiary of Lockheed Martin Corporation, operates SNL/NM. This annual report summarizes data and the compliance status of Sandia Corporation's environmental protection and monitoring programs through December 31, 2003. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention (P2), environmental restoration (ER), oil and chemical spill prevention, and the National Environmental Policy Act (NEPA). Environmental monitoring and surveillance programs are required by DOE Order 450.1, ''Environmental Protection Program'' (DOE 2003a) and DOE Order 231.1 Chg.2, ''Environment, Safety, and Health Reporting'' (DOE 1996).

  7. A preliminary benefit-cost study of a Sandia wind farm.

    Energy Technology Data Exchange (ETDEWEB)

    Ehlen, Mark Andrew; Griffin, Taylor; Loose, Verne W.

    2011-03-01

    In response to federal mandates and incentives for renewable energy, Sandia National Laboratories conducted a feasibility study of installing an on-site wind farm on Sandia National Laboratories and Kirtland Air Force Base property. This report describes this preliminary analysis of the costs and benefits of installing and operating a 15-turbine, 30-MW-capacity wind farm that delivers an estimated 16 percent of 2010 onsite demand. The report first describes market and non-market economic costs and benefits associated with operating a wind farm, and then uses a standard life-cycle costing and benefit-cost framework to estimate the costs and benefits of a wind farm. Based on these 'best-estimates' of costs and benefits and on factor, uncertainty and sensitivity analysis, the analysis results suggest that the benefits of a Sandia wind farm are greater than its costs. The analysis techniques used herein are applicable to the economic assessment of most if not all forms of renewable energy.

  8. Beneficiary Activation in the Medicare Population

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Beneficiary Activation in the Medicare Population, published in Volume 4, Issue 4 of the Medicare and Medicaid Research Review,...

  9. 76 FR 13515 - Medicare Program; Revisions to the Reductions and Increases to Hospitals' FTE Resident Caps for...

    Science.gov (United States)

    2011-03-14

    ...' FTE Resident Caps for Graduate Medical Education Payment Purposes AGENCY: Centers for Medicare... education affiliated groups for the purpose of determining possible full-time equivalent resident cap... caps for direct GME under Medicare for certain hospitals, and to authorize the ``redistribution'' of...

  10. Cataract surgery among Medicare beneficiaries.

    Science.gov (United States)

    Schein, Oliver D; Cassard, Sandra D; Tielsch, James M; Gower, Emily W

    2012-10-01

    To present descriptive epidemiology of cataract surgery among Medicare recipients in the United States. Cataract surgery performed on Medicare beneficiaries in 2003 and 2004. Medicare claims data were used to identify all cataract surgery claims for procedures performed in the United States in 2003-2004. Standard assumptions were used to limit the claims to actual cataract surgery procedures performed. Summary statistics were created to determine the number of procedures performed for each outcome of interest: cataract surgery rates by age, sex, race and state; surgical volume by facility type and surgeon characteristics; time interval between first- and second-eye cataract surgery. The national cataract surgery rate for 2003-2004 was 61.8 per 1000 Medicare beneficiary person-years. The rate was significantly higher for females and for those aged 75-84 years. After adjustment for age and sex, blacks had approximately a 30% lower rate of surgery than whites. While only 5% of cataract surgeons performed more than 500 cataract surgeries annually, these surgeons performed 26% of the total cataract surgeries. Increasing surgical volume was found to be highly correlated with use of ambulatory surgical centers and reduced time interval between first- and second-eye surgery in the same patient. The epidemiology of cataract surgery in the United States Medicare population documents substantial variation in surgical rates by race, sex, age, and by certain provider characteristics.

  11. Hypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: A multidisciplinary group practice observational study.

    Science.gov (United States)

    Chaddha, Ashish; Smith, Maureen A; Palta, Mari; Johnson, Heather M

    2018-04-23

    Patients with diabetes mellitus and cardiovascular disease have a high risk of mortality and/or recurrent cardiovascular events. Hypertension control is critical for secondary prevention of cardiovascular events. The objective was to determine rates and predictors of achieving hypertension control among Medicare patients with diabetes and uncontrolled hypertension after hospital discharge for an initial cardiac event. A retrospective analysis of linked electronic health record and Medicare data was performed. The primary outcome was hypertension control within 1 year after hospital discharge for an initial cardiac event. Cox proportional hazard models assessed sociodemographics, medications, utilization, and comorbidities as predictors of control. Medicare patients with diabetes were more likely to achieve hypertension control when prescribed beta-blockers at discharge or with a history of more specialty visits. Adults ≥ 80 were more likely to achieve control with diuretics. These findings demonstrate the importance of implementing guideline-directed multidisciplinary care in this complex and high-risk population. ©2018 Wiley Periodicals, Inc.

  12. Medicare annual preventive care visits: use increased among fee-for-service patients, but many do not participate.

    Science.gov (United States)

    Chung, Sukyung; Lesser, Lenard I; Lauderdale, Diane S; Johns, Nicole E; Palaniappan, Latha P; Luft, Harold S

    2015-01-01

    Under the Affordable Care Act (ACA), Medicare coverage expanded in 2011 to fully cover annual preventive care visits. We assessed the impact of coverage expansion, using 2007-13 data from primary care patients of Medicare-eligible age at the Palo Alto Medical Foundation (204,388 patient-years), which serves people in four counties near San Francisco, California. We compared trends in preventive visits and recommended preventive services among Medicare fee-for-service and Medicare health maintenance organization (HMO) patients as well as non-Medicare patients ages 65-75 who were covered by private fee-for-service and private HMO plans. Among Medicare fee-for-service patients, the annual use of preventive visits rose from 1.4 percent before the implementation of the ACA to 27.5 percent afterward. This increase was significantly larger than was seen for patients in the other insurance groups. Nevertheless, rates of annual preventive care visit use among Medicare fee-for-service patients remained 10-20 percentage points lower than was the case for people with private coverage (43-44 percent) or those in a Medicare HMO (53 percent). ACA policy changes led to increased preventive service use by Medicare fee-for-service beneficiaries, which suggests that Medicare coverage expansion is an effective way to increase seniors' use of preventive services. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Calendar Year 2013 Annual Site Environmental Report for Sandia National Laboratories, Albuquerque, New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Stacy [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-09-01

    Sandia National Laboratories, New Mexico is a government-owned/contractor-operated facility. Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, manages and operates the laboratory for the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA). The DOE/NNSA, Sandia Field Office administers the contract and oversees contractor operations at the site. This annual report summarizes data and the compliance status of Sandia Corporation’s sustainability, environmental protection, and monitoring programs through December 31, 2013. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention, environmental restoration, oil and chemical spill prevention, and implementation of the National Environmental Policy Act. Environmental monitoring and surveillance programs are required by DOE Order 231.1B, Environment, Safety, and Health Reporting (DOE 2012).

  14. Calendar Year 2013 Annual Site Environmental Report for Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Griffith, Stacy

    2014-01-01

    Sandia National Laboratories, New Mexico is a government-owned/contractor-operated facility. Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, manages and operates the laboratory for the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA). The DOE/NNSA, Sandia Field Office administers the contract and oversees contractor operations at the site. This annual report summarizes data and the compliance status of Sandia Corporation's sustainability, environmental protection, and monitoring programs through December 31, 2013. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention, environmental restoration, oil and chemical spill prevention, and implementation of the National Environmental Policy Act. Environmental monitoring and surveillance programs are required by DOE Order 231.1B, Environment, Safety, and Health Reporting (DOE 2012).

  15. Sandia National Laboratories: Up on the roof

    Science.gov (United States)

    Library Events Careers View All Jobs Students & Postdocs Internships & Co-ops Fellowships load of rooftop solar photovoltaic (PV) installations," says structural engineer Steve Dwyer (6912 structural issues. "I couldn't believe it was a problem," says Steve, who led the Sandia test team

  16. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...

  17. ByLaws for the Governance of the Sandia National Laboratories Sandia Postdoctoral Development (SPD) Association.

    Energy Technology Data Exchange (ETDEWEB)

    McBride, Amber Alane Fisher; McBride, Amber Alane Fisher; Rodgers, Theron; Dong, Wen; Juan, Pierre-Alexandre; Barkholtz, Heather; Alley, William Morgan; Wolk, Benjamin Matthew; Vane, Zachary Phillips; Priye, Aashish; Ball, Cameron Scott

    2017-03-01

    The purpose of this document is to define the rules of governance for the Sandia Postdoctoral Development (SPD) Association. This includes election procedures for filling vacancies on the SPD board, an all-purpose voting procedure, and definitions for the roles and responsibilities of each SPD board member. The voting procedures can also be used to amend the by-laws, as well as to create, dissolve, or consolidate vacant SPD board positions.

  18. Specialty Drug Spending Trends Among Medicare And Medicare Advantage Enrollees, 2007–11

    OpenAIRE

    Trish, Erin; Joyce, Geoffrey; Goldman, Dana P.

    2014-01-01

    Specialty pharmaceuticals include most injectable and biologic agents used to treat complex conditions such as rheumatoid arthritis, multiple sclerosis, and cancer. We analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007–11 pharmacy claims data from a 20 percent sample of Medicare beneficiaries. Annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, from $2,641 to $8,976. H...

  19. Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

    Science.gov (United States)

    Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

    2016-09-01

    At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The

  20. Development and Evaluation of a Sandia Cooler-based Refrigerator Condenser

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Terry A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kariya, Harumichi Arthur [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Leick, Michael T. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Zimmerman, Mark D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Li, Manjie [Univ. of Maryland, College Park, MD (United States); Du, Yilin [Univ. of Maryland, College Park, MD (United States); Lee, Hoseong [Univ. of Maryland, College Park, MD (United States); Hwang, Yunho [Univ. of Maryland, College Park, MD (United States); Radermacher, Reinhard [Univ. of Maryland, College Park, MD (United States)

    2015-07-01

    This report describes the first design of a refrigerator condenser using the Sandia Cooler, i.e. air - bearing supported rotating heat - sink impeller. The project included ba seline performance testing of a residential refrigerator, analysis and design development of a Sandia Cooler condenser assembly including a spiral channel baseplate, and performance measurement and validation of this condenser system as incorporated into the residential refrigerator. Comparable performance was achieved in a 60% smaller volume package. The improved modeling parameters can now be used to guide more optimized designs and more accurately predict performance.

  1. Sandia Laboratories technical capabilities. Auxiliary capabilities: environmental health information science

    International Nuclear Information System (INIS)

    1975-09-01

    Sandia Laboratories is an engineering laboratory in which research, development, testing, and evaluation capabilities are integrated by program management for the generation of advanced designs. In fulfilling its primary responsibility to ERDA, Sandia Laboratories has acquired extensive research and development capabilities. The purpose of this series of documents is to catalog the many technical capabilities of the Laboratories. After the listing of capabilities, supporting information is provided in the form of highlights, which show applications. This document deals with auxiliary capabilities, in particular, environmental health and information science. (11 figures, 1 table) (RWR)

  2. Energetic materials research and development activities at Sandia National Laboratories supported under DP-10 programs

    Energy Technology Data Exchange (ETDEWEB)

    Ratzel, A.C. III

    1998-09-01

    This report provides summary descriptions of Energetic Materials (EM) Research and Development activities performed at Sandia National Laboratories and funded through the Department of Energy DP-10 Program Office in FY97 and FY98. The work falls under three major focus areas: EM Chemistry, EM Characterization, and EM Phenomenological Model Development. The research supports the Sandia component mission and also Sandia's overall role as safety steward for the DOE Nuclear Weapons Complex.

  3. Sandia Laboratories technical capabilities: instrumentation and data systems

    International Nuclear Information System (INIS)

    Lundergain, C.D.; Mead, P.L.

    1975-12-01

    This report characterizes the instrumentation and data systems capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  4. Sandia National Laboratories: National Security Missions: Defense Systems

    Science.gov (United States)

    ; Technology Defense Systems & Assessments About Defense Systems & Assessments Program Areas Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios ; Culture Work-Life Balance Special Programs Nuclear Weapons Defense Systems Global Security Energy Facebook

  5. An overview of semiconductor bridge, SCB, applications at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Bickes, R.W. Jr.; Grubelich, M.C.; Harris, S.M.; Merson, J.A.; Weinlein, J.H.

    1995-05-01

    The semiconductor bridge, SCB, developed by Sandia National Laboratories is a maturing technology now being used in several applications by Sandia customers. Most applications arose because of a need at the system level to provide explosive assemblies that were light weight, small volume, low cost and required small quantities of electrical energy to function -- for the purposes of this paper we define an explosive assembly to mean the combination of the firing set and an explosive component. As a result, and because conventional firing systems could not meet the stringent size, weight and energy requirements of our customers, we designed and are investigating SCB applications that range from devices for Sandia applications to igniters for fireworks. We present in this paper an overview of SCB technology with specific examples of the system designed for our customers to meet modern requirements that sophisticated explosive systems must satisfy in today`s market environments.

  6. Medicare, physicians, and patients.

    Science.gov (United States)

    Hacker, Joseph F

    2004-05-01

    There are many other provisions to the MMA. It is important to remind our patients that these changes are voluntary. If patients are satisfied with their current Medicare benefits and plan, they need not change to these new plans. However, as physicians we should familiarize ourselves with these new Medicare options so as to better advise our patients. For more information, visit www.ama-assn.org. The Medical Society of Delaware will strive to keep you informed as these new changes are implemented.

  7. Sandia National Laboratories: Fabrication, Testing and Validation

    Science.gov (United States)

    digital and analog elements. * Cadence Process-Design Kit. Structured ASIC Sandia National Laboratories demonstrate complex multilevel devices such as micro-mass-analysis systems up to 25 microns thick and novel possible to fabricate a wide very large variety of useful devices. Micro-Mass-Analysis Systems Applications

  8. Implementing the Corrective Action Management Unit at Sandia National Laboratories, New Mexico

    International Nuclear Information System (INIS)

    Moore, Darlene R.; Schrader, Scott A.; King, Gabriel G.; Cormier, John

    2000-01-01

    In September 1997, following significant public and regulator interaction, Sandia Corporation (Sandia) was granted a Resource Conservation and Recovery Act (RCRA) and Hazardous Solid Waste Amendment (HSWA) permit modification allowing construction and operation of a Correction Action Management Unit (CAMU). The CAMU follows recent regulatory guidance that allows for cost-effective, expedient cleanup of contaminated sites and management of hazardous remediation wastes. The CAMU was designed to store, treat, and provide long-term management for Environmental Restoration (ER) derived wastes. The 154 square meter CAMU site at Sandia National Laboratories, New Mexico (SNL/NM), includes facilities for storing bulk soils and containerized wastes, for treatment of bulk soils, and has a containment cell for long-term disposition of waste. Proposed treatment operations include soil washing and low temperature thermal desorption. The first waste was accepted into the CAMU for temporary storage in January 1999. Construction at the CAMU was completed in March 1999, and baseline monitoring of the containment cell has commenced. At completion of operations the facility will be closed, the waste containment cell will be covered, and long-term post-closure monitoring will begin. Sandia's CAMU is the only such facility within the US Department of Energy (DOE) complex. Implementing this innovative approach to ER waste management has required successful coordination with community representatives, state and federal regulators, the DOE, Sandia corporate management, and contractors. It is expected that cost savings to taxpayers will be significant. The life-cycle CAMU project cost is currently projected to be approximately $12 million

  9. Sandia Laboratories technical capabilities: design, definition, and fabrication

    International Nuclear Information System (INIS)

    1976-12-01

    This report characterizes the design definition and fabrication capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs. 13 figures

  10. Sandia Laboratories technical capabilities: design, definition, and fabrication

    Energy Technology Data Exchange (ETDEWEB)

    1976-12-01

    This report characterizes the design definition and fabrication capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs. 13 figures.

  11. Use of Medicare's Diabetes Self-Management Training Benefit

    Science.gov (United States)

    Strawbridge, Larisa M.; Lloyd, Jennifer T.; Meadow, Ann; Riley, Gerald F.; Howell, Benjamin L.

    2015-01-01

    Medicare began reimbursing for outpatient diabetes self-management training (DSMT) in 2000; however, little is known about program utilization. Individuals diagnosed with diabetes in 2010 were identified from a 20% random selection of the Medicare fee-for-service population (N = 110,064). Medicare administrative and claims files were used to…

  12. Effect of medicare payment on rural health care systems.

    Science.gov (United States)

    McBride, Timothy D; Mueller, Keith J

    2002-01-01

    Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

  13. Sandia`s computer support units: The first three years

    Energy Technology Data Exchange (ETDEWEB)

    Harris, R.N. [Sandia National Labs., Albuquerque, NM (United States). Labs. Computing Dept.

    1997-11-01

    This paper describes the method by which Sandia National Laboratories has deployed information technology to the line organizations and to the desktop as part of the integrated information services organization under the direction of the Chief Information officer. This deployment has been done by the Computer Support Unit (CSU) Department. The CSU approach is based on the principle of providing local customer service with a corporate perspective. Success required an approach that was both customer compelled at times and market or corporate focused in most cases. Above all, a complete solution was required that included a comprehensive method of technology choices and development, process development, technology implementation, and support. It is the authors hope that this information will be useful in the development of a customer-focused business strategy for information technology deployment and support. Descriptions of current status reflect the status as of May 1997.

  14. Identifying the Transgender Population in the Medicare Program

    Science.gov (United States)

    Proctor, Kimberly; Haffer, Samuel C.; Ewald, Erin; Hodge, Carla; James, Cara V.

    2016-01-01

    Abstract Purpose: To identify and describe the transgender population in the Medicare program using administrative data. Methods: Using a combination of International Classification of Diseases ninth edition (ICD-9) codes relating to transsexualism and gender identity disorder, we analyzed 100% of the 2013 Centers for Medicare & Medicaid Services (CMS) Medicare Fee-For-Service (FFS) “final action” claims from both institutional and noninstitutional providers (∼1 billion claims) to identify individuals who may be transgender Medicare beneficiaries. To confirm, we developed and applied a multistage validation process. Results: Four thousand ninety-eight transgender beneficiaries were identified, of which ∼90% had confirmatory diagnoses, billing codes, or evidence of a hormone prescription. In general, the racial, ethnic, and geographic distribution of the Medicare transgender population tends to reflect the broader Medicare population. However, age, original entitlement status, and disease burden of the transgender population appear substantially different. Conclusions: Using a variety of claims information, ranging from claims history to additional diagnoses, billing modifiers, and hormone prescriptions, we demonstrate that administrative data provide a valuable resource for identifying a lower bound of the Medicare transgender population. In addition, we provide a baseline description of the diversity and disease burden of the population and a framework for future research. PMID:28861539

  15. Site Environmental Report for 2010 Sandia National Laboratories, California.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2011-06-01

    Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor-operated laboratory. Sandia Corporation, a Lockheed Martin Company, manages and operates the laboratory for the Department of Energy's National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office administers the contract and oversees contractor operations at the site. This Site Environmental Report for 2010 was prepared in accordance with DOE Order 231.1A (DOE 2004a). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2010. General site and environmental program information is also included. The Site Environmental Report is divided into ten chapters. Chapter 1, the Executive Summary, highlights compliance and monitoring results obtained in 2010. Chapter 2 provides a brief introduction to SNL/CA and the existing environment found on site. Chapter 3 summarizes SNL/CA's compliance activities with the major environmental requirements applicable to site operations. Chapter 4 presents information on environmental management, performance measures, and environmental programs. Chapter 5 presents the results of monitoring and surveillance activities in 2010. Chapter 6 discusses quality assurance. Chapters 7 through 9 provide supporting information for the report and Chapter 10 is the report distribution list.

  16. 76 FR 70456 - Decision To Evaluate a Petition To Designate a Class of Employees From Sandia National Laboratory...

    Science.gov (United States)

    2011-11-14

    ... Employees From Sandia National Laboratory, Albuquerque, NM, To Be Included in the Special Exposure Cohort... evaluate a petition to designate a class of employees from Sandia National Laboratory, Albuquerque, New... revision as warranted by the evaluation, is as follows: Facility: Sandia National Laboratory. Location...

  17. 78 FR 56706 - Decision to Evaluate a Petition to Designate a Class of Employees from the Sandia National...

    Science.gov (United States)

    2013-09-13

    ... Employees from the Sandia National Laboratory-Livermore in Livermore, California To Be Included in the... decision to evaluate a petition to designate a class of employees from the Sandia National Laboratory...: Facility: Sandia National Laboratory-Livermore Location: Livermore, California. Job Titles and/or Job...

  18. Evaluation of Medicare Health Support chronic disease pilot program.

    Science.gov (United States)

    Cromwell, Jerry; McCall, Nancy; Burton, Joe

    2008-01-01

    The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

  19. Sandia SWiFT Wind Turbine Manual.

    Energy Technology Data Exchange (ETDEWEB)

    White, Jonathan; LeBlanc, Bruce Philip; Berg, Jonathan Charles; Bryant, Joshua; Johnson, Wesley D.; Paquette, Joshua

    2016-01-01

    The Scaled Wind Farm Technology (SWiFT) facility, operated by Sandia National Laboratories for the U.S. Department of Energy's Wind and Water Power Program, is a wind energy research site with multiple wind turbines scaled for the experimental study of wake dynamics, advanced rotor development, turbine control, and advanced sensing for production-scale wind farms. The SWiFT site currently includes three variable-speed, pitch-regulated, three-bladed wind turbines. The six volumes of this manual provide a detailed description of the SWiFT wind turbines, including their operation and user interfaces, electrical and mechanical systems, assembly and commissioning procedures, and safety systems. Further dissemination only as authorized to U.S. Government agencies and their contractors; other requests shall be approved by the originating facility or higher DOE programmatic authority. 111 UNCLASSIFIED UNLIMITED RELEASE Sandia SWiFT Wind Turbine Manual (SAND2016-0746 ) approved by: Department Manager SWiFT Site Lead Dave Minster (6121) Date Jonathan White (6121) Date SWiFT Site Supervisor Dave Mitchell (6121) Date Note: Document revision logs are found after the title page of each volume of this manual. iv

  20. Sandia technology: Engineering and science applications

    Science.gov (United States)

    Maydew, M. C.; Parrot, H.; Dale, B. C.; Floyd, H. L.; Leonard, J. A.; Parrot, L.

    1990-12-01

    This report discusses: protecting environment, safety, and health; Sandia's quality initiative; Sandia vigorously pursues technology transfer; scientific and technical education support programs; nuclear weapons development; recognizing battlefield targets with trained artificial neural networks; battlefield robotics: warfare at a distance; a spinning shell sizes up the enemy; thwarting would-be nuclear terrorists; unattended video surveillance system for nuclear facilities; making the skies safer for travelers; onboard instrumentation system to evaluate performance of stockpile bombs; keeping track with lasers; extended-life lithium batteries; a remote digital video link acquires images securely; guiding high-performance missiles with laser gyroscopes; nonvolatile memory chips for space applications; initiating weapon explosives with lasers; next-generation optoelectronics and microelectronics technology developments; chemometrics: new methods for improving chemical analysis; research team focuses ion beam to record-breaking intensities; standardizing the volt to quantum accuracy; new techniques improve robotic software development productivity; a practical laser plasma source for generating soft x-rays; exploring metal grain boundaries; massively parallel computing; modeling the amount of desiccant needed for moisture control; attacking pollution with sunshine; designing fuel-conversion catalysts with computers; extending a nuclear power plant's useful life; plasma-facing components for the International Thermonuclear Experimental Reactor.

  1. Identifiable Data Files - Medicare Provider Analysis and ...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Provider Analysis and Review (MEDPAR) File contains data from claims for services provided to beneficiaries admitted to Medicare certified inpatient...

  2. Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

    Science.gov (United States)

    Gross, D J; Alecxih, L; Gibson, M J; Corea, J; Caplan, C; Brangan, N

    1999-04-01

    services, but spent less than the other groups on prescription drugs and dental care-services not covered by Medicare. While Medicaid provides substantial protection for some lower-income Medicare beneficiaries, out-of-pocket health care spending continues to be a substantial burden for most of this population. Medicare reform discussions that focus on shifting more costs to beneficiaries should take into account the dramatic costs of health care already faced by this vulnerable population.

  3. Medicare Current Beneficiary Survey - Limited Data Set

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a representative national sample of the Medicare population. There are two...

  4. Medicare FFS Jurisdiction Error Rate Contribution Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services CMS is dedicated to continually strengthening and improving the Medicare program, which provides vital services to...

  5. Medicare program; appeals of CMS or CMS contractor determinations when a provider or supplier fails to meet the requirements for Medicare billing privileges. Final rule.

    Science.gov (United States)

    2008-06-27

    This final rule implements a number of regulatory provisions that are applicable to all providers and suppliers, including durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. This final rule establishes appeals processes for all providers and suppliers whose enrollment, reenrollment or revalidation application for Medicare billing privileges is denied and whose Medicare billing privileges are revoked. It also establishes timeframes for deciding enrollment appeals by an Administrative Law Judge (ALJ) within the Department of Health and Human Services (DHHS) or the Departmental Appeals Board (DAB), or Board, within the DHHS; and processing timeframes for CMS' Medicare fee-for-service (FFS) contractors. In addition, this final rule allows Medicare FFS contractors to revoke Medicare billing privileges when a provider or supplier submits a claim or claims for services that could not have been furnished to a beneficiary. This final rule also specifies that a Medicare contractor may establish a Medicare enrollment bar for any provider or supplier whose billing privileges have been revoked. Lastly, the final rule requires that all providers and suppliers receive Medicare payments by electronic funds transfer (EFT) if the provider or supplier, is submitting an initial enrollment application to Medicare, changing their enrollment information, revalidating or re-enrolling in the Medicare program.

  6. 2013 Annual Site Environmental Report for Sandia National Laboratories Tonopah Test Range Nevada & Kauai Test Facility Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Stacy Rene [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Agogino, Karen [National Nuclear Security Administration (NNSA), Washington, DC (United States); Li, Jun [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); White, Nancy [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Minitrez, Alexandra [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Avery, Penny [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Bailey-White, Brenda [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Bonaguidi, Joseph [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Catechis, Christopher [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); duMond, Michael [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Eckstein, Joanna [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Evelo, Stacie [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Forston, William [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Herring, III, Allen [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Lantow, Tiffany [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Martinez, Reuben [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Mauser, Joseph [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Miller, Amy [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Miller, Mark [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Payne, Jennifer [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Peek, Dennis [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Reiser, Anita [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Ricketson, Sherry [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Roma, Charles [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Salinas, Stephanie [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Ullrich, Rebecca [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

    2014-08-01

    Tonopah Test Range (TTR) in Nevada and Kauai Test Facility (KTF) in Hawaii are government-owned, contractor-operated facilities managed and operated by Sandia Corporation (Sandia), a wholly owned subsidiary of Lockheed Martin Corporation. The U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA), through the Sandia Field Office (SFO), in Albuquerque, New Mexico, administers the contract and oversees contractor operations at TTR and KTF. Sandia manages and conducts operations at TTR in support of the DOE/NNSA’s Weapons Ordnance Program and has operated the site since 1957. Navarro Research and Engineering subcontracts to Sandia in administering most of the environmental programs at TTR. Sandia operates KTF as a rocket preparation launching and tracking facility. This Annual Site Environmental Report summarizes data and the compliance status of the sustainability, environmental protection, and monitoring program at TTR and KTF through Calendar Year 2013. The compliance status of environmental regulations applicable at these sites include state and federal regulations governing air emissions, wastewater effluent, waste management, terrestrial surveillance, Environmental Restoration (ER) cleanup activities, and the National Environmental Policy Act. Sandia is responsible only for those environmental program activities related to its operations. The DOE/NNSA/Nevada Field Office retains responsibility for the cleanup and management of TTR ER sites. Environmental monitoring and surveillance programs are required by DOE Order 231.1B, Environment, Safety, and Health Reporting (DOE 2012).

  7. Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set

    International Nuclear Information System (INIS)

    Vu, Charles C.; Lanni, Thomas B.; Robertson, John M.

    2016-01-01

    Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other

  8. Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set

    Energy Technology Data Exchange (ETDEWEB)

    Vu, Charles C.; Lanni, Thomas B.; Robertson, John M., E-mail: JRobertson@beaumont.edu

    2016-04-01

    Purpose: The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. Methods and Materials: The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. Results: There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (P<.001). On multivariate analysis, technical services billing (P<.001), male sex (P<.001), and rural location (P=.007) were predictive of higher Medicare reimbursement. Conclusions: The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other

  9. Medicare Physician and Other Supplier Interactive Dataset

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data - Physician and Other...

  10. Medicares Hospice Benefit - Analysis of Utilization and..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Descriptive analyses reported in Medicares Hospice Benefit - Analysis of Utilization and Resource Use, published in Volume 4, Issue 3 of the Medicare and Medicaid...

  11. 75 FR 22409 - Decision To Evaluate a Petition To Designate a Class of Employees From the Sandia National...

    Science.gov (United States)

    2010-04-28

    ... Employees From the Sandia National Laboratory in Albuquerque, NM, To Be Included in the Special Exposure... decision to evaluate a petition to designate a class of employees from the Sandia National Laboratory in..., subject to revision as warranted by the evaluation, is as follows: Facility: Sandia National Laboratory...

  12. Use of Medicare services before and after introduction of the prospective payment system.

    Science.gov (United States)

    Manton, K G; Woodbury, M A; Vertrees, J C; Stallard, E

    1993-08-01

    The case mix-adjusted pattern of use of health care services, especially posthospital care, is compared before and after the introduction of Medicare's Prospective Payment System (PPS). The 1982 and 1984 National Long Term Care Surveys (NLTCS) linked to Medicare administrative records 1982-1986 provide health and health service use data for 12-month periods before and after the introduction of PPS. Case-mix differences between pre- and post-periods are controlled by using the Grade of Membership model to identify health groups from the NLTCS data. Differences in timing (e.g., hospital length of stay) were controlled using life table models estimated for each health group, that is, service use patterns pre- and post-PPS are compared within groups. Hospital LOS and admission rates declined post-PPS. Changes in the timing and location of death occurred but, overall, mortality did not increase. Changes in post-acute care service use by elderly, chronically disabled Medicare beneficiaries were observed: home health service use increased overall and among the unmarried disabled population. PPS did not adversely affect quality of care as reflected in mortality or in hospital readmissions. Moreover, the differential use of post-acute care, and changes in hospital LOS by health group, indicate that the system responded, specific to marital status and age, to the severity of needs of chronically disabled persons.

  13. NREL- and Sandia-Developed HyStEP Device Receives Far West FLC Award | News

    Science.gov (United States)

    | NREL NREL- and Sandia-Developed HyStEP Device Receives Far West FLC Award NREL- and Sandia -Developed HyStEP Device Receives Far West FLC Award September 1, 2016 The National Renewable Energy technologies and boost the regional economy. As FLC awards are granted for outstanding achievements in

  14. Medicare-Medicaid Enrollee Profiles (State and National)

    Data.gov (United States)

    U.S. Department of Health & Human Services — Today there are over 10 million Medicare-Medicaid enrollees in the United States.To provide a greater understanding of the Medicare-Medicaid enrollee population, the...

  15. Measuring Coding Intensity in Medicare Advantage - SUPP.

    Data.gov (United States)

    U.S. Department of Health & Human Services — In 2004, Medicare implemented a risk-adjustment system that pays Medicare Advantage (MA) plans based on diagnoses reported for their enrollees, giving the plans an...

  16. Statistical Uncertainty in the Medicare Shared Savings...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to analysis reported in Statistical Uncertainty in the Medicare Shared Savings Program published in Volume 2, Issue 4 of the Medicare and Medicaid Research...

  17. Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

    Science.gov (United States)

    Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

    2013-10-01

    Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

  18. Medicare Coverage Database

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD...

  19. 42 CFR 460.90 - PACE benefits under Medicare and Medicaid.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false PACE benefits under Medicare and Medicaid. 460.90 Section 460.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... FOR THE ELDERLY (PACE) PACE Services § 460.90 PACE benefits under Medicare and Medicaid. If a Medicare...

  20. 2017 Annual Terrestrial Sampling Plan for Sandia National Laboratories/New Mexico on Kirtland Air Force Base

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Stacy R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-02-01

    The 2017 Annual Terrestrial Sampling Plan for Sandia National Laboratories/New Mexico on Kirtland Air Force Base has been prepared in accordance with the “Letter of Agreement Between Department of Energy, National Nuclear Security Administration, Sandia Field Office (DOE/NNSA/SFO) and 377th Air Base Wing (ABW), Kirtland Air Force Base (KAFB) for Terrestrial Sampling” (signed January 2017), Sandia National Laboratories, New Mexico (SNL/NM). The Letter of Agreement requires submittal of an annual terrestrial sampling plan.

  1. 2018 Annual Terrestrial Sampling Plan for Sandia National Laboratories/New Mexico on Kirtland Air Force Base.

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, Stacy R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2018-01-01

    The 2018 Annual Terrestrial Sampling Plan for Sandia National Laboratories/New Mexico on Kirtland Air Force Base has been prepared in accordance with the “Letter of Agreement Between Department of Energy, National Nuclear Security Administration, Sandia Field Office (DOE/NNSA/SFO) and 377th Air Base Wing (ABW), Kirtland Air Force Base (KAFB) for Terrestrial Sampling” (signed January 2017), Sandia National Laboratories, New Mexico (SNL/NM). The Letter of Agreement requires submittal of an annual terrestrial sampling plan.

  2. 42 CFR 408.82 - Conditions for group billing.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Conditions for group billing. 408.82 Section 408.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE... for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

  3. Sandia Laboratories plutonium protection system

    International Nuclear Information System (INIS)

    Bernard, E.A.; Miyoshi, D.S.; Gutierrez, F.D.

    1977-01-01

    Sandia Laboratories is developing an improved plutonium protection system (PPS) to demonstrate new concepts for enhancing special nuclear materials safeguards. PPS concepts include separation of functions, real-time item accountability and improved means for control of materials, activities and personnel access. Physical barriers and a secure communications network are designed into the system to offer greater protection against sabotage, diversion and theft attempts. Prototype systems are being constructed at Hanford, Washington and Albuquerque, New Mexico and will be subjected to a comprehensive testing and evaluation program

  4. Brand-Name Prescription Drug Use Among Diabetes Patients in the VA and Medicare Part D: A National Comparison

    Science.gov (United States)

    Gellad, Walid F.; Donohue, Julie M.; Zhao, Xinhua; Mor, Maria K.; Thorpe, Carolyn T.; Smith, Jeremy; Good, Chester B.; Fine, Michael J.; Morden, Nancy E.

    2013-01-01

    Background Medicare Part D and the Department of Veterans Affairs (VA) use different approaches to manage prescription drug benefits, with implications for spending. Medicare relies on private plans with distinct formularies, whereas VA administers its own benefit using a national formulary. Objective To compare overall and regional rates of brand-name drug use among older adults with diabetes in Medicare and VA. Design Retrospective cohort Setting Medicare and VA Patients National sample in 2008 of 1,061,095 Part D beneficiaries and 510,485 Veterans age 65+ with diabetes. Measurements Percent of patients on oral hypoglycemics, statins, and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers who filled brand-name drugs and percent of patients on long-acting insulin who filled analogues. We compared sociodemographic and health-status adjusted hospital referral region (HRR) brand-name use to examine local practice patterns, and calculated changes in spending if each system’s brand-name use mirrored the other. Results Brand-name use in Medicare was 2–3 times that of VA: 35.3% vs. 12.7% for oral hypoglycemics, 50.7% vs. 18.2% for statins, 42.5% vs. 20.8% for angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers, and 75.1% vs. 27.0% for insulin analogues. Adjusted HRR brand-name statin use ranged (5th to 95th percentile) from 41.0%–58.3% in Medicare and 6.2%–38.2% in VA. For each drug group, the HRR at the 95th percentile in VA had lower brand-name use than the 5th percentile HRR in Medicare. Medicare spending in this population would have been $1.4 billion less if brand-name use matched the VA for these medications. Limitation This analysis cannot fully describe the factors underlying differences in brand-name use. Conclusions Medicare beneficiaries with diabetes use 2–3 times more brand-name drugs than a comparable group within VA, at substantial excess cost. Primary Funding Sources VA; NIH; RWJF PMID:23752663

  5. Geographic variation in Medicare and the military healthcare system.

    Science.gov (United States)

    Adesoye, Taiwo; Kimsey, Linda G; Lipsitz, Stuart R; Nguyen, Louis L; Goodney, Philip; Olaiya, Samuel; Weissman, Joel S

    2017-08-01

    To compare geographic variation in healthcare spending and utilization between the Military Health System (MHS) and Medicare across hospital referral regions (HRRs). Retrospective analysis. Data on age-, sex-, and race-adjusted Medicare per capita expenditure and utilization measures by HRR were obtained from the Dartmouth Atlas for 2007 to 2010. Similarly, adjusted data from 2007 and 2010 were obtained from the MHS Data Repository and patients assigned to HRRs. We compared high- and low-spending regions, and computed coefficient of variation (CoV) and correlation coefficients for healthcare spending, hospital inpatient days, hip surgery, and back surgery between MHS and Medicare patients. We found significant variation in spending and utilization across HRRs in both the MHS and Medicare. CoV for spending was higher in the MHS compared with Medicare, (0.24 vs 0.15, respectively) and CoV for inpatient days was 0.36 in the MHS versus 0.19 in Medicare. The CoV for back surgery was also greater in the MHS compared with Medicare (0.47 vs 0.29, respectively). Per capita Medicare spending per HRR was significantly correlated to adjusted MHS spending (r = 0.3; P spending markets in both systems were not comparable; lower spending markets were located mostly in the Midwest. In comparing 2 systems with similar pricing schemes, differences in spending likely reflect variation in utilization and the influence of local provider culture.

  6. Medicare Hospice Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — More Medicare beneficiaries are taking advantage of the quality and compassionate care provided through the hospice benefit. As greater numbers of beneficiaries have...

  7. The Sandia/Arzamas-16 Magazine-to-Magazine Remote Monitoring Field Trial Evaluation

    International Nuclear Information System (INIS)

    Barkanov, Boris; Blagin, Sergei; Croessmann, Dennis; Damico, Joe; Ehle, Steve; Nilsen, Curt

    1999-01-01

    Sandia National Laboratories and the Russian Federal Nuclear Center-All Russian Research Institute for Experimental Physics (VNIIEF) (also known as Arzamas-16) are collaborating on ways to assure the highest standards of safety, security, and international accountability of fissile material. For these collaborations, sensors and information technologies have been identified as important in reaching these standards in a cost-effective manner. Specifically, Sandia and VNIIEF have established a series of remote monitoring field trials to provide a mechanism for joint research and development on storage monitoring systems. These efforts consist of the ''Container-to-Container'', ''Magazine-to-Magazine'', and ''Facility-to-Facility'' field trials. This paper will describe the evaluation exercise Sandia and VNIIEF conducted on the Magazine-to-Magazine systems. Topics covered will include a description of the evaluation philosophy, how the various sensors and system features were tested, evaluation results, and lessons learned

  8. Medicare Enrollment Dashboard

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Office of Enterprise Data and Analytics has developed a new interactive Medicare Enrollment Dashboard, which provides current information on the number of...

  9. Plutonium working group report on environmental, safety and health vulnerabilities associated with the department's plutonium storage. Volume II, Appendix B, Part 10: Sandia National Laboratories - New Mexico site assessment team report

    International Nuclear Information System (INIS)

    1994-09-01

    On March 15, 1994, Secretary O'Leary directed the Office of Environment, Safety and Health to conduct an environment, safety and health (ES ampersand H) vulnerability study of plutonium at DOE sites. This report presents Sandia National Laboratories'/New Mexico (SNL/NM) response to that request. Sandia National Laboratories (SNL) is a multi-program laboratory operated for United States Department of Energy(DOE) by Martin Marietta Corporation. The primary mission of Sandia is research and development of nuclear weapons systems for concept to retirement. The laboratory also has extensive programs in nuclear reactor safety, nuclear safeguards, energy research, and microelectronics. The facilities addressed in the SNL/NM Site Assessment include the Hot Cell Facility (HCF), the Annular Core Research Reactor (ACRR), and dedicated on-site nuclear material storage facilities. Also included in the assessment were sealed radiation sources that contain plutonium

  10. Audit of Sandia Corporation`s pension plans and other prefunded benefits

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-06

    The audit disclosed that Sandia`s pension plans had $588.9 million in excess assets as of December 31, 1990, on a current value basis. If plan terminations and spin-offs occurred, at least $408.8 million of this amount could be returned to the Government without affecting the pension benefits that Sandia employees and retirees have earned. We recommended that Albuquerque take the necessary action to reduce the excess assets in the pension plans and recover the Government`s share. However, Albuquerque disagreed with the recommendation. Albuquerque justified leaving the excess assets in the pension plans to fund future plan amendments; to avoid future funding contributions; to avoid the costs and time-consuming administrative steps associated with taking action; and to prevent damaging effects on employee morale. We analyzed these points, and concluded that they should not prevent the Department from initiating action to return excess assets to the Government. Actuarial analysis of the pension plans showed that, even if certain plan adjustments were made, the plans were overfunded by $256 million as of December 31, 1991 (on an actuarial value basis).

  11. Predictors of regional Medicare expenditures for otolaryngology physician services.

    Science.gov (United States)

    Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N

    2017-06-01

    To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society

  12. Guidelines for Sandia ASCI Verification and Validation Plans - Content and Format: Version 1.0

    Energy Technology Data Exchange (ETDEWEB)

    TRUCANO,TIMOTHY G.; MOYA,JAIME L.

    1999-12-01

    This report summarizes general guidelines for the development of Verification and Validation (V and V) plans for ASCI code projects at Sandia National Laboratories. The main content categories recommended by these guidelines for explicit treatment in Sandia V and V plans are (1) stockpile drivers influencing the code development project (2) the key phenomena to be modeled by the individual code; (3) software verification strategy and test plan; and (4) code validation strategy and test plans. The authors of this document anticipate that the needed content of the V and V plans for the Sandia ASCI codes will evolve as time passes. These needs will be reflected by future versions of this document.

  13. Sandia and the Waste Isolation Pilot Plant, 1974-1999

    International Nuclear Information System (INIS)

    Mora, Carl J.

    2000-01-01

    Engineers have learned to design and build big projects, which certainly describes the WIPP project, but also includes defense projects, highway networks, space exploration, the Internet, etc., through what has been called a messily complex embracing of contradictions. When something massive and complicated has to be built these days, it leads to a protracted political process in which every special interest makes a stand, lobbyists exert what influence they can, lawmakers bicker, contractors change things, Congress struggles with costs, environmentalists hold things up--and this is good. It may seem amazing that anything gets done, but when it does, everyone has had their say. It's an intensely democratic, even if expensive and time-consuming, process. The corporate historian of Sandia National Laboratories presents a unique background of the WIPP project and Sandia's part in it

  14. The Initiative to extend Medicare into Mexico: a case study in changing U.S. Health Care Policy

    Directory of Open Access Journals (Sweden)

    Roberto A. Ibarra

    2011-10-01

    Full Text Available This study examines the geo-political activities of interest groups, governments and multinational corporations involved in an initiative to extend Medicare to U.S. retirees residing in Mexico.  If the initiative to change the current Medicare policy succeeds, the relocation of Medicare-eligible populations from the U.S. to Mexico is likely to increase; the U.S. is expected to gain cost-savings for taxpayers on Medicare; Mexico can develop senior-housing and options for long-term care it currently lacks; and foreign-led multinational corporations will increase their profits and dominance, fostering even more privatization in Mexico’s health care sector. By exploring new issues about retirement migration and health this study seeks to gain knowledge about the phenomena in a number of areas.  First, the retirement migration of North Americans to Latin America is an under-studied phenomenon in the fields of social gerontology, migration research, and health policy studies.  Second, the Medicare in Mexico initiative is even less well-known among health policy scholars than the retirement migration phenomenon into Mexico. Yet this initiative is inherently international in scope and involves a number of US-based institutions and interest groups actively promoting the project from within Mexico. Thus, the initiative has important geo-political and socio-economic implications for reforming health care systems in the U.S. and Mexico.

  15. Sandia's experience in designing and implementing integrated high security physical protection systems

    International Nuclear Information System (INIS)

    Caskey, D.L.

    1986-01-01

    As DOE's lead laboratory for physical security, Sandia National Laboratories has had a major physical security program for over ten years. Activities have ranged from component development and evaluation, to full scale system design and implementation. This paper presents some of the lessons learned in designing and implementing state-of-the-art high security physical protection systems for a number of government facilities. A generic system design is discussed for illustration purposes. Sandia efforts to transfer technology to industry are described

  16. Did recent changes in Medicare reimbursement hit teaching hospitals harder?

    Science.gov (United States)

    Konetzka, R Tamara; Zhu, Jingsan; Volpp, Kevin G

    2005-11-01

    To inform the policy debate on Medicare reimbursement by examining the financial effects of the Balanced Budget Act of 1997 (BBA) and subsequent adjustments on major academic medical centers, minor teaching hospitals, and nonteaching hospitals. The authors simulated the impacts of BBA and subsequent BBA adjustments to predict the independent effects of changes in Medicare reimbursement on hospital revenues using 1997-2001 Medicare Cost Reports for all short-term acute-care hospitals in the United States. The authors also calculated actual (nonsimulated) operating and total margins among major teaching, minor teaching, and nonteaching hospitals to account for hospital response to the changes. The BBA and subsequent refinements reduced Medicare revenues to a greater degree in major teaching hospitals, but the fact that such hospitals had a smaller proportion of Medicare patients meant that the BBA reduced overall revenues by similar percentages across major, minor, and nonteaching hospitals. Consistently lower margins may have made teaching hospitals more vulnerable to cuts in Medicare support. Recent Medicare changes affected revenues at teaching and nonteaching hospitals more similarly than is commonly believed. However, the Medicare cuts under the BBA probably exacerbated preexisting financial strain on major teaching hospitals, and increased Medicare funding may not suffice to eliminate the strain. This report's findings are consistent with recent calls to support needed services of teaching hospitals through all-payer or general funds.

  17. Compilation of Sandia Laboratories technical capabilities

    International Nuclear Information System (INIS)

    Lundergan, C.D.; Mead, P.L.

    1975-11-01

    This report is a compilation of 17 individual documents that together summarize the technical capabilities of Sandia Laboratories. Each document in this compilation contains details about a specific area of capability. Examples of application of the capability to research and development problems are provided. An eighteenth document summarizes the content of the other seventeen. Each of these documents was issued with a separate report number (SAND 74-0073A through SAND 74-0091, except -0078)

  18. Sandia National Laboratories focus issue: introduction.

    Science.gov (United States)

    Boye, Robert

    2014-08-20

    For more than six decades, Sandia has provided the critical science and technology to address the nation's most challenging issues. Our original nuclear weapons mission has been complemented with work in defense systems, energy and climate, as well as international and homeland security. Our vision is to be a premier science and engineering laboratory for technology solutions to the most challenging problems that threaten peace and freedom for our nation and the globe.

  19. County-Level Population Economic Status and Medicare Imaging Resource Consumption.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Hughes, Danny R; Prabhakar, Anand M; Duszak, Richard

    2017-06-01

    The aim of this study was to assess relationships between county-level variation in Medicare beneficiary imaging resource consumption and measures of population economic status. The 2013 CMS Geographic Variation Public Use File was used to identify county-level per capita Medicare fee-for-service imaging utilization and nationally standardized costs to the Medicare program. The County Health Rankings public data set was used to identify county-level measures of population economic status. Regional variation was assessed, and multivariate regressions were performed. Imaging events per 1,000 Medicare beneficiaries varied 1.8-fold (range, 2,723-4,843) at the state level and 5.3-fold (range, 1,228-6,455) at the county level. Per capita nationally standardized imaging costs to Medicare varied 4.2-fold (range, $84-$353) at the state level and 14.1-fold (range, $33-$471) at the county level. Within individual states, county-level utilization varied on average 2.0-fold (range, 1.1- to 3.1-fold), and costs varied 2.8-fold (range, 1.1- to 6.4-fold). For both large urban populations and small rural states, Medicare imaging resource consumption was heterogeneously variable at the county level. Adjusting for county-level gender, ethnicity, rural status, and population density, countywide unemployment rates showed strong independent positive associations with Medicare imaging events (β = 26.96) and costs (β = 4.37), whereas uninsured rates showed strong independent positive associations with Medicare imaging costs (β = 2.68). Medicare imaging utilization and costs both vary far more at the county than at the state level. Unfavorable measures of county-level population economic status in the non-Medicare population are independently associated with greater Medicare imaging resource consumption. Future efforts to optimize Medicare imaging use should consider the influence of local indigenous socioeconomic factors outside the scope of traditional beneficiary-focused policy

  20. Value-based contracting innovated Medicare advantage healthcare delivery and improved survival.

    Science.gov (United States)

    Mandal, Aloke K; Tagomori, Gene K; Felix, Randell V; Howell, Scott C

    2017-02-01

    In Medicare Advantage (MA) with its CMS Hierarchical Condition Categories (CMS-HCC) payment model, CMS reimburses private plans (Medicare Advantage Organizations [MAOs]) with prospective, monthly, health-based or risk-adjusted, capitated payments. The effect of this payment methodology on healthcare delivery remains debatable. How value-based contracting generates cost efficiencies and improves clinical outcomes in MA is studied. A difference in contracting arrangements between an MAO and 2 provider groups facilitated an intervention-control, preintervention-postintervention, difference-in-differences approach among statistically similar, elderly, community-dwelling MA enrollees within one metropolitan statistical area. Starting in 2009, for intervention-group MA enrollees, the MAO and a provider group agreed to full-risk capitation combined with a revenue gainshare. The gainshare was based on increases in the Risk Adjustment Factor (RAF), which modified the CMS-HCC payments. For the control group, the MAO continued to reimburse another provider group through fee-for-service. RAF, utilization, and survival were followed until December 31, 2012. The intervention group's mean RAF increased significantly (P based visits (P based care for these MA enrollees with multiple comorbidities, a 6% survival benefit with a 32.8% lower hazard of death (P Value-based contracting can drive utilization patterns and improve clinical outcomes among chronically ill, elderly MA members.

  1. lambda-3, Sandia's 100-J HF laser system

    International Nuclear Information System (INIS)

    Klein, R.A.

    1979-09-01

    Sandia's lambda-geometry intermediate electron-beam-initiated HF amplifier is described in sufficient detail such that a similar system could be designed, constructed and characterized. Items included are the design of the laser cell, magnetic field design and measurements, electron-beam calorimetry, and typical laser results

  2. Nuclear fuel cycle safety research at Sandia Laboratories

    International Nuclear Information System (INIS)

    Ericson, D.M. Jr.

    1978-11-01

    This paper provides a brief introduction to Sandia Laboratories and an overview of Nuclear Regulatory Commission sponsored safety research with particular emphasis on light water reactor related activities. Several experimental and analytical programs are highlighted and the range of activities of a typical staff member illustrated

  3. 1994 Site Environmental Report Sandia National Laboratories Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Shyr, L.J.; Wiggins, T.; White, B.B.

    1995-09-01

    This 1994 report contains data from routine radiological and nonradiological environmental monitoring activities. Summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, environmental restoration, and various waste management programs for Sandia National Laboratories in Albuquerque, New Mexico, are included. The maximum off-site dose impact from air emissions was calculated to be 1.5 x 10 -4 millirem. The total population within a 50-mile radius of Sandia National Laboratories/New Mexico received an estimated collective dose of 0.012 person-rem during 1994 from the laboratories' operations. This report is prepared for the U.S. Department of Energy in compliance with DOE Order 5400.1

  4. Aquatic macroinvertebrates and water quality in Sandia Canyon

    International Nuclear Information System (INIS)

    Bennett, K.

    1994-05-01

    In 1990, field studies of water quality and stream macroinvertebrate communities were initiated in Sandia Canyon at Los Alamos National Laboratory. The studies were designed to establish baseline data and to determine the effects of routine discharges of industrial and sanitary waste. Water quality measurements were taken and aquatic macroinvertebrates sampled at three permanent stations within the canyon. Two of the three sample stations are located where the stream regularly receives industrial and sanitary waste effluents. These stations exhibited a low diversity of macroinvertebrates and slightly degraded water quality. The last sample station, located approximately 0.4 km (0.25 mi) downstream from the nearest wastewater outfall, appears to be in a zone of recovery where water quality parameters more closely resemble those found in natural streams in the Los Alamos area. A large increase in macroinvertebrate diversity was also observed at the third station. These results indicate that effluents discharged into Sandia Canyon have a marked effect on water quality and aquatic macroinvertebrate communities

  5. The Center For Medicare And Medicaid Innovation's blueprint for rapid-cycle evaluation of new care and payment models.

    Science.gov (United States)

    Shrank, William

    2013-04-01

    The Affordable Care Act established the Center for Medicare and Medicaid Innovation to test innovative payment and service delivery models. The goal is to reduce program expenditures while preserving or improving the quality of care provided to beneficiaries of Medicare, Medicaid, and the Children's Health Insurance Program. Central to the success of the Innovation Center is a new, rapid-cycle approach to evaluation. This article describes that approach--setting forth how the Rapid Cycle Evaluation Group aims to deliver frequent feedback to providers in support of continuous quality improvement, while rigorously evaluating the outcomes of each model tested. This article also describes the relationship between the group's work and that of the Office of the Actuary at the Centers for Medicare and Medicaid Services, which plays a central role in the assessment of new models.

  6. Parkinson’s Disease and Home Healthcare Use and Expenditures among Elderly Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Sandipan Bhattacharjee

    2015-01-01

    Full Text Available This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years with Parkinson’s disease (PD compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.

  7. Medicare Part D Roulette, Potential Implications of Random..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare Part D Roulette, Potential Implications of Random Assignment and Plan Restrictions Dual-eligible (Medicare and Medicaid) beneficiaries are randomly assigned...

  8. Reforming Medicare through 'version 2.0' of accountable care.

    Science.gov (United States)

    Lieberman, Steven M

    2013-07-01

    Medicare needs fundamental reform to achieve fiscal sustainability, improve value and quality, and preserve beneficiaries' access to physicians. Physician fees will fall by one-quarter in 2014 under current law, and the dire federal budget outlook virtually precludes increasing Medicare spending. There is a growing consensus among policy makers that reforming fee-for-service payment, which has long served as the backbone of Medicare, is unavoidable. Accountable care organizations (ACOs) provide a new payment alternative but currently have limited tools to control cost growth or engage and reward beneficiaries and providers. To fundamentally reform Medicare, this article proposes an enhanced version of ACOs that would eliminate the scheduled physician fee cuts, allow fees to increase with inflation, and enhance ACOs' ability to manage care. In exchange, the proposal would require modest reductions in overall Medicare spending and require ACOs to accept increased accountability and financial risk. It would cause per beneficiary Medicare spending by 2023 to fall 4.2 percent below current Congressional Budget Office projections and help the program achieve fiscal sustainability.

  9. The Impact of Medicare Part D on Self-Employment.

    Science.gov (United States)

    Moulton, Jeremy G; Diebold, Jeffrey C; Scott, John C

    2017-01-01

    We explore the relationship between access to affordable health insurance and self-employment using exogenous variation from the introduction of Medicare Part D that reduced the out-of-pocket cost of prescription drugs and improved health outcomes in a difference-in-differences model using the American Community Survey. We find that our treatment group of individuals aged 65-69 were 0.5 percentage points (or 5%) more likely to be self-employed in relation to a control group aged 60-64.

  10. Medicare Beneficiary Knowledge of the Part D Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment According to findings appearing in Medicare Beneficiary Knowledge...

  11. Provider Distribution Changes in Dual-Energy X-Ray Absorptiometry in the Medicare Population Over the Past Decade.

    Science.gov (United States)

    Intenzo, Charles M; Parker, Laurence; Levin, David C; Kim, Sung M; Rao, Vijay M

    2016-01-01

    Both radiologists as well as nonimaging physicians perform dual-energy X-ray absorptiometry (DXA) imaging in the United States. This study aims to compare provider distribution between these physician groups on the Medicare population, which is the predominant age group of patients evaluated by this imaging procedure. Using the 2 relevant Current Procedural Terminology, Fourth Edition codes for DXA scans, source data were obtained from the CMS Physician Supplier Procedure Summary Master Files from 2003 through 2013. DXA scan procedure volumes for radiologists and nonradiologists on Medicare patients were tabulated. Utilization rates were calculated. From 2003 to 2013, the total number of DXA scans performed on Medicare patients decreased by 2%. However, over the same period, the number of scans performed by radiologists had increased by 25% over nonimaging specialists, whose utilization had declined by approximately the same amount. From 2003 to 2013, the rate of utilization of DXA scans in the Medicare fee-for-service population declined somewhat. However, radiologists continue to gain market share from other specialists and now predominate in this type of imaging by a substantial margin. Copyright © 2016 International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

  12. Disease prevention policy under Medicare: a historical and political analysis.

    Science.gov (United States)

    Schauffler, H H

    1993-01-01

    I review the history and politics of Medicare disease prevention policy and identify factors associated with the success or failure of legislative initiatives to add preventive services benefits to Medicare. Between 1965 and 1990, 453 bills for Medicare preventive services were introduced in the U.S. Congress, but not until 1980, after 350 bills had failed, was the first preventive service added to the Medicare program. Medicare currently pays for only four of the 44 preventive services recommended for the elderly by the U.S. Preventive Services Task Force (pneumococcal and hepatitis B vaccinations, Pap smears, and mammography). In addition, Congress has funded demonstration programs for the influenza vaccine and comprehensive preventive services. The preventive services added to Medicare reflect the bias of the biomedical model toward screening and immunizations. Counseling services have received the least legislative attention. Factors associated with successful enactment include single-benefit bills, incorporation into budget-deficit reduction legislation, documented evidence of cost-effectiveness, public hearings, sponsorship by chairs of key congressional committees, and persistent congressional leadership. Factors associated with failure include lack of support from Medicare beneficiaries, lack of professional support, impact on total Medicare expenditures, disagreement over or failure to address payment and financing mechanisms, and competing congressional priorities.

  13. Variation in Payment Rates under Medicare's Inpatient Prospective Payment System.

    Science.gov (United States)

    Krinsky, Sam; Ryan, Andrew M; Mijanovich, Tod; Blustein, Jan

    2017-04-01

    To measure variation in payment rates under Medicare's Inpatient Prospective Payment System (IPPS) and identify the main payment adjustments that drive variation. Medicare cost reports for all Medicare-certified hospitals, 1987-2013, and Dartmouth Atlas geographic files. We measure the Medicare payment rate as a hospital's total acute inpatient Medicare Part A payment, divided by the standard IPPS payment for its geographic area. We assess variation using several measures, both within local markets and nationally. We perform a factor decomposition to identify the share of variation attributable to specific adjustments. We also describe the characteristics of hospitals receiving different payment rates and evaluate changes in the magnitude of the main adjustments over time. Data downloaded from the Centers for Medicare and Medicaid Services, the National Bureau of Economic Research, and the Dartmouth Atlas. In 2013, Medicare paid for acute inpatient discharges at a rate 31 percent above the IPPS base. For the top 10 percent of discharges, the mean rate was double the IPPS base. Variations were driven by adjustments for medical education and care to low-income populations. The magnitude of variation has increased over time. Adjustments are a large and growing share of Medicare hospital payments, and they create significant variation in payment rates. © Health Research and Educational Trust.

  14. Growth in HMO share of the Medicare market, 1989-1994.

    Science.gov (United States)

    Welch, W P

    1996-01-01

    Between 1989 and 1994 the health maintenance organization (HMO) share of the Medicare market grew rapidly. It is still heavily concentrated geographically, however. The most influential factor in this growth is HMO penetration into an area's general health care market. Medicare payment rates and prior Medicare HMO penetration also have an impact, but their effects are much weaker. Thus, payment rate reform is likely to have only a modest impact on Medicare HMO growth in the short term. In the longer term, the HMO share of the Medicare market will continue to grow, because HMO penetration in the general health care market is growing rapidly.

  15. No association between Centers for Medicare and Medicaid services payments and volume of Medicare beneficiaries or per-capita health care costs for each state.

    Science.gov (United States)

    Harewood, Gavin C; Alsaffar, Omar

    2015-03-01

    The Centers for Medicare and Medicaid Services recently published data on Medicare payments to physicians for 2012. We investigated regional variations in payments to gastroenterologists and evaluated whether payments correlated with the number of Medicare patients in each state. We found that the mean payment per gastroenterologist in each state ranged from $35,293 in Minnesota to $175,028 in Mississippi. Adjusted per-physician payments ranged from $11 per patient in Hawaii to $62 per patient in Washington, DC. There was no correlation between the mean per-physician payment and the mean number of Medicare patients per physician (r = 0.09), there also was no correlation between the mean per-physician payment and the overall mean per-capita health care costs for each state (r = -0.22). There was a 5.6-fold difference between the states with the lowest and highest adjusted Medicare payments to gastroenterologists. Therefore, the Centers for Medicare and Medicaid Services payments do not appear to be associated with the volume of Medicare beneficiaries or overall per-capita health care costs for each state. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Computational geomechanics and applications at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Arguello, Jose Guadalupe Jr.

    2010-01-01

    Sandia National Laboratories (SNL) is a multi-program national laboratory in the business of national security, whose primary mission is nuclear weapons (NW). It is a prime contractor to the USDOE, operating under the NNSA and is one of the three NW national laboratories. It has a long history of involvement in the area of geomechanics, starting with the some of the earliest weapons tests at Nevada. Projects in which geomechanics support (in general) and computational geomechanics support (in particular) are at the forefront at Sandia, range from those associated with civilian programs to those in the defense programs. SNL has had significant involvement and participation in the Waste Isolation Pilot Plant (low-level defense nuclear waste), the Yucca Mountain Project (formerly proposed for commercial spent fuel and high-level nuclear waste), and the Strategic Petroleum Reserve (the nation's emergency petroleum store). In addition, numerous industrial partners seek-out our computational/geomechanics expertise, and there are efforts in compressed air and natural gas storage, as well as in CO 2 Sequestration. Likewise, there have also been collaborative past efforts in the areas of compactable reservoir response, the response of salt structures associated with reservoirs, and basin modeling for the Oil and Gas industry. There are also efforts on the defense front, ranging from assessment of vulnerability of infrastructure to defeat of hardened targets, which require an understanding and application of computational geomechanics. Several examples from some of these areas will be described and discussed to give the audience a flavor of the type of work currently being performed at Sandia in the general area of geomechanics.

  17. Compilation of Sandia Laboratories technical capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Lundergan, C. D.; Mead, P. L. [eds.

    1975-11-01

    This report is a compilation of 17 individual documents that together summarize the technical capabilities of Sandia Laboratories. Each document in this compilation contains details about a specific area of capability. Examples of application of the capability to research and development problems are provided. An eighteenth document summarizes the content of the other seventeen. Each of these documents was issued with a separate report number (SAND 74-0073A through SAND 74-0091, except -0078). (RWR)

  18. Sandia and the Waste Isolation Pilot Plant, 1974--1999

    Energy Technology Data Exchange (ETDEWEB)

    MORA,CARL J.

    2000-04-11

    Engineers have learned to design and build big projects, which certainly describes the WIPP project, but also includes defense projects, highway networks, space exploration, the Internet, etc., through what has been called a messily complex embracing of contradictions. When something massive and complicated has to be built these days, it leads to a protracted political process in which every special interest makes a stand, lobbyists exert what influence they can, lawmakers bicker, contractors change things, Congress struggles with costs, environmentalists hold things up--and this is good. It may seem amazing that anything gets done, but when it does, everyone has had their say. It's an intensely democratic, even if expensive and time-consuming, process. The corporate historian of Sandia National Laboratories presents a unique background of the WIPP project and Sandia's part in it.

  19. Medicare Advantage Plans

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  20. Your Medicare Rights

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  1. What Is Medicare?

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  2. What Medicare Covers

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  3. Looking at CER from Medicare's perspective.

    Science.gov (United States)

    Mohr, Penny

    2012-05-01

    Comparative effectiveness research (CER) is rapidly adding to the amount of data available to health care coverage and payment decision makers. Medicare's decisions have a large effect on coverage and reimbursement policies throughout the health insurance industry and will likely influence the entire U.S. health care system; thus, examining its role in integrating CER into policy is crucial. To describe the potential benefits of CER to support payment and coverage decisions in the Medicare program, limitations on its use,the role of the Centers for Medicare & Medicaid Services (CMS) in improving the infrastructure for CER, and to discuss challenges that must be addressed to integrate CER into CMS's decision-making process. A defining feature of CER is that it provides the type of evidence that will help decision makers, such as patients, clinicians, and payers,make more informed treatment and policy decisions. Because CMS is responsible for more than 47 million elderly and disabled beneficiaries, the way that Medicare uses CER has the potential to have a large impact on public and individual health. Currently many critical payment and coverage decisions within the Medicare program are made on the basis of poor quality evidence, and CER has the potential to greatly improve the quality of decision making. Despite common misconceptions, CMS is not prohibited by law from using CER apart from some reasonable limitations. CMS is,however, required to support the development of the CER infrastructure by making their data more readily available to researchers. While CER has substantial potential to improve the quality of the agency's policy decisions,challenges remain to integrate CER into Medicare's processes. These challenges include statutory ambiguities, lack of sufficient staff and internal resources to take advantage of CER, and the lack of an active voice in setting priorities for CER and study design. Although challenges exist, CER has the potential to greatly

  4. Variations in Medicare Reimbursement in Radiation Oncology: An Analysis of the Medicare Provider Utilization and Payment Data Set.

    Science.gov (United States)

    Vu, Charles C; Lanni, Thomas B; Robertson, John M

    2016-04-01

    The purposes of this study were to summarize recently published data on Medicare reimbursement to individual radiation oncologists and to identify the causes of variation in Medicare reimbursement in radiation oncology. The Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (POSPUF), which details nearly all services provided by radiation oncologists in 2012, was used for this study. The data were filtered and analyzed by physician and by billing code. Statistical analysis was performed to identify differences in reimbursements based on sex, rurality, billing of technical services, or location in a certificate of need (CON) state. There were 4135 radiation oncologists who received a total of $1,499,625,803 in payments from Medicare in 2012. Seventy-five percent of radiation oncologists were male. The median reimbursement was $146,453. The code with the highest total reimbursement was 77418 (radiation treatment delivery intensity modulated radiation therapy [IMRT]). The most commonly billed evaluation and management (E/M) code for new visits was 99205 (49%). The most commonly billed E/M code for established visits was 99213 (54%). Forty percent of providers billed none of their new office visits using 99205 (the highest E/M billing code), whereas 34% of providers billed all of their new office visits using 99205. For the 1510 radiation oncologists (37%) who billed technical services, median Medicare reimbursement was $606,008, compared with $93,921 for all other radiation oncologists (Preimbursement. The billing of technical services, with their high capital and labor overhead requirements, limits any comparison in reimbursement between individual radiation oncologists or between radiation oncologists and other specialists. Male sex and rural practice location are independent predictors of higher total Medicare reimbursements. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Leadership development study :success profile competencies and high-performing leaders at Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Katherine M.; Mulligan, Deborah Rae; Szenasi, Gail L.; Crowder, Stephen Vernon

    2005-04-01

    Sandia is undergoing tremendous change. Sandia's executive management recognized the need for leadership development. About ten years ago the Business, Leadership, and Management Development department in partnership with executive management developed and implemented the organizational leadership Success Profile Competencies to help address some of the changes on the horizon such as workforce losses and lack of a skill set in the area of interpersonal skills. This study addresses the need for the Business, Leadership, and Management Development department to provide statistically sound data in two areas. One is to demonstrate that the organizational 360-degree success profile assessment tool has made a difference for leaders. A second area is to demonstrate the presence of high performing leaders at the Labs. The study utilized two tools to address these two areas. Study participants were made up of individuals who have solid data on Sandia's 360-degree success profile assessment tool. The second assessment tool was comprised of those leaders who participated in the Lockheed Martin Corporation Employee Preferences Survey. Statistical data supports the connection between leader indicators and the 360-degree assessment tool. The study also indicates the presence of high performing leaders at Sandia.

  6. Medicare Post-Acute Care Episodes and Payment Bundling

    Data.gov (United States)

    U.S. Department of Health & Human Services — Published in Volume 4, Issue 1, of Medicare and Medicaid Research Review, this paper provides an overview of results examining alternative Medicare post-acute care...

  7. The Impact of Hospital-Acquired Conditions on Medicare..

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in The Impact of Hospital-Acquired Conditions on Medicare Program Payments, published in Volume 4, Issue 4 of the Medicare and...

  8. Medicare and Medicaid Trends in Health Care Sectors

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) provides monthly and fiscal-year-to-date income and expenditure trends for Medicare Hospital Insurance (HI) and...

  9. Measuring Coding Intensity in the Medicare Advantage Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In 2004, Medicare implemented a risk-adjustment system that pays Medicare Advantage (MA) plans based on diagnoses reported for their enrollees, giving the plans an...

  10. Description and outcomes of a Medicare case management program by nurses.

    Science.gov (United States)

    Allen, S A

    1999-01-01

    During the current environment of cost-cutting and restructuring, case management is viewed as a means of providing comprehensive, coordinated care while reducing costs. Studies of community-based case management have been disappointing. This study evaluates a Medicare service, Management and Evaluation of the Care Plan (MAE), as a model of nurses providing case management in the home. Three groups were compared: MAE (N = 176), non-MAE (N = 187) and newly discharged (N = 93). Utilization data was collected over one year. Overall, subjects were unmarried older women with three functional limitations, four medical diagnoses and averaged 43 home care visits and one hospitalization. MAE patients were older, had more functional and environmental limitations, less ADL independence, and a worse prognosis, yet used significantly less health care than non-MAE recipients did. Regression analysis was performed using group membership and hospital and home care utilization as dependent variables. Although the project was conducted at one site, overall the sample was similar to the national Medicare population.

  11. Rotor instrumentation circuits for the Sandia 34-meter vertical axis wind turbine

    Science.gov (United States)

    Sutherland, Herbert J.; Stephenson, William A.

    1988-07-01

    Sandia National Laboratories has erected a research oriented, 34-meter diameter, Darrieus vertical axis wind turbine near Bushland, Texas, which has been designated the Sandia 34-m VAWT Test Bed. To meet present and future research needs, the machine was equipped with a large array of sensors. This manuscript details the sensors initially placed on the rotor, their respective instrumentation circuits, and the provisions incorporated into the design of the rotor instrumentation circuits for future research. This manuscript was written as a reference manual for the rotor instrumentation of the Test Bed.

  12. Sandia National Laboratories, California proposed CREATE facility environmental baseline survey.

    Energy Technology Data Exchange (ETDEWEB)

    Catechis, Christopher Spyros

    2013-10-01

    Sandia National Laboratories, Environmental Programs completed an environmental baseline survey (EBS) of 12.6 acres located at Sandia National Laboratories/California (SNL/CA) in support of the proposed Collaboration in Research and Engineering for Advanced Technology and Education (CREATE) Facility. The survey area is comprised of several parcels of land within SNL/CA, County of Alameda, California. The survey area is located within T 3S, R 2E, Section 13. The purpose of this EBS is to document the nature, magnitude, and extent of any environmental contamination of the property; identify potential environmental contamination liabilities associated with the property; develop sufficient information to assess the health and safety risks; and ensure adequate protection for human health and the environment related to a specific property.

  13. National Environmental Policy Act (NEPA) Compliance Guide, Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

    1995-08-01

    This report contains a comprehensive National Environmental Policy Act (NEPA) Compliance Guide for the Sandia National Laboratories. It is based on the Council on Environmental Quality (CEQ) NEPA regulations in 40 CFR Parts 1500 through 1508; the US Department of Energy (DOE) N-EPA implementing procedures in 10 CFR Part 102 1; DOE Order 5440.1E; the DOE ``Secretarial Policy Statement on the National Environmental Policy Act`` of June 1994- Sandia NEPA compliance procedures-, and other CEQ and DOE guidance. The Guide includes step-by-step procedures for preparation of Environmental Checklists/Action Descriptions Memoranda (ECL/ADMs), Environmental Assessments (EAs), and Environmental Impact Statements (EISs). It also includes sections on ``Dealing With NEPA Documentation Problems`` and ``Special N-EPA Compliance Issues.``

  14. Ever Enrolled Medicare Population Estimates from the MCBS..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Findings reported in Ever Enrolled Medicare Population Estimates from the MCBS Access to Care (ATC) Files, published in Volume 4, Issue 2 of the Medicare and...

  15. Medicare Advantage Rates and Statistics - FFS Data (1998-...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare fee-for-service data for each county broken out by aged, disabled, and ESRD beneficiaries including data on total Medicare fee-for-service reimbursement and...

  16. Medicare depreciation; useful life guidelines--HCFA. Proposed rule.

    Science.gov (United States)

    1982-09-30

    We are proposing to amend Medicare regulations to clarify which useful life guidelines providers of health care services may use to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize HHS useful life guidelines or, if none have been published by HHS, the American Hospital Association (AHA) useful life guidelines of 1973 or IRS guidelines. We are proposing to eliminate the reference to IRS guidelines because those previously acceptable for Medicare purposes are outdated and have been made obsolete by the IRS or by statutory change. We would also delete the specific reference to the 1973 AHA guidelines. In addition, we intend this amendment to clarify that certain tax legislation on accelerated depreciation, recently passed by Congress, does not apply to the Medicare program.

  17. 1985 environmental report: Sandia National Laboratories, Tonopah Test Range, Tonopah, Nevada

    International Nuclear Information System (INIS)

    Millard, G.C.

    1986-04-01

    The Tonopah Test Range is located about 160 air miles northwest of Las Vegas, Nevada, and covers 525 square miles within the Nellis Air Force Base Bombing and Gunnery Range. The range is used for various DOE tests involving high and low altitude projectiles. Operations that affect the environment are mainly road construction, preparation of instrumentation sites, and disturbance of the terrain from projectile impacts. Monitoring of the test range is done annually by the US Environmental Protection Agency to supplement Sandia's monitoring effort associated with Sandia test activities. Monitoring results for 1984 indicate that test range operations do not adversely affect the offsite environment or the public

  18. Collision course? Donald Trump, Paul Ryan, and the fate of Medicare.

    Science.gov (United States)

    Oberlander, Jonathan

    2018-04-10

    The election of Donald Trump as president of the United States raises questions about the future of Medicare. How will Medicare fare under Republican-led government? There are several compelling reasons that the Trump administration and Congressional Republicans might avoid Medicare reform, including the political risks of taking on a popular program, the difficulties the party has encountered in trying to dismantle the Patient Protection and Affordable Care Act (ACA), the importance of older Americans to the GOP coalition, and President Trump's views about Medicare. However, because of fiscal pressures and the commitment of Speaker of the House Paul Ryan and other Republicans to entitlement reform, the GOP nonetheless could end up attempting to make major changes in Medicare. Alternatively, Republican efforts to repeal and undermine the ACA could unintentionally enhance the political fortunes of proposals to expand Medicare. Consequently, the fate of Medicare during the Trump administration remains highly uncertain.

  19. 42 CFR 403.206 - General standards for Medicare supplemental policies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false General standards for Medicare supplemental policies. 403.206 Section 403.206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Medicare Supplemental Policies...

  20. 76 FR 50212 - Site-Wide Environmental Impact Statement for Sandia National Laboratories, New Mexico (SNL/NM)

    Science.gov (United States)

    2011-08-12

    ... Environmental Impact Statement for Sandia National Laboratories, New Mexico (DOE/EIS-0281-SA-04), DOE/NNSA... Environmental Impact Statement for Sandia National Laboratories, New Mexico for the Installation of a Petawatt..., New Mexico Final Supplement Analysis for the Site-Wide Environmental Impact Statement (2006 SNL/NM...

  1. Relationships between Medicare Advantage contract characteristics and quality-of-care ratings: an observational analysis of Medicare Advantage star ratings.

    Science.gov (United States)

    Xu, Peng; Burgess, James F; Cabral, Howard; Soria-Saucedo, Rene; Kazis, Lewis E

    2015-03-03

    The Centers for Medicare & Medicaid Services (CMS) publishes star ratings on Medicare Advantage (MA) contracts to measure plan quality of care with implications for reimbursement and bonuses. To investigate whether MA contract characteristics are associated with quality of care through the Medicare plan star ratings. Retrospective study of MA star ratings in 2010. Unadjusted and adjusted multivariable linear regression models assessed the relationship between 5-star rating summary scores and plan characteristics. CMS MA contracts nationally. 409 (71%) of a total of 575 MA contracts, covering 10.56 million Medicare beneficiaries (90% of the MA population) in the United States in 2010. The MA quality ratings summary score (stars range from 1 to 5) is a quality measure based on 36 indicators related to processes of care, health outcomes, access to care, and beneficiary satisfaction. Nonprofit, larger, and older MA contracts were more likely to receive higher star ratings. Star ratings ranged from 2 to 5. Nonprofit contracts received an average 0.55 (95% CI, 0.42 to 0.67) higher star ratings than for-profit contracts (P  star ratings than for-profit contracts. When comparing health plans in the future, the CMS should give increasing attention to for-profit plans with lower quality ratings and consider developing programs to assist newer and smaller plans in improving their care for Medicare beneficiaries. None.

  2. Final report for Texas A&M University Group Contribution to DE-FG02-09ER25949/DE-SC0002505: Topology for Statistical Modeling of Petascale Data (and ASCR-funded collaboration between Sandia National Labs, Texas A&M University and University of Utah)

    Energy Technology Data Exchange (ETDEWEB)

    Rojas, Joseph Maurice [Texas A& M University

    2013-02-27

    We summarize the contributions of the Texas A\\&M University Group to the project (DE-FG02-09ER25949/DE-SC0002505: Topology for Statistical Modeling of Petascale Data - an ASCR-funded collaboration between Sandia National Labs, Texas A\\&M U, and U Utah) during 6/9/2011 -- 2/27/2013.

  3. Characteristics of otolaryngology claims to Medicare in 2012.

    Science.gov (United States)

    Bhattacharyya, Neil; Lin, Harrison W

    2014-11-01

    The Medicare provider utilization and payment public use datafile for 2012 was analyzed with respect to otolaryngology specialty providers to characterize otolaryngology services billed to and reimbursed by Medicare, both overall and according to provider characteristics. Among 8450 otolaryngology specialty providers submitting claims, the top 5 billed services were (count in millions): 99213 (2.23), 95165 (1.81), 99203 (0.92), 99214 (0.83), and 69210 (0.71), and the top 5 total reimbursed services were (aggregate total reimbursements in millions): 99213 ($114), 99203 ($68), 99214 ($63), 31231 ($60), and 31575 ($47). There was a mean of 1567 services billed per provider with an average (yearly) total reimbursement from Medicare of $76,068 per provider. These data characterize the current level of provision of otolaryngology services to the Medicare population. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.

  4. The effects of Medicare Health Management Organizations on hospital operating profit in Florida.

    Science.gov (United States)

    Large, John T; Sear, Alan M

    2005-02-01

    Between 1992 and 1997, the number of members enrolled in Medicare Health Management Organizations (HMOs) nationwide in the USA more than doubled. During this period, managed care organizations wielded considerable influence over the health care of a large segment of the Medicare population in Florida. This study examined the impact on operational profit of 148 short-term, acute-care Florida hospitals in this period from Medicare HMO patients, as part of a hospital's payer mix. Three measures of hospital profitability were used: operating profit per actual bed, total operating profit with no adjustment for bed size, and operating margins. The multivariate statistical model employed in this study was a linear mixed model with an autoregressive order one (AR[1]) parametric structure on the covariance matrix. The results of the study indicate that Florida hospitals experienced greater profit pressures from Medicare HMO inpatients than from traditional Medicare inpatients. Further, these hospitals could have experienced positive profit effects with greater traditional Medicare participation and negative financial effects with greater Medicare HMO participation. Additionally, Medicare HMO patients appear to have been admitted to hospitals in worse health condition than those in traditional Medicare. Medicare HMO patients were more likely to have used emergency rooms as the source of admission than traditional Medicare patients. Also, Medicare HMO patients were more likely to have been admitted as emergent cases than traditional Medicare patients. Other research has shown that Medicare HMO patients, at the time of enrolment, are probably healthier than traditional Medicare enrollees, but here they appear to have been admitted to hospitals with higher levels of severity of illness. Explanations are offered for these findings.

  5. Can health promotion programs save Medicare money?

    Directory of Open Access Journals (Sweden)

    Ron Z Goetzel

    2007-04-01

    Full Text Available Ron Z Goetzel1, David Shechter2, Ronald J Ozminkowski1, David C Stapleton3, Pauline J Lapin4, J Michael McGinnis5, Catherine R Gordon6, Lester Breslow71Institute for Health and Productivity Studies, Cornell University, Washington, DC; 2Health and Productivity Research, Thomson Medstat, Santa Barbara, CA; 3Cornell Institute for Policy Research, Cornell University, Washington, DC; 4Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, MD; 5National Academy of Sciences, Institute of Medicine, The National Academies, Washington, DC; 6Office of the Director, Centers for Disease Control and Prevention, Washington, DC; 7UCLA School of Public Health, Dept. of Health Services, Los Angeles, CA, USAAbstract: The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program.Keywords: health promotion, return on investment, Medicare, financial

  6. Power source evaluation capabilities at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Doughty, D.H.; Butler, P.C.

    1996-04-01

    Sandia National Laboratories maintains one of the most comprehensive power source characterization facilities in the U.S. National Laboratory system. This paper describes the capabilities for evaluation of fuel cell technologies. The facility has a rechargeable battery test laboratory and a test area for performing nondestructive and functional computer-controlled testing of cells and batteries.

  7. The Medicare Hospital Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations.

    Science.gov (United States)

    Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P

    2014-06-01

    To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. © Health Research and Educational Trust.

  8. The bribery statute: a new weapon against Medicare fraud.

    Science.gov (United States)

    Cozort, L A

    2001-03-01

    A May 2000 U.S. Supreme Court decision determining when a Federal bribery statute can be used to fight Medicare fraud has ramifications for healthcare providers. In Fischer v. United States, the Court concluded that healthcare providers that participate in Medicare are considered to receive benefits as set forth in the bribery statute and thus can be prosecuted for fraudulent activities against the government under the statute. The statute mandates a fine, imprisonment for up to 10 years, or both for anyone convicted under it. Provider organizations that receive Medicare payments and business associates of such organizations should be aware that the government may step up its use of the bribery law in prosecuting fraudulent activity. In addition, although the case pertained specifically to healthcare providers that participate in Medicare, providers that do not participate in Medicare may wish to evaluate the advisability of accepting other Federal funding because of the possible reach of the bribery statute.

  9. Can health promotion programs save Medicare money?

    Science.gov (United States)

    Goetzel, Ron Z; Shechter, David; Ozminkowski, Ronald J; Stapleton, David C; Lapin, Pauline J; McGinnis, J Michael; Gordon, Catherine R; Breslow, Lester

    2007-01-01

    The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program. PMID:18044084

  10. 75 FR 46833 - 45th Anniversary of Medicare and Medicaid

    Science.gov (United States)

    2010-08-03

    ... Part III The President Proclamation 8544--45th Anniversary of Medicare and Medicaid #0; #0; #0..., 2010 45th Anniversary of Medicare and Medicaid By the President of the United States of America A Proclamation When President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965, millions...

  11. The Design-to-Analysis Process at Sandia National Laboratories Observations and Recommendations; TOPICAL

    International Nuclear Information System (INIS)

    BURNS, SHAWN P.; HARRISON, RANDY J.; DOBRANICH, DEAN

    2001-01-01

    The efficiency of the design-to-analysis process for translating solid-model-based design data to computational analysis model data plays a central role in the application of computational analysis to engineering design and certification. A review of the literature from within Sandia as well as from industry shows that the design-to-analysis process involves a number of complex organizational and technological issues. This study focuses on the design-to-analysis process from a business process standpoint and is intended to generate discussion regarding this important issue. Observations obtained from Sandia staff member and management interviews suggest that the current Sandia design-to-analysis process is not mature and that this cross-organizational issue requires committed high-level ownership. A key recommendation of the study is that additional resources should be provided to the computer aided design organizations to support design-to-analysis. A robust community of practice is also needed to continuously improve the design-to-analysis process and to provide a corporate perspective

  12. The Sandia Report and U.S. Achievement: An Assessment.

    Science.gov (United States)

    Stedman, Lawrence C.

    1994-01-01

    The article assesses the report of the Sandia National Laboratory's contentions about decline in Scholactic Aptitude Test Scores, National Assessment of Educational Progress achievement, and international assessments. The article suggests the report is generally right about steady trends but seriously flawed by several errors. (SM)

  13. Annotated bibliography National Environmental Policy Act (NEPA) documents for Sandia National Laboratories

    International Nuclear Information System (INIS)

    Harris, J.M.

    1995-04-01

    The following annotated bibliography lists documents prepared by the Department of Energy (DOE), and predecessor agencies, to meet the requirements of the National Environmental Policy Act (NEPA) for activities and facilities at Sandia National Laboratories sites. For each NEPA document summary information and a brief discussion of content is provided. This information may be used to reduce the amount of time or cost associated with NEPA compliance for future Sandia National Laboratories projects. This summary may be used to identify model documents, documents to use as sources of information, or documents from which to tier additional NEPA documents

  14. Annotated bibliography National Environmental Policy Act (NEPA) documents for Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Harris, J.M.

    1995-04-01

    The following annotated bibliography lists documents prepared by the Department of Energy (DOE), and predecessor agencies, to meet the requirements of the National Environmental Policy Act (NEPA) for activities and facilities at Sandia National Laboratories sites. For each NEPA document summary information and a brief discussion of content is provided. This information may be used to reduce the amount of time or cost associated with NEPA compliance for future Sandia National Laboratories projects. This summary may be used to identify model documents, documents to use as sources of information, or documents from which to tier additional NEPA documents.

  15. The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

    2018-04-01

    To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.

  16. 42 CFR 411.204 - Medicare benefits secondary to LGHP benefits.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medicare benefits secondary to LGHP benefits. 411... benefits secondary to LGHP benefits. (a) Medicare benefits are secondary to benefits payable by an LGHP for services furnished during any month in which the individual— (1) Is entitled to Medicare Part A benefits...

  17. Design and operation of the Sandia Pilot Plant

    International Nuclear Information System (INIS)

    Morris, M.E.

    1980-01-01

    An 8 ton/day dry sewage sludge irradiator was designed and constructed at Sandia National Laboratories in the last half of 1977 and in 1978; and was charged with 137 Cs and made operational in the spring of 1979. The design of the major subsystems of the irradiator is described. Subsequent operational experiences are also summarized

  18. MIPPA: First Broad Changes to Medicare Part D Plan Operations.

    Science.gov (United States)

    LeMasurier, Jean D; Edgar, Babette

    2009-04-01

    In July 2008, as part of broad Medicare reform, Congress passed the first major legislative changes to Medicare Part D since its enactment in 2003-the Medicare Improvements for Patients and Providers Act. This new legislation has significant implications for how Part D plans can market and enroll Medicare beneficiaries. The new legislation also strengthened beneficiary protections, expanded the low-income subsidy provisions originally included in Part D, and expanded Part D coverage. These changes have significant implications for the operation of Part D plans and can affect those involved in benefit design, including specialty pharmacy coverage. This article discusses the major changes that took effect on January 1, 2009, and have immediate implications for Part D plan sponsors, including Medicare Advantage plans and stand-alone prescription drug plans.

  19. An Analysis of Medicare Reimbursement to Ophthalmologists: Years 2012 to 2013.

    Science.gov (United States)

    Han, Everett; Baisiwala, Shivani; Jain, Atul; Bundorf, M Kate; Pershing, Suzann

    2017-10-01

    To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. Retrospective, cross-sectional study. A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement. Published by Elsevier Inc.

  20. Paying Medicare Advantage plans: To level or tilt the playing field.

    Science.gov (United States)

    Glazer, Jacob; McGuire, Thomas G

    2017-12-01

    Medicare beneficiaries are eligible for health insurance through the public option of traditional Medicare (TM) or may join a private Medicare Advantage (MA) plan. Both are highly subsidized but in different ways. Medicare pays for most of costs directly in TM, and subsidizes MA plans based on a "benchmark" for each beneficiary choosing a private plan. The level of this benchmark is arguably the most important policy decision Medicare makes about the MA program. Many analysts recommend equalizing Medicare's subsidy across the options - referred to in policy circles as a "level playing field." This paper studies the normative question of how to set the level of the benchmark, applying the versatile model developed by Einav and Finkelstein (EF) to Medicare. The EF framework implies unequal subsidies to counteract risk selection across plan types. We also study other reasons to tilt the field: the relative efficiency of MA vs. TM, market power of MA plans, and institutional features of the way Medicare determines subsidies and premiums. After review of the empirical and policy literature, we conclude that in areas where the MA market is competitive, the benchmark should be set below average costs in TM, but in areas characterized by imperfect competition in MA, it should be raised in order to offset output (enrollment) restrictions by plans with market power. We also recommend specific modifications of Medicare rules to make demand for MA more price elastic. Copyright © 2016. Published by Elsevier B.V.

  1. Sulimar Queen environmental restoration project closure package Sandia environmental stewardship exemplar.

    Energy Technology Data Exchange (ETDEWEB)

    Tillman, Jack B.

    2008-09-01

    In March 2008, Sandia National Laboratories (Sandia), in partnership with the Bureau of Land Management, Roswell Field Office, completed its responsibilities to plug and abandon wells and restore the surface conditions for the Sulimar Queens Unit, a 2,500 acre oil field, in Chaves County, Southeast New Mexico. Sandia assumed this liability in an agreement to obtain property to create a field laboratory to perform extensive testing and experimentation on enhanced oil recovery techniques for shallow oil fields. In addition to plugging and abandoning 28 wells, the project included the removal of surface structures and surface reclamation of disturbed lands associated with all plugged and abandoned wells, access roads, and other auxiliary facilities within unit boundaries. A contracting strategy was implemented to mitigate risk and reduce cost. As the unit is an important wildlife habitat for prairie chickens, sand dune lizards, and mule deer, the criteria for the restoration and construction process were designed to protect and enhance the wildlife habitat. Lessons learned from this project include: (1) extreme caution should be exercised when entering agreements that include future liabilities, (2) partnering with the regulator has huge benefits, and (3) working with industry experts, who were familiar with the work, and subcontractors, who provided the network to complete the project cost effectively.

  2. Sandia National Laboratories, California Environmental Management System program manual.

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2013-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004 and Department of Energy (DOE) Order 436.1.

  3. Sandia National Laboratories, California Environmental Management System program manual

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, Barbara L.

    2014-04-01

    The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004 and Department of Energy (DOE) Order 436.1.

  4. SANDIA MOUNTAIN WILDERNESS, NEW MEXICO.

    Science.gov (United States)

    Hedlund, D.C.; Kness, R.F.

    1984-01-01

    Geologic and mineral-resource investigations in the Sandia Mountains in New Mexico indicate that a small part of the area has a probable mineral-resource potential. Most of the mineral occurrences are small barite-fluorite veins that occur along faults on the eastern slope of the range. The barite veins in the Landsend area and in the Tunnel Spring area are classed as having a probable mineral-resource potential. Fluorite veins which occur at the La Luz mine contain silver-bearing galeana and the area near this mine is regarded as having a probable resource potential for silver. No energy resources were identified in this study.

  5. Mapping Medicare Disparities Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Office of Minority Health has designed an interactive map, the Mapping Medicare Disparities Tool, to identify areas of disparities between subgroups of...

  6. Tiger Team assessment of the Sandia National Laboratories, Albuquerque

    Energy Technology Data Exchange (ETDEWEB)

    1991-05-01

    This report documents the Tiger Team Assessment of Sandia National Laboratories (SNL), Albuquerque, located in Albuquerque, New Mexico. SNL, Albuquerque, is operated by the Sandia Corporation (a wholly owned subsidiary of the American Telephone and Telegraph Company) for the US Department of Energy (DOE). The environmental assessment also included DOE tenant facilities at Ross Aviation, Albuquerque Microelectronics Operation, and the Central Training Academy. The assessment was conducted from April 15 to May 24, 1991, under the auspices of DOE's Office of Special Projects under the Assistant Secretary for Environment, Safety and Health (ES H). The assessment was comprehensive, encompassing ES H disciplines, management, self-assessments, and quality assurance; transportation; and waste management operations. Compliance with applicable federal, state, and local regulations; applicable DOE Orders; best management practices; and internal SNL, Albuquerque, requirements were assessed. In addition, an evaluation of the adequacy and effectiveness of DOE and SNL, Albuquerque management of ES H programs was conducted.

  7. Tiger Team assessment of the Sandia National Laboratories, Albuquerque

    International Nuclear Information System (INIS)

    1991-05-01

    This report documents the Tiger Team Assessment of Sandia National Laboratories (SNL), Albuquerque, located in Albuquerque, New Mexico. SNL, Albuquerque, is operated by the Sandia Corporation (a wholly owned subsidiary of the American Telephone and Telegraph Company) for the US Department of Energy (DOE). The environmental assessment also included DOE tenant facilities at Ross Aviation, Albuquerque Microelectronics Operation, and the Central Training Academy. The assessment was conducted from April 15 to May 24, 1991, under the auspices of DOE's Office of Special Projects under the Assistant Secretary for Environment, Safety and Health (ES ampersand H). The assessment was comprehensive, encompassing ES ampersand H disciplines, management, self-assessments, and quality assurance; transportation; and waste management operations. Compliance with applicable federal, state, and local regulations; applicable DOE Orders; best management practices; and internal SNL, Albuquerque, requirements were assessed. In addition, an evaluation of the adequacy and effectiveness of DOE and SNL, Albuquerque management of ES ampersand H programs was conducted

  8. POLLUTION PREVENTION OPPORTUNITY ASSESSMENT - GEOCHEMISTRY LABORATORY AT SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    These reports summarize pollution prevention opportunity assessments conducted jointly by EPA and DOE at the Geochemistry Laboratory and the Manufacturing and Fabrication Repair Laboratory at the Department of Energy's Sandia National Laboratories facility in Albuquerque, New Mex...

  9. Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.

    Science.gov (United States)

    Keohane, Laura M; Rahman, Momotazur; Mor, Vincent

    2016-04-01

    To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.

  10. 76 FR 19527 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    Science.gov (United States)

    2011-04-07

    ...). Under these provisions, providers of services and suppliers can continue to receive traditional Medicare... Plans and Integration of Community Resources 11. ACO Marketing Guidelines 12. Program Integrity... the Institute of Medicine report: Safety, effectiveness, patient-centeredness, timeliness, efficiency...

  11. Environmental Monitoring Plan, Sandia National Laboratories, Livermore

    International Nuclear Information System (INIS)

    Holland, R.C.

    1992-06-01

    This Environmental Monitoring Plan was written to fulfill the requirements of DOE Order 5400.1 and DOE Environmental Regulatory Guide DOE/EH 0173T. This Plan documents the background, organizational structure, and methods used for effluent monitoring and environmental surveillance at Sandia National Laboratories, Livermore. The design, rationale, and historical results of the environmental monitoring system are discussed in detail. Throughout the Plan, recommendations for improvements to the monitoring system are made. 61 refs

  12. Medication adherence and Medicare expenditure among beneficiaries with heart failure.

    Science.gov (United States)

    Lopert, Ruth; Shoemaker, J Samantha; Davidoff, Amy; Shaffer, Thomas; Abdulhalim, Abdulla M; Lloyd, Jennifer; Stuart, Bruce

    2012-09-01

    To (1) measure utilization of and adherence to heart failure medications and (2) assess whether better adherence is associated with lower Medicare spending. Pooled cross-sectional design using six 3-year cohorts of Medicare beneficiaries with congestive heart failure (CHF) from 1997 through 2005 (N = 2204). Adherence to treatment was measured using average daily pill counts. Bivariate and multivariate methods were used to examine the relationship between medication adherence and Medicare spending. Multivariate analyses included extensive variables to control for confounding, including healthy adherer bias. Approximately 58% of the cohort were taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), 72% a diuretic, 37% a beta-blocker, and 34% a cardiac glycoside. Unadjusted results showed that a 10% increase in average daily pill count for ACE inhibitors or ARBs, beta-blockers, diuretics, or cardiac glycosides was associated with reductions in Medicare spending of $508 (not significant [NS]), $608 (NS), $250 (NS), and $1244 (P <.05), respectively. Estimated adjusted marginal effects of a 10% increase in daily pill counts for beta-blockers and cardiac glycosides were reductions in cumulative 3-year Medicare spending of $510 to $561 and $750 to $923, respectively (P <.05). Higher levels of medication adherence among Medicare beneficiaries with CHF were associated with lower cumulative Medicare spending over 3 years, with savings generally exceeding the costs of the drugs in question.

  13. Examining Measures of Income and Poverty in Medicare Administrative Data.

    Science.gov (United States)

    Samson, Lok Wong; Finegold, Kenneth; Ahmed, Azeem; Jensen, Matthew; Filice, Clara E; Joynt, Karen E

    2017-12-01

    Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, because Medicare administrative data contains limited information about individual economic status. Information gleaned from other sources-such as the Medicaid and Supplemental Security Income programs-can be used in some cases to approximate the income of Medicare beneficiaries. However, such information is limited in its availability and applicability to all beneficiaries. Neighborhood-level measures of income can be used to infer individual-level income, but level of neighborhood aggregation impacts accuracy and usability of the data. Community-level composite measures of economic status have been shown to be associated with health and health outcomes of Medicare beneficiaries and may capture neighborhood effects that are separate from individual effects, but are not readily available in Medicare data and do not serve to replace information about individual economic status. There is no single best method of obtaining income data from Medicare files, but understanding strengths and limitations of different approaches to identifying economic status will help researchers choose the best method for their particular purpose, and help policymakers interpret studies using measures of income.

  14. Environmental assessment of the Environmental Restoration Project at Sandia National Laboratories/New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    Sandia National Laboratories/New Mexico (SNL/NM) is managed and operated for the U.S. Department of Energy (DOE) by Sandia Corporation, a subsidiary of the Lockheed Martin Company. SNL/NM is located on land controlled by DOE within the boundaries of Kirtland Air Force Base (KAFB) in Albuquerque, New Mexico. The major responsibilities of SNL/NM are the support of national security and energy projects. This report provides an environmental assessment of proposed remedial action activities at the solid waste management units at SNL/NM. A risk assessment of health hazards is also discussed.

  15. DEMONSTRATION BULLETIN: IN SITU ELECTROKINETIC EXTRACTION SYSTEM - SANDIA NATIONAL LABORATORIES

    Science.gov (United States)

    Sandia National Laboratories (SNL) has developed an in situ soil remediation system that uses electrokinetic principles to remediate hexavalent chromium-contaminated unsaturated or partially saturated soils. The technology involves the in situ application of direct current to the...

  16. Sources of funding for adult and paediatric CT procedures at a metropolitan tertiary hospital: How much do Medicare statistics really cover?

    Science.gov (United States)

    Hayton, Anna; Wallace, Anthony; Johnston, Peter

    2015-12-01

    The radiation dose to the Australian paediatric population as a result of medical imaging is of growing concern, in particular the dose from CT. Estimates of the Australian population dose have largely relied on Medicare Australia statistics, which capture only a fraction of those imaging procedures actually performed. The fraction not captured has been estimated using a value obtained for a survey of the adult population in the mid-1990s. To better quantify the fraction of procedures that are not captured by Medicare Australia, procedure frequency and funding data for adult and paediatric patients were obtained from a metropolitan tertiary teaching and research hospital. Five calendar years of data were obtained with a financial class specified for each individual procedure. The financial classes were grouped to give the percentage of Medicare Australia billable procedures for both adult and paediatric patients. The data were also grouped to align with the Medicare Australia age cohorts. The percentage of CT procedures billable to Medicare Australia increased from 16% to 28% between 2008 and 2012. In 2012, the percentage billable for adult and paediatric patients was 28% and 33%, respectively; however, many adult CT procedures are performed at stand-alone clinics, which bulk bill. Using Medicare Australia statistics alone, the frequency of paediatric CT procedures performed on the Australian paediatric population will be grossly under estimated. A correction factor of 4.5 is suggested for paediatric procedures and 1.5 for adult procedures. The fraction of actual procedures performed that are captured by Medicare Australia will vary with time. © 2015 The Royal Australian and New Zealand College of Radiologists.

  17. Sandia National Laboratories/New Mexico Environmental Information Document - Volume II

    Energy Technology Data Exchange (ETDEWEB)

    GUERRERO, JOSEPH V.; KUZIO, KENNETH A.; JOHNS, WILLIAM H.; BAYLISS, LINDA S.; BAILEY-WHITE, BRENDA E.

    1999-09-01

    This Sandia National Laboratories/New Mexico Environmental Information Document (EID) compiles information on the existing environment, or environmental baseline, for SNUNM. Much of the information is drawn from existing reports and databases supplemented by new research and data. The SNL/NM EID, together with the Sandia National Laboratories/New Mexico Facilities and Safety Information Document, provide a basis for assessing the environment, safety, and health aspects of operating selected facilities at SNL/NM. The environmental baseline provides a record of the existing physical, biological, and socioeconomic environment at SNL/NLM prior to being altered (beneficially or adversely) by proposed programs or projects. More specifically, the EID provides information on the following topics: Geology; Land Use; Hydrology and Water Resources; Air Quality and Meteorology; Ecology; Noise and Vibration; Cultural Resources; Visual Resources; Socioeconomic and Community Services; Transportation; Material Management; Waste Management; and Regulatory Requirements.

  18. Sandia National Laboratories/New Mexico Environmental Information Document - Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    BAYLISS, LINDA S.; GUERRERO, JOSEPH V.; JOHNS, WILLIAM H.; KUZIO, KENNETH A.; BAILEY-WHITE, BRENDA E.

    1999-09-01

    This Sandia National Laboratories/New Mexico Environmental Information Document (EID) compiles information on the existing environment, or environmental baseline, for SNUNM. Much of the information is drawn from existing reports and databases supplemented by new research and data. The SNL/NM EID, together with the Sandia National Laboratories/New Mexico Facilities and Safety Information Document, provide a basis for assessing the environment, safety, and health aspects of operating selected facilities at SNL/NM. The environmental baseline provides a record of the existing physical, biological, and socioeconomic environment at SNL/NLM prior to being altered (beneficially or adversely) by proposed programs or projects. More specifically, the EID provides information on the following topics: Geology; Land Use; Hydrology and Water Resources; Air Quality and Meteorology; Ecology; Noise and Vibration; Cultural Resources; Visual Resources; Socioeconomic and Community Services; Transportation; Material Management; Waste Management; and Regulatory Requirements.

  19. Equipment qualification testing methodology research at Sandia Laboratories

    International Nuclear Information System (INIS)

    Jeppesen, D.

    1983-01-01

    The Equipment Qualification Research Testing (EQRT) program is an evolutionary outgrowth of the Qualification Testing Evaluation (QTE) program at Sandia. The primary emphasis of the program has been qualification methodology research. The EQRT program offers to the industry a research-oriented perspective on qualification-related component performance, as well as refinements to component testing standards which are based upon actual component testing research

  20. Sandia National Laboratories, California Chemical Management Program annual report.

    Energy Technology Data Exchange (ETDEWEB)

    Brynildson, Mark E.

    2012-02-01

    The annual program report provides detailed information about all aspects of the Sandia National Laboratories, California (SNL/CA) Chemical Management Program. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. This program annual report describes the activities undertaken during the calender past year, and activities planned in future years to implement the Chemical Management Program, one of six programs that supports environmental management at SNL/CA. SNL/CA is responsible for tracking chemicals (chemical and biological materials), providing Material Safety Data Sheets (MSDS) and for regulatory compliance reporting according to a variety of chemical regulations. The principal regulations for chemical tracking are the Emergency Planning Community Right-to-Know Act (EPCRA) and the California Right-to-Know regulations. The regulations, the Hazard Communication/Lab Standard of the Occupational Safety and Health Administration (OSHA) are also key to the CM Program. The CM Program is also responsible for supporting chemical safety and information requirements for a variety of Integrated Enabling Services (IMS) programs primarily the Industrial Hygiene, Waste Management, Fire Protection, Air Quality, Emergency Management, Environmental Monitoring and Pollution Prevention programs. The principal program tool is the Chemical Information System (CIS). The system contains two key elements: the MSDS library and the chemical container-tracking database that is readily accessible to all Members of the Sandia Workforce. The primary goal of the CM Program is to ensure safe and effective chemical management at Sandia/CA. This is done by efficiently collecting and managing chemical information for our customers who include Line, regulators, DOE and ES and H programs to ensure compliance with regulations and to streamline customer business processes that require chemical information.

  1. Design and initial deployment of the wireless local area networking infrastructure at Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Long, John P.; Hamill, Michael J.; Mitchell, M. G.; Miller, Marc M.; Witzke, Edward L.; Wiener, Dallas J

    2006-11-01

    A major portion of the Wireless Networking Project at Sandia National Laboratories over the last few years has been to examine IEEE 802.11 wireless networking for possible use at Sandia and if practical, introduce this technology. This project team deployed 802.11a, b, and g Wireless Local Area Networking at Sandia. This report examines the basics of wireless networking and captures key results from project tests and experiments. It also records project members thoughts and designs on wireless LAN architecture and security issues. It documents some of the actions and milestones of this project, including pilot and production deployment of wireless networking equipment, and captures the team's rationale behind some of the decisions made. Finally, the report examines lessons learned, future directions, and conclusions.

  2. Massively Parallel Computing at Sandia and Its Application to National Defense

    National Research Council Canada - National Science Library

    Dosanjh, Sudip

    1991-01-01

    Two years ago, researchers at Sandia National Laboratories showed that a massively parallel computer with 1024 processors could solve scientific problems more than 1000 times faster than a single processor...

  3. Medicare Advantage Rates and Statistics - FFS Data 2008-2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare fee-for-service data for each county broken out by aged, disabled, and ESRD beneficiaries including data on total Medicare fee-for-service reimbursement and...

  4. Joint Sandia/NIOSH exercise on aerosol contamination using the BROOM tool.

    Energy Technology Data Exchange (ETDEWEB)

    Ramsey, James L., Jr. (.,; .); Melton, Brad; Finley, Patrick; Brockman, John; Peyton, Chad E.; Tucker, Mark David; Einfeld, Wayne; Brown, Gary Stephen; Griffith, Richard O.; Lucero, Daniel A.; Knowlton, Robert G.; McKenna, Sean Andrew; Ho, Pauline

    2006-06-01

    In February of 2005, a joint exercise involving Sandia National Laboratories (SNL) and the National Institute for Occupational Safety and Health (NIOSH) was conducted in Albuquerque, NM. The SNL participants included the team developing the Building Restoration Operations and Optimization Model (BROOM), a software product developed to expedite sampling and data management activities applicable to facility restoration following a biological contamination event. Integrated data-collection, data-management, and visualization software improve the efficiency of cleanup, minimize facility downtime, and provide a transparent basis for reopening. The exercise was held at an SNL facility, the Coronado Club, a now-closed social club for Sandia employees located on Kirtland Air Force Base. Both NIOSH and SNL had specific objectives for the exercise, and all objectives were met.

  5. 42 CFR 460.168 - Reinstatement in other Medicare and Medicaid programs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Reinstatement in other Medicare and Medicaid programs. 460.168 Section 460.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Reinstatement in other Medicare and Medicaid programs. To facilitate a participant's reinstatement in other...

  6. Reforming funding for chronic illness: Medicare-CDM.

    Science.gov (United States)

    Swerissen, Hal; Taylor, Michael J

    2008-02-01

    Chronic diseases are a major challenge for the Australian health care system in terms of both the provision of quality care and expenditure, and these challenges will only increase in the future. Various programs have been instituted under the Medicare system to provide increased funding for chronic care, but essentially these programs still follow the traditional fee-for-service model. This paper proposes a realignment and extension of current Medicare chronic disease management programs into a framework that provides general practitioners and other health professionals with the necessary "tools" for high quality care planning and ongoing management, and incorporating international models of outcome-linked funding. The integration of social support services with the Medicare system is also a necessary step in providing high quality care for patients with complex needs requiring additional support.

  7. Pulsed Power: Sandia's Plans for the New Millenium

    International Nuclear Information System (INIS)

    Quintenz, Jeffrey P.

    2000-01-01

    Pulsed power science and engineering activities at Sandia National Laboratories grew out of a programmatic need for intense radiation sources to advance capabilities in radiographic imaging and to create environments for testing and certifying the hardness of components and systems to radiation in hostile environments. By the early 1970s, scientists in laboratories around the world began utilizing pulsed power drivers with very short (10s of nanoseconds) pulse lengths for Inertial Confinement Fusion (ICF) experiments. In the United States, Defense Programs within the Department of Energy has sponsored this research. Recent progress in pulsed power, specifically fast-pulsed-power-driven z pinches, in creating temperatures relevant to ICF has been remarkable. Worldwide developments in pulsed power technologies and increased applications in both defense and industry are contrasted with ever increasing stress on research and development tiding. The current environment has prompted us at Sandia to evaluate our role in the continued development of pulsed power science and to consider options for the future. This presentation will highlight our recent progress and provide an overview of our plans as we begin the new millennium

  8. Analysis of Sandia in-pile EOS experiments

    International Nuclear Information System (INIS)

    Breitung, W.; Gorham-Bergeron, E.; Murata, K.K.

    1979-01-01

    Preliminary analysis has been carried out of the dynamic in-pile equation-of-state measurements for UO 2 , conducted at Sandia Laboratories, aimed at reducing the uncertainties in the effective UO 2 enthalpy corresponding to the measured pressures. Of the remaining width of the p-H band of some 350 J/g, about 200 J/g originate in the uncertainties of the analytical modelling and about 150 J/g result from the scatter in the experimental data

  9. Association of the position of a hospital-acquired condition diagnosis code with changes in medicare severity diagnosis-related group assignment.

    Science.gov (United States)

    Johnson, Tricia; Kane, Jason M; Odwazny, Richard; McNutt, Robert

    2014-11-01

    Incentives to improve quality include paying less for adverse events, including the Centers for Medicare and Medicaid Services' policy to not pay additionally for events classified as hospital-acquired conditions (HACs). This policy is controversial, as variable coding practices at hospitals may lead to differences in the inclusion and position of HACs in the list of codes used for Medicare Severity Diagnosis-Related Group (MS-DRG) assignment. Evaluate changes in MS-DRG assignment for patients with an HAC and test the association of the position of an HAC in the list of International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes with change in MS-DRG assignment. Retrospective analysis of patients discharged from hospital members of the University HealthSystem Consortium's Clinical Data Base between October 2007 and April 2008. Comparisons were made between the MS-DRG assigned when the HAC was not included in the list of ICD-9 diagnosis codes and the MS-DRG that would have been assigned had the HAC code been included in the assignment. Of the 7027 patients with an HAC, 13.8% changed MS-DRG assignment when the HAC was removed. An HAC in the second position versus third position or lower was associated with a 40-fold increase in the likelihood of MS-DRG change. The position of an HAC in the list of diagnosis codes, rather than the presence of an HAC, is associated with a change in MS-DRG assignment. HACs have little effect on reimbursement unless the HAC is in the second position and patients have minor severity of illness. © 2014 Society of Hospital Medicine.

  10. Paying Medicare Advantage Plans: To Level or Tilt the Playing Field

    Science.gov (United States)

    Glazer, Jacob; McGuire, Thomas G.

    2017-01-01

    Medicare beneficiaries are eligible for health insurance through the public option of traditional Medicare (TM) or may join a private Medicare Advantage (MA) plan. Both are highly subsidized but in different ways. Medicare pays for most of costs directly in TM, and makes a subsidy payment to an MA plan based on a “benchmark” for each beneficiary choosing a private plan. The level of this benchmark is arguably the most important policy decision Medicare makes about the MA program. Presently, about 30% of beneficiaries are in MA, and Medicare subsidizes MA plans more on average than TM. Many analysts recommend equalizing Medicare’s subsidy across the options – referred to in policy circles as a “level playing field.” This paper studies the normative question of how to set the level of the benchmark, applying the versatile model of plan choice developed by Einav and Finkelstein (EF) to Medicare. The EF framework implies unequal subsidies to counteract risk selection across plan types. We also study other reasons to tilt the field: the relative efficiency of MA vs. TM, market power of MA plans, and institutional features of the way Medicare determines subsidies and premiums. After review of the empirical and policy literature, we conclude that in areas where the MA market is competitive, the benchmark should be set below average costs in TM, but in areas characterized by imperfect competition in MA, it should be raised in order to offset output (enrollment) restrictions by plans with market power. We also recommend specific modifications of Medicare rules to make demand for MA more price elastic. PMID:28318667

  11. 76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    Science.gov (United States)

    2011-11-02

    ... Furnished by Non-Physician Practitioners in the Assignment Process c. Assignment of Beneficiaries to ACOs... Insurance Program CMP Civil Monetary Penalties CMS Centers for Medicare & Medicaid Services CNM Certified... the current payment system by rewarding providers for delivering high quality, efficient clinical care...

  12. U.S. Department of Energy, Sandia National Laboratories: Printing Case Study

    Science.gov (United States)

    The U.S. Department of Energy, Sandia National Laboratories (SNL), New Mexico quantified the costs associated with individual desktop printing devices, for comparison with costs associated with using networked copiers as printers

  13. Sandia's Particle Beam Fusion Program

    International Nuclear Information System (INIS)

    Sweeney, M.A.

    1979-01-01

    Sandia's Particle Beam Fusion Program is investigating pulsed electron and light ion beam accelerators, with the goal of demonstrating the practical application of such drivers as igniters in inertial confinement fusion (ICF) reactors. Recent developments in the program are described. Traditionally, two requirements of ICF reactor operation have been the most difficult to satisfy in conceptual designs. Adequate standoff of critical components from damaging pellet emissions must be assured, and the shot repetition rate must be consistent with the desired reactor power level at reasonable pellet gains. Progress in power compression, beam focusing and transport, first-wall protection schemes, and net-energy-gain target design shows how these requirements can be met

  14. Diagnosis and Treatment of Osteoporosis Before and After Fracture: A Side-by-Side Analysis of Commercially Insured and Medicare Advantage Osteoporosis Patients.

    Science.gov (United States)

    Weaver, Jessica; Sajjan, Shiva; Lewiecki, E Michael; Harris, Steven T

    2017-07-01

    Although treatment for osteoporosis is recommended by U.S. clinical guidelines, a lack of diagnosis and treatment is common among patients with osteoporotic fractures. To determine the rates of osteoporosis diagnosis and treatment before and after various types of fractures. This was a retrospective claims analysis using data from the Humana Medicare Advantage claims (Medicare group) and Optum Insight Clinformatics Data Mart commercial claims (Commercial group). Patients included in the study had a claim for a qualifying fracture occurring between January 2008 and December 2013 (the index fracture), were continuously enrolled in the health plan for ≥ 1 year before and after the index fracture, and were aged ≥ 65 years in the Medicare group or ≥ 50 years in the Commercial group at the time of the index fracture. Fragility fractures and osteoporosis diagnoses were identified from ICD-9-CM codes. Treatment for osteoporosis included oral and injectable therapies identified by National Drug Code numbers and Healthcare Common Procedure Coding System codes. Diagnosis and treatment rates were assessed during the 1-year periods before and after the index fracture. All analyses were conducted by fracture type (vertebral, hip, nonhip/nonvertebral [NHNV], and multiple), with stratification by age and sex. No comparisons were made between the Medicare and Commercial groups; rather, McNemar tests were used to compare prefracture versus postfracture diagnosis and treatment rates within each group. For inclusion in the Medicare group, 45,603 patients were identified, and 54,145 patients were identified for the Commercial group. In the prefracture period, the osteoporosis diagnosis rates ranged from 12.0% (NHNV) to 21.5% (vertebral) in the Medicare group and from 5.3% (NHNV) to 12.1% (vertebral) in the Commercial group. In the postfracture period, diagnosis rates significantly increased (P types but did not exceed 42.1% (vertebral) in the Medicare group and 27.7% (vertebral

  15. Student Assistance Program Sandia High School 1985-86 Report.

    Science.gov (United States)

    Boyce-Prather, Margaret; Shainline, Michael

    This document presents data from the second year of the Student Assistance Program, a counseling program to help students who may be abusing drugs or alcohol, implemented at Sandia High School in the Albuquerque (New Mexico) Public School system. Data are included from the program's monthly records sheets, from parent involvement questionnaires,…

  16. Sandia Wake Imaging System Field Test Report: 2015 Deployment at the Scaled Wind Farm Technology (SWiFT) Facility.

    Energy Technology Data Exchange (ETDEWEB)

    Naughton, Brian Thomas [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Herges, Thomas [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-10-01

    This report presents the objectives, configuration, procedures, reporting , roles , and responsibilities and subsequent results for the field demonstration of the Sandia Wake Imaging System (SWIS) at the Sandia Scaled Wind Farm Technology (SWiFT) facility near Lubbock, Texas in June and July 2015.

  17. Claims and Appeals (Medicare)

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  18. Improving the design of competitive bidding in Medicare Advantage.

    Science.gov (United States)

    Cawley, John H; Whitford, Andrew B

    2007-04-01

    In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which required that in 2006 the Centers for Medicare and Medicaid Services (CMS) implement a system of competitive bids to set payments for the Medicare Advantage program. Managed care plans now bid for the right to enroll Medicare beneficiaries. Data from the first year of bidding suggest that imperfect competition is limiting the success of the bidding system. This article offers suggestions to improve this system based on findings from auction theory and previous government-run auctions. In particular, CMS can benefit by adjusting its system of competitive bids in four ways: credibly committing to regulations governing bidding; limiting the scope for collusion, entry deterrence, and predatory behavior among bidders; adjusting how benchmark reimbursement rates are set; and accounting for asymmetric information among bidders.

  19. Seismic and geologic investigations of the Sandia Livermore Laboratory site

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    This report describes results of a seismic and geologic investigation in the vicinity of Sandia Laboratories property and Sandia's Tritium Building at Livermore, California. The investigation was done to define any seismically capable faults in the immediate area and to obtain necessary information to support estimates of future possible or probable ground motions. The work included a variety of geophysical measurements, trenching, seismologic studies, geologic examination, and evaluation of possible ground surface rupture at the site. Ground motions due to the maximum potential earthquake are estimated, and probability of exceedance for various levels of peak ground acceleration is calculated. Descriptions of the various calculations and investigative techniques used and the data obtained are presented. Information obtained from other sources relevant to subsurface geology and faulting is also given. Correlation and evaluation of the various lines of evidence and conclusions regarding the seismic hazard to the Tritium Building are included

  20. A Longitudinal Analysis of Site of Death: The Effects of Continuous Enrollment in Medicare Advantage Versus Conventional Medicare.

    Science.gov (United States)

    Chen, Elizabeth Edmiston; Miller, Edward Alan

    2017-09-01

    This study assessed the odds of dying in hospital associated with enrollment in Medicare Advantage (M-A) versus conventional Medicare Fee-for-Service (M-FFS). Data were derived from the 2008 and 2010 waves of the Health and Retirement Study ( n = 1,030). The sample consisted of elderly Medicare beneficiaries who died in 2008-2010 (34% died in hospital, and 66% died at home, in long-term senior care, a hospice facility, or other setting). Logistic regression estimated the odds of dying in hospital for those continuously enrolled in M-A from 2008 until death compared to those continuously enrolled in M-FFS and those switching between the two plans. Results indicate that decedents continuously enrolled in M-A had 43% lower odds of dying in hospital compared to those continuously enrolled in M-FFS. Financial incentives in M-A contracts may reduce the odds of dying in hospital.

  1. 76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative

    Science.gov (United States)

    2011-10-03

    ...] Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare & Medicaid Services... organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to... the Comprehensive Primary Care initiative or the application process. SUPPLEMENTARY INFORMATION: I...

  2. Chronic Disease Prevalence and Medicare Advantage Market Penetration

    Science.gov (United States)

    Bernell, Stephanie Lazarus; Casim, Faizan M.; Wilmott, Jennifer; Pearson, Lindsey; Byler, Caitlin M.; Zhang, Zidong

    2015-01-01

    By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary’s portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS) Household Component data to construct an aggregate index that captures multiple diagnoses in one outcome measure (Chronic Disease Severity Index [CDSI]). The MEPS data for 8089 Medicare beneficiaries are merged with MA market penetration data from Centers for Medicare and Medicaid Services (CMS). Ordinary least squares regressions are run with SAS 9.3 to model the effects of MA market penetration on CDSI. The results suggest that each percentage increase in MA market penetration is associated with a greater than 2-point decline in CDSI (lower burden of cardiometabolic chronic disease). Spill-over effects may be driving improvements in the cardiometabolic health of beneficiary populations in counties with elevated levels of MA market penetration. PMID:28462266

  3. MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

    Science.gov (United States)

    ROBBINS, JACOB A.

    2015-01-01

    The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687

  4. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.

    Science.gov (United States)

    Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D

    2011-10-14

    Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.

  5. Large-Scale Testing and High-Fidelity Simulation Capabilities at Sandia National Laboratories to Support Space Power and Propulsion

    International Nuclear Information System (INIS)

    Dobranich, Dean; Blanchat, Thomas K.

    2008-01-01

    Sandia National Laboratories, as a Department of Energy, National Nuclear Security Agency, has major responsibility to ensure the safety and security needs of nuclear weapons. As such, with an experienced research staff, Sandia maintains a spectrum of modeling and simulation capabilities integrated with experimental and large-scale test capabilities. This expertise and these capabilities offer considerable resources for addressing issues of interest to the space power and propulsion communities. This paper presents Sandia's capability to perform thermal qualification (analysis, test, modeling and simulation) using a representative weapon system as an example demonstrating the potential to support NASA's Lunar Reactor System

  6. Structural design of the Sandia 34-M Vertical Axis Wind Turbine

    Science.gov (United States)

    Berg, D. E.

    Sandia National Laboratories, as the lead DOE laboratory for Vertical Axis Wind Turbine (VAWT) development, is currently designing a 34-meter diameter Darrieus-type VAWT. This turbine will be a research test bed which provides a focus for advancing technology and validating design and fabrication techniques in a size range suitable for utility use. Structural data from this machine will allow structural modeling to be refined and verified for a turbine on which the gravity effects and stochastic wind loading are significant. Performance data from it will allow aerodynamic modeling to be refined and verified. The design effort incorporates Sandia's state-of-the-art analysis tools in the design of a complete machine. The analytic tools used in this design are discussed and the conceptual design procedure is described.

  7. Independent technical review of the Sandia National Laboratories Environmental Restoration Project

    International Nuclear Information System (INIS)

    1994-11-01

    An Independent Technical Review was conducted of the Environmental Restoration Project. The objective of the review was recommendations, from a commercial perspective, on a systems level path forward to safe, minimum cost and schedule project completion. The work presented represents the consensus analysis and recommendations of thirteen individuals with varied backgrounds, expertise, and experience. The ITR team recommends that the barriers to the opportunity described in the diagnosis be eliminated using an integrated DOE-Sandia system approach. Piecemeal changes will not result in the desired commercial efficiency. DOE needs to operate as the contracting agency for a Major System Acquisition. If it does not, commercial performance will not be achieved regardless of the contractor. Likewise, Sandia needs to establish and implement the necessary project structure and management systems to operate with commercial contractor like efficiency

  8. Regional variation in Medicare payments for medical imaging: radiologists versus nonradiologists.

    Science.gov (United States)

    Rosman, David A; Nsiah, Eugene; Hughes, Danny R; Duszak, Richard

    2015-05-01

    The purpose of this article was to study regional variation in Medicare Physician Fee Schedule (MPFS) payments for medical imaging to radiologists compared with nonradiologists. Using a 5% random sample of all Medicare enrollees, which covered approximately 2.5 million Part B beneficiaries in 2011, total professional-only, technical-only, and global MPFS spending was calculated on a state-by-state and United States Census Bureau regional basis for all Medicare Berenson-Eggers Type of Service-defined medical imaging services. Payments to radiologists versus nonradiologists were identified and variation was analyzed. Nationally, mean MPFS medical imaging spending per Medicare beneficiary was $207.17 ($95.71 [46.2%] to radiologists vs $111.46 [53.8%] to nonradiologists). Of professional-only (typically interpretation) payments, 20.6% went to nonradiologists. Of technical-only (typically owned equipment) payments, 84.9% went to nonradiologists. Of global (both professional and technical) payments, 70.1% went to nonradiologists. The percentage of MPFS medical imaging spending on nonradiologists ranged from 32% (Minnesota) to 69.5% (South Carolina). The percentage of MPFS payments for medical imaging to nonradiologists exceeded those to radiologists in 58.8% of states. The relative percentage of MPFS payments to nonradiologists was highest in the South (58.5%) and lowest in the Northeast (48.0%). Nationally, 53.8% of MPFS payments for medical imaging services are made to nonradiologists, who claim a majority of MPFS payments in most states dominated by noninterpretive payments. This majority spending on nonradiologists may have implications in bundled and capitated payment models for radiology services. Medical imaging payment policy initiatives must consider the roles of all provider groups and associated regional variation.

  9. 42 CFR 411.53 - Basis for conditional Medicare payment in no-fault cases.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Basis for conditional Medicare payment in no-fault... Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.53 Basis for conditional Medicare payment in no-fault cases. (a) A conditional Medicare payment may be made in no-fault...

  10. Radioactive material package testing capabilities at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Uncapher, W.L.; Hohnstreiter, G.F.

    1995-01-01

    Evaluation and certification of radioactive and hazardous material transport packages can be accomplished by subjecting these packages to normal transport and hypothetical accident test conditions. The regulations allow package designers to certify packages using analysis, testing, or a combination of analysis and testing. Testing can be used to substantiate assumptions used in analytical models and to demonstrate package structural and thermal response. Regulatory test conditions include impact, puncture, crush, penetration, water spray, immersion, and thermal environments. Testing facilities are used to simulate the required test conditions and provide measurement response data. Over the past four decades, comprehensive testing facilities have been developed at Sandia National Laboratories to perform a broad range of verification and certification tests on hazardous and radioactive material packages or component sections. Sandia's facilities provide an experience base that has been established during the development and certification of many package designs. These unique facilities, along with innovative instrumentation data collection capabilities and techniques, simulate a broad range of testing environments. In certain package designs, package testing can be an economical alternative to complex analysis to resolve regulatory questions or concerns

  11. Medicare capitation model, functional status, and multiple comorbidities: model accuracy

    Science.gov (United States)

    Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

    2012-01-01

    Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

  12. Beneficiary price sensitivity in the Medicare prescription drug plan market.

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D

    2010-01-01

    The Medicare stand-alone prescription drug plan (PDP) came into existence in 2006 as part of the Medicare prescription drug benefit. It is the most popular plan type among Medicare drug plans and large numbers of plans are available to all beneficiaries. In this article we present the first analysis of beneficiary price sensitivity in the PDP market. Our estimate of elasticity of enrollment with respect to premium, -1.45, is larger in magnitude than has been found in the Medicare HMO market. This high degree of beneficiary price sensitivity for PDPs is consistent with relatively low product differentiation, low fixed costs of entry in the PDP market, and the fact that, in contrast to changing HMOs, beneficiaries can select a PDP without disrupting doctor-patient relationships.

  13. Sandia equation of state data base: seslan File

    Energy Technology Data Exchange (ETDEWEB)

    Kerley, G.I. [Sandia National Labs., Albuquerque, NM (US); Christian-Frear, T.L. [RE/SPEC Inc., Albuquerque, NM (US)

    1993-06-24

    Sandia National Laboratories maintains several libraries of equation of state tables, in a modified Sesame format, for use in hydrocode calculations and other applications. This report discusses one of those libraries, the seslan file, which contains 78 tables from the Los Alamos equation of state library. Minor changes have been made to these tables, making them more convenient for code users and reducing numerical difficulties that occasionally arise in hydrocode calculations.

  14. Medicare and Medicaid Statistical Supplement

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Office of Enterprise Data and Analytics (OEDA) produced an annual Medicare and Medicaid Statistical Supplement report providing detailed statistical...

  15. Pulsed power safety and technical training at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Goldstein, S.A.; Zawadzkas, G.A.; Donovan, G.L.; Mikkelson, K.A.; Sharpe, A.W.; Johnston, R.R.

    1987-01-01

    The expansion of pulsed power applications research at Sandia National Labs requires increasing technician-level support from individuals trained in high voltage, short pulse technology. Large superpower generators need a broad-based training curriculum in all aspects of accelerator operation to satisfy recent Department of Energy (DOE) desires for formal certification of accelerator operators. This paper discusses the status of Sandia's safety and technical training program in pulsed power technology directed mainly towards high school graduate and technical school level students. Present safety training methodology requires that hazards for experimental facilities are identified first, a specific curriculum is then tailored to individuals' background experiences and hazards involved with their current assignments. In the technical training program, certification requirements are being established and a coursework program has been initiated in which subjects are organized into two sections. The first covers electrical principles and physical properties of pulsed power components. The second presents various support-type subsystems for accelerators

  16. The Sandia total-dose estimator: SANDOSE description and user guide

    International Nuclear Information System (INIS)

    Turner, C.D.

    1995-02-01

    The SANdia total-DOSe Estimator (SANDOSE) is used to estimate total radiation dose to a (BRL-CAT) solid model, SANDOSE uses the mass-sectoring technique to sample the model using ray-tracing techniques. The code is integrated directly into the BRL-CAD solid model editor and is operated using a simple graphical user interface. Several diagnostic tools are available to allow the user to analyze the results. Based on limited validation using several benchmark problems, results can be expected to fall between a 10% underestimate and a factor of 2 overestimate of the actual dose predicted by rigorous radiation transport techniques. However, other situations may be encountered where the results might fall outside of this range. The code is written in C and uses X-windows graphics. It presently runs on SUN SPARCstations, but in theory could be ported to any workstation with a C compiler and X-windows. SANDOSE is available via license by contacting either the Sandia National Laboratories Technology Transfer Center or the author

  17. Medicare Referring Provider DMEPOS PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset, which is part of CMSs Medicare Provider Utilization and Payment Data, details information on Durable Medical Equipment, Prosthetics, Orthotics and...

  18. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  19. 20 CFR 404.1018b - Medicare qualified government employment.

    Science.gov (United States)

    2010-04-01

    ... AND DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Work Excluded from Employment § 404.1018b Medicare qualified government employment. (a) General. The work of a... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medicare qualified government employment. 404...

  20. Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey

    Science.gov (United States)

    Gindi, Renee; Cohen, Robin A.

    2012-01-01

    Objectives Using linked administrative data, to validate Medicare coverage estimates among adults aged 65 or older from the National Health Interview Survey (NHIS), and to assess the impact of a recently added Medicare probe question on the validity of these estimates. Data sources Linked 2005 NHIS and Master Beneficiary Record and Payment History Update System files from the Social Security Administration (SSA). Study design We compared Medicare coverage reported on NHIS with “benchmark” benefit records from SSA. Principal findings With the addition of the probe question, more reports of coverage were captured, and the agreement between the NHIS-reported coverage and SSA records increased from 88% to 95%. Few additional overreports were observed. Conclusions Increased accuracy of the Medicare coverage status of NHIS participants was achieved with the Medicare probe question. Though some misclassification remains, data users interested in Medicare coverage as an outcome or correlate can use this survey measure with confidence. PMID:24800138

  1. Impact of late-to-refill reminder calls on medication adherence in the Medicare Part D population: evaluation of a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Taitel MS

    2017-02-01

    Full Text Available Michael S Taitel, Ying Mu, Angshuman Gooptu, Youbei Lou Health Analytics, Research & Reporting, Walgreen Co., Deerfield, IL, USA Objectives: This study evaluates a nationwide pharmacy chain’s late-to-refill (LTR reminder program that entails local pharmacists placing reminder calls to Medicare Part D patients. Methods: We conducted a randomized controlled study among 735,218 patients who exhibited nonadherent behavior by not refilling a maintenance medication 3 days from an expected refill date. Patients were randomly assigned to an intervention group who received LTR reminder calls or to a control group. We used Walgreens pharmaceutical claims data from 2015 to estimate the impact of LTR calls on short-term and annual adherence. Results: The initial refill rate within the first 14 days of the expected refill date significantly increased in the intervention group by 22.8% (6.09 percentage points compared to the control group (P<0.001. The proportion of days covered (PDC in the intervention group increased significantly by 1.5% (0.856 percentage points relative to the control group (P<0.001 over 365 days. Patients in the intervention group were significantly more adherent (PDC ≥80% by 3% (0.97 percentage points compared to the control group (P<0.001. Over a 270-day follow-up period, persistence significantly increased by 2.15 days in the intervention group (P<0.001. Conclusion: Results from this study suggest that LTR reminder calls increased adherence for Medicare Part D patients who are late in refilling their medications and therefore have the potential to reduce their risk for hospitalization and health care costs. Additionally, the intervention increased the number of patients with PDC ≥80% by ~3%, positively impacting Medicare Part D plan quality rating. Keywords: reminder system, tailored intervention, Medicare Part D, adherence, persistence

  2. Chronic Conditions among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data used in the chronic condition reports are based upon CMS administrative enrollment and claims data for Medicare beneficiaries enrolled in the...

  3. lambda-3, Sandia's 100-J HF laser system

    Energy Technology Data Exchange (ETDEWEB)

    Klein, R.A.

    1979-09-01

    Sandia's lambda-geometry intermediate electron-beam-initiated HF amplifier is described in sufficient detail such that a similar system could be designed, constructed and characterized. Items included are the design of the laser cell, magnetic field design and measurements, electron-beam calorimetry, and typical laser results.

  4. 1995 Site environmental report Sandia National Laboratories, Albuquerque, New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Shyr, L.J.; Duncan, D. [eds.; Sanchez, R.

    1996-09-01

    This 1995 report contains data from routine radiological and non-radiological environmental monitoring activities. Summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, environmental restoration and various waste management programs at Sandia National Laboratories in Albuquerque, New Mexico, are included.

  5. 1995 Site environmental report Sandia National Laboratories, Albuquerque, New Mexico

    International Nuclear Information System (INIS)

    Shyr, L.J.; Duncan, D.; Sanchez, R.

    1996-09-01

    This 1995 report contains data from routine radiological and non-radiological environmental monitoring activities. Summaries of significant environmental compliance programs in progress, such as National Environmental Policy Act documentation, environmental permits, environmental restoration and various waste management programs at Sandia National Laboratories in Albuquerque, New Mexico, are included

  6. Dosimetry report for the Sandia irradiator for dried sewage solids

    International Nuclear Information System (INIS)

    Greene, R.T.; McFarland, E.W.; Dickson, H.W.

    1981-06-01

    Gamma dose measurements were made at the Sandia Irradiator for Dried Sewage Solids. Passive plastic, chemical, and thermoluminescent dosimeters were exposed in the facility under conditions designed to simulate typical plant operation. Absolute dose and dose distribution information were obtained in air, water, compost, fruit, and sewage sludge

  7. 75 FR 52629 - Medicare Program; Establishing Additional Medicare Durable Medical Equipment, Prosthetics...

    Science.gov (United States)

    2010-08-27

    ... outpatient rehabilitation facility (CORF), a home health agency (HHA), or a hospice that has in effect an agreement to participate in Medicare, or a clinic, a rehabilitation agency, or a public health agency that... devices used for reduction of fractures and dislocation'' as one of the ``medical and other health...

  8. Chronic Disease Prevalence and Medicare Advantage Market Penetration

    Directory of Open Access Journals (Sweden)

    Steven W. Howard

    2015-10-01

    Full Text Available By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary’s portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS Household Component data to construct an aggregate index that captures multiple diagnoses in one outcome measure (Chronic Disease Severity Index [CDSI]. The MEPS data for 8089 Medicare beneficiaries are merged with MA market penetration data from Centers for Medicare and Medicaid Services (CMS. Ordinary least squares regressions are run with SAS 9.3 to model the effects of MA market penetration on CDSI. The results suggest that each percentage increase in MA market penetration is associated with a greater than 2-point decline in CDSI (lower burden of cardiometabolic chronic disease. Spill-over effects may be driving improvements in the cardiometabolic health of beneficiary populations in counties with elevated levels of MA market penetration.

  9. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.

    Science.gov (United States)

    Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S

    2013-05-01

    This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.

  10. 42 CFR 424.540 - Deactivation of Medicare billing privileges.

    Science.gov (United States)

    2010-10-01

    ... change in practice location, a change of any managing employee, and a change in billing services. A... 42 Public Health 3 2010-10-01 2010-10-01 false Deactivation of Medicare billing privileges. 424.540 Section 424.540 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

  11. Factors associated with independent pharmacy owners' satisfaction with Medicare Part D contracts.

    Science.gov (United States)

    Zhang, Su; Doucette, William R; Urmie, Julie M; Xie, Yang; Brooks, John M

    2010-06-01

    As Medicare Part D contracts apply pressure on the profitability of independent pharmacies, there is concern about their owners' willingness to sign such contracts. Identifying factors affecting independent pharmacy owners' satisfaction with Medicare Part D contracts could inform policy makers in managing Medicare Part D. (1) To identify influences on independent pharmacy owners' satisfaction with Medicare Part D contracts and (2) to characterize comments made by independent pharmacy owners about Medicare Part D. This cross-sectional study used a mail survey of independent pharmacy owners in 15 states comprising 6 Medicare regions to collect information on their most- and least-favorable Medicare Part D contracts, including satisfaction, contract management activities, market position, pharmacy operation, and specific payment levels on brand and generic drugs. Of the 1649 surveys mailed, 296 surveys were analyzed. The regression models for satisfaction with both the least and the most-favorable Part D contracts were significant (Pequity. For the least-favorable contract, influences were negotiation, equity, generic rate bonus, and medication therapy management (MTM) payment. About one-third of the survey respondents made at least 1 comment. The most frequent themes in the comments were that Medicare Part D reimbursement rate is too low (28%) and that contracts are offered without negotiation in a "take it or leave it" manner (20%). Equity, contending, negotiation, generic rate bonus, and MTM payments were identified as the influences of independent pharmacy owners' satisfaction toward Medicare Part D contracts. Generic rate bonus and MTM payment provide additional financial incentives to less financially favorable contracts and, in turn, contribute to independent pharmacy owner's satisfaction toward these contracts. Copyright 2010 Elsevier Inc. All rights reserved.

  12. Medicare payments to the neurology workforce in 2012.

    Science.gov (United States)

    Skolarus, Lesli E; Burke, James F; Callaghan, Brian C; Becker, Amanda; Kerber, Kevin A

    2015-04-28

    Little is known about how neurology payments vary by service type (i.e., evaluation and management [E/M] vs tests/treatments) and compare to other specialties, yet this information is necessary to help neurology define its position on proposed payment reform. Medicare Provider Utilization and Payment Data from 2012 were used. These data included all direct payments to providers who care for fee-for-service Medicare recipients. Total payment was determined by medical specialty and for various services (e.g., E/M, EEG, electromyography/nerve conduction studies, polysomnography) within neurology. Payment and proportion of services were then calculated across neurologists' payment categories. Neurologists comprised 1.5% (12,317) of individual providers who received Medicare payments and were paid $1.15 billion by Medicare in 2012. Sixty percent ($686 million) of the Medicare payment to neurologists was for E/M, which was a lower proportion than primary providers (approximately 85%) and higher than surgical subspecialties (range 9%-51%). The median neurologist received nearly 75% of their payments from E/M. Two-thirds of neurologists received 60% or more of their payment from E/M services and over 20% received all of their payment from E/M services. Neurologists in the highest payment category performed more services, of which a lower proportion were E/M, and performed at a facility, compared to neurologists in lower payment categories. E/M is the dominant source of payment to the majority of neurologists and should be prioritized by neurology in payment restructuring efforts. © 2015 American Academy of Neurology.

  13. Implementing Virtual Private Networking for Enabling Lower Cost, More Secure Wide Area Communications at Sandia National Laboratories; TOPICAL

    International Nuclear Information System (INIS)

    MILLER, MARC M.; YONEK JR., GEORGE A.

    2001-01-01

    Virtual Private Networking is a new communications technology that promises lower cost, more secure wide area communications by leveraging public networks such as the Internet. Sandia National Laboratories has embraced the technology for interconnecting remote sites to Sandia's corporate network, and for enabling remote access users for both dial-up and broadband access

  14. Autonomy and Complexity at Sandia Executive Summary of Academic Alliance Workshop on Autonomy and Complex Systems.

    Energy Technology Data Exchange (ETDEWEB)

    Hayden, Nancy Kay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kleban, Stephen D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-05-01

    Sandia has identified autonomy as a strategic initiative and an important area for providing national leadership. A key question is, “How might autonomy change how we think about the national security challenges we address and the kinds of solutions we deliver?” Three workshops at Sandia early in 2017 brought together internal stakeholders and potential academic partners in autonomy to address this question. The first focused on programmatic applications and needs. The second explored existing internal capabilities and research and development needs. This report summarizes the outcome of the third workshop, held March 3, 2017 in Albuquerque, NM, which engaged Academic Alliance partners in autonomy efforts at Sandia by discussing research needs and synergistic areas of interest within the complex systems and system modeling domains, and identifying opportunities for partnering on laboratory directed and other joint research opportunities.

  15. 76 FR 48563 - Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2011...

    Science.gov (United States)

    2011-08-08

    ... Medicare and Medicaid Services Medicare and Medicaid Programs; Quarterly Listing of Program Issuances... Centers for Medicare & Medicaid Services [CMS-9066-NC] Medicare and Medicaid Programs; Quarterly Listing... Medicare & Medicaid Services (CMS), HHS. ACTION: Notice with comment period. SUMMARY: This quarterly notice...

  16. 76 FR 26805 - Medicare Program; Hospice Wage Index for Fiscal Year 2012

    Science.gov (United States)

    2011-05-09

    ..., and hospices in low-wage index areas are unfairly advantaged. The commenter felt that our not wage... Medicare & Medicaid Services 42 CFR Part 418 Medicare Program; Hospice Wage Index for Fiscal Year 2012... [CMS-1355-P] RIN 0938-AQ31 Medicare Program; Hospice Wage Index for Fiscal Year 2012 AGENCY: Centers...

  17. Comparing the Health Care Experiences of Medicare Beneficiaries with and without Depressive Symptoms in Medicare Managed Care versus Fee-for-Service.

    Science.gov (United States)

    Martino, Steven C; Elliott, Marc N; Haviland, Amelia M; Saliba, Debra; Burkhart, Q; Kanouse, David E

    2016-06-01

    To compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. Multivariate linear regression was used to test whether case-mix-adjusted associations between depressive symptoms and patient experience differed for beneficiaries in MA versus FFS. Dependent measures included four measures of beneficiaries' experiences with doctors (e.g., reports of doctor communication) and seven measures of beneficiaries' experiences with plans (e.g., customer service). Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care than in FFS. Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. © Health Research and Educational Trust.

  18. Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?

    Science.gov (United States)

    Taylor, Donald H; Bhavsar, Nrupen A; Bull, Janet H; Kassner, Cordt T; Olson, Andrew; Boucher, Nathan A

    2018-05-01

    On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis. All age-eligible Medicare decedents who received care and died in North Carolina in calendar years 2009 and 2010. Costs to Medicare for hospice and other healthcare services. Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates. Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

  19. Sandia's recent results in particle beam research

    International Nuclear Information System (INIS)

    Yonas, G.

    1977-01-01

    Recent results in the Sandia particle beam fusion research program are briefly discussed. Ignition of pellet fusion targets by both electron and ion beams are under study. Power concentration, dielectric breakdown, diode optimization, and beam-target interaction experiments are briefly described. Magnetic insulation considerations are discussed. Efforts to utilize higher impedance diode sources and reduce minimum power pulse widths are described. Analyses indicate that particle beam ignition systems might yield pellet gains greater than 10 in hybrid and approximately 100 in pure fusion reactors. A bibliography of 23 references is included

  20. Functional impairment and hospital readmission in Medicare seniors.

    Science.gov (United States)

    Greysen, S Ryan; Stijacic Cenzer, Irena; Auerbach, Andrew D; Covinsky, Kenneth E

    2015-04-01

    Medicare currently penalizes hospitals for high readmission rates for seniors but does not account for common age-related syndromes, such as functional impairment. To assess the effects of functional impairment on Medicare hospital readmissions given the high prevalence of functional impairments in community-dwelling seniors. We created a nationally representative cohort of 7854 community-dwelling seniors in the Health and Retirement Study, with 22,289 Medicare hospitalizations from January 1, 2000, through December 31, 2010. Outcome was 30-day readmission assessed by Medicare claims. The main predictor was functional impairment determined from the Health and Retirement Study interview preceding hospitalization, stratified into the following 5 levels: no functional impairments, difficulty with 1 or more instrumental activities of daily living, difficulty with 1 or more activities of daily living (ADL), dependency (need for help) in 1 to 2 ADLs, and dependency in 3 or more ADLs. Adjustment variables included age, race/ethnicity, sex, annual income, net worth, comorbid conditions (Elixhauser score from Medicare claims), and prior admission. We performed multivariable logistic regression to adjust for clustering at the patient level to characterize the association of functional impairments and readmission. Patients had a mean (SD) age of 78.5 (7.7) years (range, 65-105 years); 58.4% were female, 84.9% were white, 89.6% reported 3 or more comorbidities, and 86.0% had 1 or more hospitalizations in the previous year. Overall, 48.3% had some level of functional impairment before admission, and 15.5% of hospitalizations were followed by readmission within 30 days. We found a progressive increase in the adjusted risk of readmission as the degree of functional impairment increased: 13.5% with no functional impairment, 14.3% with difficulty with 1 or more instrumental activities of daily living (odds ratio [OR], 1.06; 95% CI, 0.94-1.20), 14.4% with difficulty with 1 or more

  1. National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM)

    International Nuclear Information System (INIS)

    Wolff, T.A.

    1998-08-01

    This report on National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM) chronicles past and current compliance activities and includes a recommended strategy that can be implemented for continued improvement. This report provides a list of important references. Attachment 1 contains the table of contents for SAND95-1648, National Environmental Policy Act (NEPA) Compliance Guide Sandia National Laboratories (Hansen, 1995). Attachment 2 contains a list of published environmental assessments (EAs) and environmental impact statements (EISs) prepared by SNL/NM. Attachment 3 contains abstracts of NEPA compliance papers authored by SNL/NM and its contractors

  2. National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM)

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, T.A. [Sandia National Labs., Albuquerque, NM (United States). Community Involvement and Issues Management Dept.; Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

    1998-08-01

    This report on National Environmental Policy Act (NEPA) compliance at Sandia National Laboratories/New Mexico (SNL/NM) chronicles past and current compliance activities and includes a recommended strategy that can be implemented for continued improvement. This report provides a list of important references. Attachment 1 contains the table of contents for SAND95-1648, National Environmental Policy Act (NEPA) Compliance Guide Sandia National Laboratories (Hansen, 1995). Attachment 2 contains a list of published environmental assessments (EAs) and environmental impact statements (EISs) prepared by SNL/NM. Attachment 3 contains abstracts of NEPA compliance papers authored by SNL/NM and its contractors.

  3. Competitive pricing and the challenge of cost control in medicare.

    Science.gov (United States)

    Coulam, Robert F; Feldman, Roger D; Dowd, Bryan E

    2011-08-01

    The Medicare program faces a serious challenge: it must find ways to control costs but must do so through a system of congressional oversight that necessarily limits its choices. We look at one approach to prudent purchasing - competitive pricing - that Medicare has attempted many times and in various ways since the beginning of the program, and in all but one case unsuccessfully due to the politics of provider opposition working through Congress and the courts. We look at some related efforts to change Medicare pricing to explore when the program has been successful in making dramatic changes in how it pays for health care. A set of recommendations emerges for ways to respond to the impediments of law and politics that have obstructed change to more efficient payment methods. Except in unusual cases, competitive pricing threatens too many stakeholders in too many ways for key political actors to support it. But an unusual case may arise in the coming Medicare fiscal crisis, a crisis related in part to the prices Medicare pays. At that point, competitive pricing may look less like a problem and more like a solution coming at a time when the system badly needs one.

  4. Canadian Medicare: prognosis guarded.

    Science.gov (United States)

    Naylor, C D; Fooks, C; Williams, J I

    1995-08-01

    Beset by unprecedented fiscal pressures, Canadian medicare has reached a crossroads. The authors review the impact of recent cuts in federal transfer payments on provincial health care programs and offer seven suggestions to policymakers trying to accommodate these reductions. (1) Go slowly: public health care spending is no longer rising and few provinces have the necessary systems in place to manage major reductions. (2) Target reductions, rewarding quality and efficiency instead of making across-the-board cuts. (3) Replace blame with praise:give health care professionals and institutions credit for their contributions. (4) Learn from the successful programs and policies already in place across the country. (5) Foster horizontal and vertical integration of services. (6) Promote physician leadership by rewarding efforts to promote the efficient use of resources. (7) Monitor the effects of cutbacks: physician groups should cooperate with government in maintaining a national "report card" on services, costs and the health status of Canadians.

  5. Bibliography: Sandia Laboratories hybrid microcircuit and related thin film technology (revised)

    International Nuclear Information System (INIS)

    Oswalt, J.A.

    1975-12-01

    Sandia originated documents (94) describing aspects of technology development related to hybrid microcircuits and thin films are summarized. Authors, titles, and abstracts are given for each unclassified document. The papers are categorized according to the various technologies involved in hybrid microcircuit production

  6. Risk of Infection After Intra-articular Steroid Injection at the Time of Ankle Arthroscopy in a Medicare Population.

    Science.gov (United States)

    Werner, Brian C; Cancienne, Jourdan M; Burrus, M Tyrrell; Park, Joseph S; Perumal, Venkat; Cooper, M Truitt

    2016-02-01

    To employ a national database to evaluate the association between intraoperative corticosteroid injection at the time of ankle arthroscopy and postoperative infection rates in Medicare patients. A national insurance database was queried for Medicare patients who underwent ankle arthroscopy, including arthroscopic removal of loose body, synovectomy, and limited or extensive debridement. Two groups were created: ankle arthroscopy with concomitant local steroid injection (n = 459) and a control group of patients who underwent ankle arthroscopy without intraoperative local steroid injection (n = 9,327). The demographics and Charlson Comorbidity Index of each group were compared. Infection rates within 6 months postoperatively were assessed using International Classification of Diseases, 9th revision, and Current Procedural Terminology codes and compared between groups using χ(2)-tests. A total of 9,786 unique patients who underwent ankle arthroscopy were included in the study. There were no statistically significant differences between the steroid injection study group and controls for the assessed infection-related variables, including gender, age group, obesity, smoking, and average Charlson Comorbidity Index. The infection rate for patients who had a local steroid injection at the time of surgery was 3.9% (18/459 patients), compared with 1.8% (168/9,327 patients) in the control group (odds ratio, 2.2; 95% confidence interval, 1.4 to 3.7; P = .002.) The majority of this difference was noted between the 65 and 79 years age groups. The use of intraoperative intraarticular corticosteroid injection at the time of ankle arthroscopy in Medicare patients is associated with significantly increased rates of postoperative infection compared with controls without intraoperative steroid injections. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. The quality of Medicaid and Medicare data obtained from CMS and its contractors: implications for pharmacoepidemiology.

    Science.gov (United States)

    Leonard, Charles E; Brensinger, Colleen M; Nam, Young Hee; Bilker, Warren B; Barosso, Geralyn M; Mangaali, Margaret J; Hennessy, Sean

    2017-04-26

    Administrative claims of United States Centers for Medicare and Medicaid Services (CMS) beneficiaries have long been used in non-experimental research. While CMS performs in-house checks of these claims, little is known of their quality for conducting pharmacoepidemiologic research. We performed exploratory analyses of the quality of Medicaid and Medicare data obtained from CMS and its contractors. Our study population consisted of Medicaid beneficiaries (with and without dual coverage by Medicare) from California, Florida, New York, Ohio, and Pennsylvania. We obtained and compiled 1999-2011 data from these state Medicaid programs (constituting about 38% of nationwide Medicaid enrollment), together with corresponding national Medicare data for dually-enrolled beneficiaries. This descriptive study examined longitudinal patterns in: dispensed prescriptions by state, by quarter; and inpatient hospitalizations by federal benefit, state, and age group. We further examined discrepancies between demographic characteristics and disease states, in particular frequencies of pregnancy complications among men and women beyond childbearing age, and prostate cancers among women. Dispensed prescriptions generally increased steadily and consistently over time, suggesting that these claims may be complete. A commercially-available National Drug Code lookup database was able to identify the dispensed drug for 95.2-99.4% of these claims. Because of co-coverage by Medicare, Medicaid data appeared to miss a substantial number of hospitalizations among beneficiaries ≥ 45 years of age. Pregnancy complication diagnoses were rare in males and in females ≥ 60 years of age, and prostate cancer diagnoses were rare in females. CMS claims from five large states obtained directly from CMS and its contractors appeared to be of high quality. Researchers using Medicaid data to study hospital outcomes should obtain supplemental Medicare data on dual enrollees, even for non-elders. Not

  8. ''Cats and Dogs'' disposition at Sandia: Last of the legacy materials

    International Nuclear Information System (INIS)

    Strong, Warren R.; Jackson, John L.

    2000-01-01

    Over the past 12 months, Sandia National Laboratories, New Mexico (SNL/NM), has successfully conducted an evaluation of its nuclear material holdings. As a result, approximately 46% of these holdings (36% by mass) have been reclassified as no defined use (NDU). Reclassification as NDU allows Sandia to determine the final disposition of a significant percentage of its legacy nuclear material. Disposition will begin some time in mid CY2000. This reclassification and the proposed disposition of the material has resulted in an extensive coordination effort lead by the Nuclear Materials Management Team (NMMT), which includes the nuclear material owners, the Radioactive Waste/Nuclear Material Disposition Department (7135), and DOE Albuquerque Operations Office. The process of identifying and reclassifying the cats and dogs or miscellaneous lots of nuclear material has also presented a number of important lessons learned for other sites in the DOE complex

  9. Prescription for trouble: Medicare Part D and patterns of computer and internet access among the elderly.

    Science.gov (United States)

    Wright, David W; Hill, Twyla J

    2009-01-01

    The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 specifically encourages Medicare enrollees to use the Internet to obtain information regarding the new prescription drug insurance plans and to enroll in a plan. This reliance on computer technology and the Internet leads to practical questions regarding implementation of the insurance coverage. For example, it seems unlikely that all Medicare enrollees have access to computers and the Internet or that they are all computer literate. This study uses the 2003 Current Population Survey to examine the effects of disability and income on computer access and Internet use among the elderly. Internet access declines with age and is exacerbated by disabilities. Also, decreases in income lead to decreases in computer ownership and use. Therefore, providing prescription drug coverage primarily through the Internet seems likely to maintain or increase stratification of access to health care, especially for low-income, disabled elderly, who are also a group most in need of health care access.

  10. Linkage of a Population-Based Cohort With Primary Data Collection to Medicare Claims: The Reasons for Geographic and Racial Differences in Stroke Study.

    Science.gov (United States)

    Xie, Fenglong; Colantonio, Lisandro D; Curtis, Jeffrey R; Safford, Monika M; Levitan, Emily B; Howard, George; Muntner, Paul

    2016-10-01

    We described the linkage of primary data with administrative claims using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and Medicare. REGARDS study data were linked with Medicare claims by use of Social Security numbers. We compared REGARDS participants by Medicare linkage status, having fee-for-service (FFS) coverage or not, and with a 5% sample of Medicare beneficiaries who had FFS coverage in 2005, overall, by age (45-64 and ≥65 years), and by race. Among REGARDS participants who were ≥65 years of age, 80% had data linked to Medicare on their study-visit date (64% with FFS coverage). No differences except race and sex were present between REGARDS participants without Medicare linkage and those with data linked to Medicare with and without FFS coverage. After the age-sex-race adjustment, comorbid conditions and health-care utilization were similar for those with FFS coverage in the REGARDS study and the 5% sample of Medicare beneficiaries. Among REGARDS participants aged 45-64 years, 11% had FFS coverage on their study-visit date. In this age group, differences were present between participants with and without FFS coverage and the Medicare 5% sample with FFS coverage. In conclusion, REGARDS participants aged ≥65 years with FFS coverage are representative of the study cohort and the US population aged ≥65 years with FFS coverage. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. 78 FR 6272 - Rules Relating to Additional Medicare Tax; Correction

    Science.gov (United States)

    2013-01-30

    ... Rules Relating to Additional Medicare Tax; Correction AGENCY: Internal Revenue Service (IRS), Treasury... regulations are relating to Additional Hospital Insurance Tax on income above threshold amounts (``Additional Medicare Tax''), as added by the Affordable Care Act. Specifically, these proposed regulations provide...

  12. The growth of medical groups paid through capitation in California.

    Science.gov (United States)

    Robinson, J C; Casalino, L P

    1995-12-21

    In California, it is common for health maintenance organizations (HMOs) to contract with large medical groups that are paid through capitation and are responsible for managing a full spectrum of medical services. We studied six large medical groups in California--Bristol Park Medical, Friendly Hills HealthCare Network, HealthCare Partners Medical Group, Mullikin Medical Centers, Palo Alto Medical Foundation, and San Jose Medical Group--that are paid through capitation and that are growing as a result of contracts with managed-care organizations. We conducted interviews and obtained data on factors such as patient enrollment, capitation and other revenue, numbers of days spent by enrollees in the hospital, and numbers of visits to physicians per enrollee. Between 1990 and 1994, the number of HMO enrollees whose care was paid for through capitation in the six medical groups increased by 91 percent, from 398,359 to 759,474. In 1994, the mean number of hospital days per 1000 HMO enrollees ranged from 120 to 149 for non-Medicare patients and from 643 to 936 days for Medicare patients. By comparison, in 1993 the mean numbers of hospital days per 1000 HMO enrollees not covered by Medicare were 232 for California and 297 for the United States; for HMO enrollees covered by Medicare, the numbers were 1337 for California and 1698 for the United States. In 1994, the average annual number of visits to physicians for HMO patients in the six groups not covered by Medicare ranged from 3.1 to 3.9; for Medicare patients, it ranged from 7.2 to 9.3; these rates were slightly lower than statewide and national rates. Four of the groups have sold their assets (such as facilities, supplies, equipment, and patients' charts) to outside investors; the physicians remain employed by physician-owned professional corporations. Medical groups paid through capitation offer a model for the status of physicians in managed-care systems that differs from the employee status offered by staff-model HMOs

  13. Spillover effects of Medicare fee reductions: evidence from ophthalmology.

    Science.gov (United States)

    Mitchell, Jean M; Hadley, Jack; Gaskin, Darrell J

    2002-09-01

    Relatively little research has examined physicians' supply responses to Medicare fee cuts especially whether fee reductions for specific procedures have "spillover" effects that cause physicians to increase the supply of other services they provide. In this study we investigate whether ophthalmologist changed their provision of non-cataract services to Medicare patients over the time period 1992-1994, when the Medicare Fee Schedule (MFS) resulted in a 17.4% reduction in the average fee paid for a cataract extraction. Following the McGuire-Pauly model of physician behavior (McGuire and Pauly, 1991), we estimated a supply function for non-cataract procedures that included three price variables (own-price, a Medicare cross-price and a private cross-price) and an income effect. The Medicare cross-price and income variables capture spillover effects. Consistent with the model's predictions, we found that the Medicare cross-price is significant and negative, implying that a 10% reduction in the fee for a cataract extraction will cause ophthalmologists to supply about 5% more non-cataract services. Second, the income variable is highly significant, but its impact on the supply of non-cataract services is trivial. The suggests that physicians behave more like profit maximizing firms than target income seekers. We also found that the own-price and the private cross-price variables are highly significant and have the expected positive and negative effects on the volume of non-cataract services respectively. Our results demonstrate the importance of evaluating volume responses to fee changes for the array of services the physician performs, not just the procedure whose fee has been reduced. Focusing only on the procedure whose fee has been cut will yield an incomplete picture of how fee reductions for specific procedures affect physician supply decisions.

  14. Brand Medications and Medicare Part D: How Eye Care Providers' Prescribing Patterns Influence Costs.

    Science.gov (United States)

    Newman-Casey, Paula Anne; Woodward, Maria A; Niziol, Leslie M; Lee, Paul P; De Lott, Lindsey B

    2018-03-01

    medications by volume than any other provider group. Efforts to reduce prescription expenditures by eye care providers should focus on increasing the use of generic medications, primarily through therapeutic substitutions. Policy changes enabling Medicare to negotiate prescription drug prices could decrease costs to Medicare. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. Measuring coding intensity in the Medicare Advantage program.

    Science.gov (United States)

    Kronick, Richard; Welch, W Pete

    2014-01-01

    In 2004, Medicare implemented a system of paying Medicare Advantage (MA) plans that gave them greater incentive than fee-for-service (FFS) providers to report diagnoses. Risk scores for all Medicare beneficiaries 2004-2013 and Medicare Current Beneficiary Survey (MCBS) data, 2006-2011. Change in average risk score for all enrollees and for stayers (beneficiaries who were in either FFS or MA for two consecutive years). Prevalence rates by Hierarchical Condition Category (HCC). Each year the average MA risk score increased faster than the average FFS score. Using the risk adjustment model in place in 2004, the average MA score as a ratio of the average FFS score would have increased from 90% in 2004 to 109% in 2013. Using the model partially implemented in 2014, the ratio would have increased from 88% to 102%. The increase in relative MA scores appears to largely reflect changes in diagnostic coding, not real increases in the morbidity of MA enrollees. In survey-based data for 2006-2011, the MA-FFS ratio of risk scores remained roughly constant at 96%. Intensity of coding varies widely by contract, with some contracts coding very similarly to FFS and others coding much more intensely than the MA average. Underpinning this relative growth in scores is particularly rapid relative growth in a subset of HCCs. Medicare has taken significant steps to mitigate the effects of coding intensity in MA, including implementing a 3.4% coding intensity adjustment in 2010 and revising the risk adjustment model in 2013 and 2014. Given the continuous relative increase in the average MA risk score, further policy changes will likely be necessary.

  16. A brief history of Sandia National Laboratories and the Department of Energy%3CU%2B2019%3Es Office of Science : interplay between science, technology, and mission.

    Energy Technology Data Exchange (ETDEWEB)

    Tsao, Jeffrey Yeenien; Myers, Samuel Maxwell, Jr.; Simmons, Jerry Alvon; McIlroy, Andrew; Vook, Frederick L.; Collis, Samuel Scott; Picraux, Samuel Thomas

    2011-08-01

    In 1957, Sandia National Laboratories (Sandia) initiated its first programs in fundamental science, in support of its primary nuclear weapons mission. In 1974, Sandia initiated programs in fundamental science supported by the Department of Energy's Office of Science (DOE-SC). These latter programs have grown to the point where, today in 2011, support of Sandia's programs in fundamental science is dominated by that Office. In comparison with Sandia's programs in technology and mission applications, however, Sandia's programs in fundamental science are small. Hence, Sandia's fundamental science has been strongly influenced by close interactions with technology and mission applications. In many instances, these interactions have been of great mutual benefit, with synergies akin to a positive 'Casimir's spiral' of progress. In this report, we review the history of Sandia's fundamental science programs supported by the Office of Science. We present: (a) a technical and budgetary snapshot of Sandia's current programs supported by the various suboffices within DOE-SC; (b) statistics of highly-cited articles supported by DOE-SC; (c) four case studies (ion-solid interactions, combustion science, compound semiconductors, advanced computing) with an emphasis on mutually beneficial interactions between science, technology, and mission; and (d) appendices with key memos and reminiscences related to fundamental science at Sandia.

  17. Disease management for chronically ill beneficiaries in traditional Medicare.

    Science.gov (United States)

    Bott, David M; Kapp, Mary C; Johnson, Lorraine B; Magno, Linda M

    2009-01-01

    We summarize the Centers for Medicare and Medicaid Services' (CMS's) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models.

  18. Recent advances with quiescent power supply current (I(sub DDQ)) testing at Sandia using the HP82000

    Science.gov (United States)

    Righter, A. W.; Leong, D. J.; Cox, L. B.

    Last year at the HP82000 Users Group Meeting, Sandia National Laboratories gave a presentation on I(sub DDQ) testing. This year, some advances are presented on this testing including DUT board fixturing, external DC PMU measurement, and automatic IDD-All circuit calibration. Implementation is examined more than theory, with results presented from Sandia tests. After a brief summary I(sub DDQ) theory and testing concepts, how the break (hold state) vector and data formatting present a test vector generation concern for the HP82000 is described. Fixturing of the DUT board for both types of I(sub DDQ) measurement is then discussed, along with how the continuity test and test vector generation must be taken into account. Results of a test including continuity, IDD-All and I(sub DDQ) Value measurements is shown. Next, measurement of low current using an external PMU is discussed, including noise considerations, implementation and some test results showing nA-range measurements. A method is presented for automatic calibration of the IDD-All analog comparator circuit using RM BASIC on the HP82000, with implementation and measurement results. Finally, future directions for research in this area is explored.

  19. Vertical integration strategies: revenue effects in hospital and Medicare markets.

    Science.gov (United States)

    Cody, M

    1996-01-01

    The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.

  20. Chronic Disease Prevalence and Medicare Advantage Market Penetration

    OpenAIRE

    Steven W. Howard; Stephanie Lazarus Bernell; Faizan M. Casim; Jennifer Wilmott; Lindsey Pearson; Caitlin M. Byler; Zidong Zhang

    2015-01-01

    By March 2015, 30% of all Medicare beneficiaries were enrolled in Medicare Advantage (MA) plans. Research to date has not explored the impacts of MA market penetration on individual or population health outcomes. The primary objective of this study is to examine the relationships between MA market penetration and the beneficiary?s portfolio of cardiometabolic diagnoses. This study uses 2004 to 2008 Medical Expenditure Panel Survey (MEPS) Household Component data to construct an aggregate inde...

  1. Straight chiropractic philosophy as a barrier to Medicare compliance: a discussion of 5 incongruent issues.

    Science.gov (United States)

    Seaman, David R; Soltys, Jonathan R

    2013-12-01

    The purpose of this commentary is to discuss potential 5 factors within straight chiropractic philosophy and practice that may prevent Medicare compliance. The national Medicare Benefit Policy Manual and the Florida Local Coverage Determination were reviewed to identify documentation and conceptual issues regarding chiropractic practice. Five Medicare positions were contrasted with tenets of straight chiropractic philosophy. Based on Medicare's documentation requirements, Medicare defines subluxation and chiropractic practice from the perspective of treating spinal pain and related functional disability. In contrast, traditional straight chiropractic philosophy is not based on the treatment of spinal pain and disability or other symptomatic presentations. In this context, 5 potential areas of conflict are discussed. The Medicare version of chiropractic practice is not consistent with traditional straight chiropractic philosophy, which may play a role in preventing Medicare compliance. The chiropractic profession may need to consider the fashion in which "philosophy" as it relates to technique and practice is presented to students and doctors to facilitate compliance with the documentation requirements of Medicare.

  2. Use of Welcome to Medicare Visits Among Older Adults Following the Affordable Care Act.

    Science.gov (United States)

    Misra, Arpit; Lloyd, Jennifer T; Strawbridge, Larisa M; Wensky, Suzanne G

    2018-01-01

    To encourage greater utilization of preventive services among Medicare beneficiaries, the 2010 Affordable Care Act waived coinsurance for the Welcome to Medicare visit, making this benefit free starting in 2011. The objective of this study was to determine the impact of the Affordable Care Act on Welcome to Medicare visit utilization. A 5% sample of newly enrolled fee-for-service Medicare beneficiaries for 2005-2016 was used to estimate changes in Welcome to Medicare visit use over time. An interrupted time series model examined whether Welcome to Medicare visits increased significantly after 2011, controlling for pre-intervention trends and other autocorrelation. Annual Welcome to Medicare visit rates began at 1.4% in 2005 and increased to 12.3% by 2016. The quarterly Welcome to Medicare visit rate, which was almost 1% at baseline, was increasing by 0.06% before the 2011 Affordable Care Act provision (pAct provision, the rate increased by about 1% in the first quarter of 2011 (intercept, pAct trends of lower utilization persisted over time for non-whites and improved less quickly for men, regions other than Northeast, and beneficiaries without any supplemental insurance. The Affordable Care Act, and perhaps the removal of cost sharing, was associated with increased use of the Welcome to Medicare visit; however, even with the increased use, there is room for improvement. Published by Elsevier Inc.

  3. Medicare Special Needs Plan (SNP)

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  4. Medicare Preventive and Screening Services

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  5. Massively Parallel Computing: A Sandia Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Dosanjh, Sudip S.; Greenberg, David S.; Hendrickson, Bruce; Heroux, Michael A.; Plimpton, Steve J.; Tomkins, James L.; Womble, David E.

    1999-05-06

    The computing power available to scientists and engineers has increased dramatically in the past decade, due in part to progress in making massively parallel computing practical and available. The expectation for these machines has been great. The reality is that progress has been slower than expected. Nevertheless, massively parallel computing is beginning to realize its potential for enabling significant break-throughs in science and engineering. This paper provides a perspective on the state of the field, colored by the authors' experiences using large scale parallel machines at Sandia National Laboratories. We address trends in hardware, system software and algorithms, and we also offer our view of the forces shaping the parallel computing industry.

  6. Sandia technology engineering and science accomplishments

    Energy Technology Data Exchange (ETDEWEB)

    1993-03-01

    Sandia is a DOE multiprogram engineering and science laboratory with major facilities at Albuquerque, New Mexico, and Livermore, California, and a test range near Tonapah, Nevada. We have major research and development responsibilities for nuclear weapons, arms control, energy, the environment, economic competitiveness, and other areas of importance to the needs of the nation. Our principal mission is to support national defense policies by ensuring that the nuclear weapon stockpile meets the highest standards of safety, reliability, security, use control, and military performance. Selected unclassified technical activities and accomplishments are reported here. Topics include advanced manufacturing technologies, intelligent machines, computational simulation, sensors and instrumentation, information management, energy and environment, and weapons technology.

  7. The new Sandia light ion microbeam

    Energy Technology Data Exchange (ETDEWEB)

    Vizkelethy, G., E-mail: gvizkel@sandia.gov [Sandia National Laboratories, P.O. Box 5800, MS 1056, Albuquerque, NM 87185 (United States); Doyle, B.L. [Sandia National Laboratories, P.O. Box 5800, MS 1056, Albuquerque, NM 87185 (United States); McDaniel, F.L. [Sandia National Laboratories, P.O. Box 5800, MS 1056, Albuquerque, NM 87185 (United States); University of North Texas, Denton, TX 76203 (United States)

    2012-02-15

    The Ion Beam Laboratory of Sandia National Laboratories (SNL) was recently relocated into a brand new building. The 6 MV High Voltage Engineering (HVE) tandem accelerator (hosting the heavy ion microbeam and several analytical beam lines) and the 350 kV HVE implanter with a nanobeam were moved to the new building. There were several new pieces of equipment acquired associated with the move, among them a new high brightness 3 MV Pelletron accelerator, a high resolution light ion microbeam, a nanoimplanter, and a transmission electron microscope (TEM) connected to the tandem accelerator. In this paper this new facility will be described, and initial results of the new microbeam will be presented.

  8. Review of Sandia National Laboratories - Albuquerque New Mexico DOE/DP Critical Skills Development Progrmas FY04.

    Energy Technology Data Exchange (ETDEWEB)

    Gorman, Anna K; Wilson, Dominique; CLARK, KATHERINE

    2005-09-01

    Sandia National Laboratories has developed a portfolio of programs to address the critical skills needs of the DP labs, as identified by the 1999 Chiles Commission Report. The goals are to attract and retain the best and the brightest students and transition them into Sandia - and DP Complex - employees. The US Department of Energy/Defense Programs University Partnerships funded ten laboratory critical skills development programs in FY04. This report provides a qualitative and quantitative evaluation of these programs and their status. 3

  9. Making capitated Medicare work for women: policy and research challenges.

    Science.gov (United States)

    Bierman, A S; Clancy, C M

    2000-01-01

    Growth in capitated Medicare has special ramifications for older women who comprise the majority of Medicare beneficiaries. Older women are more likely than men to have chronic conditions that lead to illness and disability, and they often have fewer financial and social resources to cope with these problems. Gender differences in health status have a number of important implications for the financing and delivery of care for older women under both traditional fee-for-service Medicare and capitation. The utilization of effective preventive interventions, new therapeutic interventions for the management of common chronic disorders, and more cost-effective models of chronic disease management could potentially extend the active life expectancy of older women. However, there are financial and delivery system barriers to achieving these objectives. Traditional FFS Medicare has gaps in coverage of care for chronic illness and disability that disproportionately impact women. Managed care potentially offers flexibility to allocate resources creatively, to develop new models of care, and offer enhanced benefits with lower out-of-pocket costs. However, challenges to realizing this potential under Medicare managed care with unique implications for older women include: possible gender bias in capitation payments, risk selection, inadequacy of risk adjustment models, benefit and market instability, and disenrollment patterns.

  10. SANDIA NATIONAL LABORATORIES IN SITU ELECTROKINETIC EXTRACTION TECHNOLOGY; INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As a part of the Superfund Innovative Technology Evaluation (SITE) Program, the U.S. Environmental Protection Agency evaluated the In-Situ Electrokinetic Extraction (ISEE) system at Sandia National Laboratories, Albuquerque, New Mexico.The SITE demonstration results show ...

  11. Competitive bidding in Medicare Advantage: effect of benchmark changes on plan bids.

    Science.gov (United States)

    Song, Zirui; Landrum, Mary Beth; Chernew, Michael E

    2013-12-01

    Bidding has been proposed to replace or complement the administered prices that Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006-2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. COMPETITIVE BIDDING IN MEDICARE ADVANTAGE: EFFECT OF BENCHMARK CHANGES ON PLAN BIDS

    Science.gov (United States)

    Song, Zirui; Landrum, Mary Beth; Chernew, Michael E.

    2013-01-01

    Bidding has been proposed to replace or complement the administered prices in Medicare pays to hospitals and health plans. In 2006, the Medicare Advantage program implemented a competitive bidding system to determine plan payments. In perfectly competitive models, plans bid their costs and thus bids are insensitive to the benchmark. Under many other models of competition, bids respond to changes in the benchmark. We conceptualize the bidding system and use an instrumental variable approach to study the effect of benchmark changes on bids. We use 2006–2010 plan payment data from the Centers for Medicare and Medicaid Services, published county benchmarks, actual realized fee-for-service costs, and Medicare Advantage enrollment. We find that a $1 increase in the benchmark leads to about a $0.53 increase in bids, suggesting that plans in the Medicare Advantage market have meaningful market power. PMID:24308881

  13. Medicare Preventive Services Quick Reference Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — This educational tool provides the following information on Medicare preventive services Healthcare Common Procedure Coding System (HCPCS)-Current Procedural...

  14. 76 FR 28196 - Medicare and Medicaid Programs; Opportunities for Alignment Under Medicaid and Medicare

    Science.gov (United States)

    2011-05-16

    ... partner with States, providers, beneficiaries and their caregivers, and other stakeholders to improve... conflicting Medicaid and Medicare requirements. This document represents the first step. We have compiled what.... We will then determine which issues to address and in what order and timeframe. All areas are...

  15. How well does a single question about health predict the financial health of Medicare managed care plans?

    Science.gov (United States)

    Bierman, A S; Bubolz, T A; Fisher, E S; Wasson, J H

    1999-01-01

    Responses to simple questions that predict subsequent health care utilization are of interest to both capitated health plans and the payer. To determine how responses to a single question about general health status predict subsequent health care expenditures. Participants in the 1992 Medicare Current Beneficiary Survey were asked the following question: "In general, compared to other people your age, would you say your health is: excellent, very good, good, fair or poor?" To obtain each participant's total Medicare expenditures and number of hospitalizations in the ensuing year, we linked the responses to this question with data from the 1993 Medicare Continuous History Survey. Nationally representative sample of 8775 noninstitutionalized Medicare beneficiaries 65 years of age and older. Annual age- and sex-adjusted Medicare expenditures and hospitalization rates. Eighteen percent of the beneficiaries rated their health as excellent, 56% rated it as very good or good, 17% rated it as fair, and 7% rated it as poor. Medicare expenditures had a marked inverse relation to self-assessed health ratings. In the year after assessment, age- and sex-adjusted annual expenditures varied fivefold, from $8743 for beneficiaries rating their health as poor to $1656 for beneficiaries rating their health as excellent. Hospitalization rates followed the same pattern: Respondents who rated their health as poor had 675 hospitalizations per 1000 beneficiaries per year compared with 136 per 1000 for those rating their health as excellent. The response to a single question about general health status strongly predicts subsequent health care utilization. Self-reports of fair or poor health identify a group of high-risk patients who may benefit from targeted interventions. Because the current Medicare capitation formula does not account for health status, health plans can maximize profits by disproportionately enrolling beneficiaries who judge their health to be good. However, they are at

  16. A pollution prevention chargeback system at Sandia National Laboratories, New Mexico

    International Nuclear Information System (INIS)

    Davis, R.; Fish, J.; Brown, C.

    1994-08-01

    Sandia National Laboratories, New Mexico (Sandia/NM) has successfully developed and implemented a chargeback system to fund the implementation of Pollution Prevention activities. In the process of establishing this system, many valuable lessons have been learned. This paper describes how the chargeback system currently functions, the benefits and drawbacks of implementing such a system, and recommendations for implementing a chargeback system at other facilities. The initial goals in establishing a chargeback system were to create (1) funding for pollution prevention implementation, including specific pollution prevention projects; and (2) awareness on the part of the line organizations of the quantities and types of waste that they generate, thus providing them with a direct incentive to reduce that waste. The chargeback system inputs waste generation data and then filters and sorts the data to serve two purposes: (1) the operation of the chargeback system; and (2) the detailed waste generation reporting used for assessing processes and identifying pollution prevention opportunities

  17. Sandia National Laboratories, California Waste Management Program annual report.

    Energy Technology Data Exchange (ETDEWEB)

    Brynildson, Mark E.

    2010-02-01

    The annual program report provides detailed information about all aspects of the Sandia National Laboratories, California (SNL/CA) Waste Management Program. It functions as supporting documentation to the SNL/CA Environmental Management System Program Manual. This annual program report describes the activities undertaken during the past year, and activities planned in future years to implement the Waste Management (WM) Program, one of six programs that supports environmental management at SNL/CA.

  18. 78 FR 72089 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2013-12-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-6051-N] Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount... period entitled ``Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening...

  19. Lessons Learned from Sandia National Laboratories' Operational Readiness Review of the Annular Core Research Reactor (ACRR)

    International Nuclear Information System (INIS)

    Bendure, Albert O.; Bryson, James W.

    1999-01-01

    The Sandia ACRR (a Hazard Category 2 Nuclear Reactor Facility) was defueled in June 1997 to modify the reactor core and control system to produce medical radioisotopes for the Department of Energy (DOE) Isotope Production Program. The DOE determined that an Operational Readiness Review (ORR) was required to confirm readiness to begin operations within the revised safety basis. This paper addresses the ORR Process, lessons learned from the Sandia and DOE ORRS of the ACRR, and the use of the ORR to confirm authorization basis implementation

  20. Use of gonioscopy in medicare beneficiaries before glaucoma surgery.

    Science.gov (United States)

    Coleman, Anne L; Yu, Fei; Evans, Stacy J

    2006-12-01

    The American Academy of Ophthalmology Preferred Practice Patterns for angle closure and open-angle glaucoma (OAG) patients recommends performing bilateral gonioscopy upon initial presentation to evaluate the possibility of narrow angle or angle-closure glaucoma (ACG) and then repeating the examination at least every 5 years. This study aims to assess how commonly eye care providers perform gonioscopy before planned glaucoma surgery in OAG, anatomic narrow angle, and ACG in the Medicare population. Data obtained from a 5% random sample of Medicare beneficiaries undergoing glaucoma surgery in the United States in 1999 were retrospectively reviewed. The proportion of patients with evidence of at least one gonioscopic examination before glaucoma surgery was determined for the period of 1995 to 1999. Demographic and clinical factors potentially influencing the decision to perform gonioscopy were also examined. Overall, gonioscopy is apparently performed in 49% of Medicare beneficiaries during the 4 to 5 years preceding glaucoma surgery. This rate was significantly lower (P gonioscopy rates (P Gonioscopy examination before glaucoma surgery in Medicare beneficiaries is underused, undercoded, and/or miscoded, given current recommendations. Underuse is of particular concern in patients undergoing laser iridotomy as it is the diagnostic test of choice in ACG.

  1. Pollution prevention opportunity assessment for MicroFab and SiFab facilities at Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, Morgan Evan

    2011-12-01

    This Pollution Prevention Opportunity Assessment (PPOA) was conducted for the MicroFab and SiFab facilities at Sandia National Laboratories/New Mexico in Fiscal Year 2011. The primary purpose of this PPOA is to provide recommendations to assist organizations in reducing the generation of waste and improving the efficiency of their processes and procedures. This report contains a summary of the information collected, the analyses performed, and recommended options for implementation. The Sandia National Laboratories Environmental Management System (EMS) and Pollution Prevention (P2) staff will continue to work with the organizations to implement the recommendations.

  2. Environmental assessment for Sandia National Laboratories/New Mexico offsite transportation of low-level radioactive waste

    International Nuclear Information System (INIS)

    1996-09-01

    Sandia National Laboratories, New Mexico (SNL/NM) is managed and operated by Sandia Corporation, a Lockheed Martin Company. SNL/NM is located on land owned by the U.S. Department of Energy (DOE) within the boundaries of the Kirtland Air Force Base (KAFB) in Albuquerque, New Mexico. The major responsibilities of SNL/NM are the support of national security and energy projects. Low-level radioactive waste (LLW) is generated by some of the activities performed at SNL/NM in support of the DOE. This report describes potential environmental effects of the shipments of low-level radioactive wastes to other sites

  3. Paying Medicare Advantage plans by competitive bidding: how much competition is there?

    Science.gov (United States)

    Biles, Brian; Pozen, Jonah; Guterman, Stuart

    2009-08-01

    Private health plans that enroll Medicare beneficiaries--known as Medicare Advantage (MA) plans--are being paid $11 billion more in 2009 than it would cost to cover these beneficiaries in regular fee-for-service Medicare. To generate Medicare savings for offsetting the costs of health reform, the Obama Administration has proposed eliminating these extra payments to private insurers and instituting a competitive bidding system that pays MA plans based on the bids they submit. This study examines the concentration of enrollment among MA plans and the degree to which firms offering MA plans actually face competition. The results show that in the large majority of U.S. counties, MA plan enrollment is highly concentrated in a small number of firms. Given the relative lack of competition in many markets as well as the potential impact on traditional Medicare, the authors call for careful consideration of a new system for setting MA plan payments.

  4. Medicare Geographic Variation - Public Use File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Geographic Variation Public Use File provides the ability to view demographic, utilization and quality indicators at the state level (including...

  5. Research and Development Program for transportation packagings at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Hohnstreiter, G.F.; Sorenson, K.B.

    1995-01-01

    This document contains information about the research and development programs dealing with waste transport at Sandia National Laboratories. This paper discusses topics such as: Why new packaging is needed; analytical methodologies and design codes;evaluation of packaging components; materials characterization; creative packaging concepts; packaging engineering and analysis; testing; and certification support

  6. 78 FR 74229 - Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, Clinical...

    Science.gov (United States)

    2013-12-10

    ... MFP Multi-Factor Productivity MGMA Medical Group Management Association MIEA-TRHCA The Medicare... 69624), we revised the methodology for calculating direct PE RVUs from the top- down to the bottom-up... Based on RVUs To calculate the payment for each physicians' service, the components of the fee schedule...

  7. The economic impact of Medicare Part D on congestive heart failure.

    Science.gov (United States)

    Dall, Timothy M; Blanchard, Tericke D; Gallo, Paul D; Semilla, April P

    2013-05-01

    Medicare Part D has had important implications for patient outcomes and treatment costs among beneficiaries with congestive heart failure (CHF). This study finds that improved medication adherence associated with expansion of drug coverage under Part D led to nearly $2.6 billion in reductions in medical expenditures annually among beneficiaries diagnosed with CHF and without prior comprehensive drug coverage, of which over $2.3 billion was savings to Medicare. Further improvements in adherence could potentially save Medicare another $1.9 billion annually, generating upwards of $22.4 billion in federal savings over 10 years.

  8. Implementing a lessons learned process at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Fosshage, Erik D.; Drewien, Celeste A.; Eras, Kenneth; Hartwig, Ronald Craig; Post, Debra S.; Stoecker, Nora Kathleen

    2016-01-01

    The Lessons Learned Process Improvement Team was tasked to gain an understanding of the existing lessons learned environment within the major programs at Sandia National Laboratories, identify opportunities for improvement in that environment as compared to desired attributes, propose alternative implementations to address existing inefficiencies, perform qualitative evaluations of alternative implementations, and recommend one or more near-term activities for prototyping and/or implementation. This report documents the work and findings of the team.

  9. Enhancing Medicares Hospital Acquired Conditions Policy

    Data.gov (United States)

    U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...

  10. Medicare-Medicaid Eligible Beneficiaries and Potentiall...

    Data.gov (United States)

    U.S. Department of Health & Human Services — More than one in four hospitalizations for those with both Medicare and full Medicaid coverage was potentially avoidable, according to findings reported in...

  11. Medicare Prescription Drug Coverage - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MMA legislation provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program, the...

  12. Environmental Testing Philosophy for a Sandia National Laboratories' Small Satellite Project - A Retrospective

    Energy Technology Data Exchange (ETDEWEB)

    CAP,JEROME S.

    2000-08-24

    Sandia has recently completed the flight certification test series for the Multi-Spectral Thermal Imaging satellite (MTI), which is a small satellite for which Sandia was the system integrator. A paper was presented at the 16th Aerospace Testing Seminar discussing plans for performing the structural dynamics certification program for that satellite. The testing philosophy was originally based on a combination of system level vibroacoustic tests and component level shock and vibration tests. However, the plans evolved to include computational analyses using both Finite Element Analysis and Statistical Energy Analysis techniques. This paper outlines the final certification process and discuss lessons learned including both things that went well and things that should/could have been done differently.

  13. Utilization and growth patterns of sacroiliac joint injections from 2000 to 2011 in the medicare population.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Hansen, Hans; Pampati, Vidyasagar; Falco, Frank J E

    2013-01-01

    certified registered nurse anesthetists, nurse practitioners, and physician assistants, these numbers increased substantially at a rate of 4,526% per 100,000 Medicare beneficiaries with 21 procedures performed in 2000 increasing to 4,953 procedures in 2011. The, majority of sacroiliac joint injections were performed in an office setting. The utilization of sacroiliac joint injections by state from 2008 to 2010 showed increases of more than 20% in New Hampshire, Alabama, Minnesota, Vermont, Oregon, Utah, Massachusetts, Kansas, and Maine. Similarly, some states showed significant decreases of 20% or more, including Oklahoma, Louisiana, Maryland, Arkansas, New York, and Hawaii. Overall, there was a 1% increase per 100,000 Medicare population from 2008 to 2010. However, 2011 showed significant increases from 2010. The limitations of this study included a lack of inclusion of Medicare participants in Medicare Advantage plans, the availability of an identifiable code for only sacroiliac joint injections, and the possibility that state claims data may include claims from other states. . This study illustrates the explosive growth of sacroiliac joint injections even more than facet joint interventions. Furthermore, certain groups of providers showed substantial increases. Overall, increases from 2008 to 2010 were nominal with 1%, but some states showed over 20% increases whereas some others showed over 20% decreases.

  14. Heart failure rehospitalization of the Medicare FFS patient: a state-level analysis exploring 30-day readmission factors.

    Science.gov (United States)

    Schmeida, Mary; Savrin, Ronald A

    2012-01-01

    Heart failure readmission among the elderly is frequent and costly to both the patient and the Medicare trust fund. In this study, the authors explore the factors that are associated with states having heart failure readmission rates that are higher than the U.S. national rate. Acute inpatient hospital settings. 50 state-level data and multivariate regression analysis is used. The dependent variable Heart Failure 30-day Readmission Worse than U.S. Rate is based on adult Medicare Fee-for-Service patients hospitalized with a primary discharge diagnosis of heart failure and for which a subsequent inpatient readmission occurred within 30 days of their last discharge. One key variable found--states with a higher resident population speaking a primary language other than English at home--that is significantly associated with a decrease in probability in states ranking "worse" on heart failure 30-day readmission. Whereas, states with a higher median income, more total days of care per 1,000 Medicare enrollees, and a greater percentage of Medicare enrollees with prescription drug coverage have a greater probability for heart failure 30-day readmission to be "worse" than the U.S. national rate. Case management interventions targeting health literacy may be more effective than other factors to improve state-level hospital status on heart failure 30-day readmission. Factors such as total days of care per 1,000 Medicare enrollees and improving patient access to postdischarge medication(s) may not be as important as literacy. Interventions aimed to prevent disparities should consider higher income population groups as vulnerable for readmission.

  15. Medicare Update: Annual Wellness Visit

    Science.gov (United States)

    ... counseling services or programs, designed to reduce risk factors, such as for weight loss, smoking cessation, fall prevention, and nutrition. • Review of the responses to the Health Risk Assessment Prepared by Leslie Fried, Alzheimer’s Association Medicare Advocacy Project. Rev. Feb 1, 2012 ...

  16. Appeals - Redetermination by a Medicare Contractor

    Data.gov (United States)

    U.S. Department of Health & Human Services — A redetermination is an examination of a claim by the fiscal intermediary (FI), carrier, or Medicare Administrative Contractor (MAC) personnel who are different from...

  17. Annual report: Purchasing and Materials Management Organization, Sandia National Laboratories, fiscal year 1992

    Energy Technology Data Exchange (ETDEWEB)

    Zaeh, R.A.

    1993-04-01

    This report summarizes the purchasing and transportation activities of the Purchasing and Materials Management Organization for Fiscal Year 1992. Activities for both the New Mexico and California locations are included. Topics covered in this report include highlights for fiscal year 1992, personnel, procurements (small business procurements, disadvantaged business procurements, woman-owned business procurements, New Mexico commercial business procurements, Bay area commercial business procurements), commitments by states and foreign countries, and transportation activities. Also listed are the twenty-five commercial contractors receiving the largest dollar commitments, commercial contractors receiving commitments of $1,000 or more, integrated contractor and federal agency commitments of $1,000 or more from Sandia National Laboratories/New Mexico and California, and transportation commitments of $1,000 or more from Sandia National Laboratories/New Mexico and California.

  18. Recent operational history of the new Sandia Pulsed Reactor III (SPR III)

    International Nuclear Information System (INIS)

    Schmidt, T.R.; Estes, B.F.; Reuscher, J.A.

    1977-01-01

    The Sandia Pulsed Reactor III (SPR III) is a fast-pulse research reactor which was designed and built at Sandia Laboratories and achieved criticality in August 1975. The reactor is now characterized and is in an operational configuration. The core consists of 18 fuel plates (258 kg fuel mass) of fully enriched uranium alloyed with 10 wt.% molybdenum. It is arranged in an annular configuration with an inside diameter of 17.78 cm, an outside diameter of 29.72 cm, and a height of 35.9 cm. The reactor core uses reflectors of copper and aluminum for control and an external bolting arrangement to secure the fuel plates. SPR III and SPR II are operated on an interchangeable basis using the same facility and control system. As of June 1977, SPR III has had over 240 operations with core temperatures up to 541 0 C

  19. Opioid Prescribing Practices of Neurosurgeons: Analysis of Medicare Part D.

    Science.gov (United States)

    Khalid, Syed I; Adogwa, Owoicho; Lilly, Daniel T; Desai, Shyam A; Vuong, Victoria D; Mehta, Ankit I; Cheng, Joseph

    2018-04-01

    The Centers for Disease Control have declared that the United States is amidst a continuing opioid epidemic, with drug overdose-related death tripling between 1999 and 2014. Among the 47,055 overdose-related deaths that occurred in 2014, 28,647 (60.9%) of them involved an opioid. The Part D Prescriber Public Use File, which is based on beneficiaries enrolled in the Medicare Part D prescription drug program, was used to query information on prescription drug events incurred by Medicare beneficiaries with a Part D prescription drug plan from 31 June 2014 to 30 June 2015. Only those providers with the specialty description of neurosurgeon, as reported on the provider's Part B claims, were included in this study. A total of 271,502 beneficiaries, accounting for 971,581 claims and 22,152,689 day supplies of medication, accounted for the $52,956,428.40 paid by the Centers for Medicare and Medicaid Services for medication that the 4085 neurosurgeons submitted to the Centers for Medicare and Medicaid Services Part D program in the 2014 calendar year. During the same year, 402,767 (41.45%) claims for 158,749 (58.47%) beneficiaries accounted for 6,458,624 (29.16%) of the day supplies of medications and $13,962,630.11 (26.37%) of the total money spent by the Centers for Medicare and Medicaid Services Part D that year. Nationwide, the ratio of opioid claims to total Medicare Part D beneficiaries was 1.48. No statistically significant regional differences were found. The opioid misuse epidemic is a complex and national issue with patterns of prescription not significantly different between regions. All neurosurgeons must be cognizant of their prescribing practices so as to best support the resolution of this public health crisis. Copyright © 2017. Published by Elsevier Inc.

  20. Sandia National Laboratories/New Mexico Environmental Baseline update--Revision 1.0

    International Nuclear Information System (INIS)

    1996-07-01

    This report provides a baseline update to provide the background information necessary for personnel to prepare clear and consise NEPA documentation. The environment of the Sandia National Laboratories is described in this document, including the ecology, meteorology, climatology, seismology, emissions, cultural resources and land use, visual resources, noise pollution, transportation, and socioeconomics