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As part of its School Meals Initiative, the U.S. Department of Agriculture-Food and Nutrition Service (USDA-FNS) now requires each state to regularly review the nutritional content of food served as part of the National School Lunch Program. The USDA-FNS asked RAND to examine how states perform nutritional reviews and how they might be able to transmit data with limited additional burden.

Children. --- National school lunch program. --- School children.

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This report examines issues surrounding the establishment of a national patient outcomes database that would be used by patients and providers to make more informed treatment decisions. It focuses on prostate cancer and surgery for osteoarthritis. The authors conclude that such longitudinal databases would be both desirable and feasible but would require substantial resources.

Outcome assessment (Medical care) - Databases - United States. --- Treatment Outcome --- Databases as Topic --- Patient Participation --- Decision Making --- Consumer Participation --- Outcome Assessment (Health Care) --- Thinking --- Information Storage and Retrieval --- Prognosis --- Patient Acceptance of Health Care --- Information Systems --- Mental Processes --- Diagnosis --- Outcome and Process Assessment (Health Care) --- Consumer Organizations --- Attitude to Health --- Information Science --- Medical Informatics Applications --- Community Health Services --- Health Care Evaluation Mechanisms --- Health Services --- Psychological Phenomena and Processes --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Medical Informatics --- Delivery of Health Care --- Quality of Health Care --- Organizations --- Psychiatry and Psychology --- Health Care Economics and Organizations --- Health Care Quality, Access, and Evaluation --- Health Care Facilities, Manpower, and Services --- Health Services Administration --- Health Care --- Medical Research --- Medicine --- Health & Biological Sciences --- Community Participation --- Administration, Health Services --- Healthcare Facilities, Manpower, and Services --- Healthcare Quality, Access, and Evaluation --- Healthcare Economics and Organizations --- Community-Based Distribution --- Contraceptive Distribution --- Delivery of Healthcare --- Dental Care Delivery --- Distribution, Non-Clinical --- Distribution, Nonclinical --- Distributional Activities --- Healthcare --- Healthcare Delivery --- Healthcare Systems --- Non-Clinical Distribution --- Nonclinical Distribution --- Delivery of Dental Care --- Health Care Delivery --- Health Care Systems --- Activities, Distributional --- Activity, Distributional --- Care, Health --- Community Based Distribution --- Community-Based Distributions --- Contraceptive Distributions --- Deliveries, Healthcare --- Delivery, Dental Care --- Delivery, Health Care --- Delivery, Healthcare --- Distribution, Community-Based --- Distribution, Contraceptive --- Distribution, Non Clinical --- Distributional Activity --- Distributions, Community-Based --- Distributions, Contraceptive --- Distributions, Non-Clinical --- Distributions, Nonclinical --- Health Care System --- Healthcare Deliveries --- Healthcare System --- Non Clinical Distribution --- Non-Clinical Distributions --- Nonclinical Distributions --- System, Health Care --- System, Healthcare --- Systems, Health Care --- Systems, Healthcare --- Non-Governmental Organizations --- Nongovernmental Organizations --- Organizations, Nongovernmental --- Non Governmental Organizations --- Non-Governmental Organization --- Nongovernmental Organization --- Organization --- Organization, Non-Governmental --- Organization, Nongovernmental --- Organizations, Non-Governmental --- Quality of Care --- Quality of Healthcare --- Care Qualities --- Care Quality --- Health Care Quality --- Healthcare Quality --- Computer Science, Medical --- Health Information Technology --- Informatics, Clinical --- Informatics, Medical --- Information Science, Medical --- Clinical Informatics --- Medical Computer Science --- Medical Information Science --- Health Information Technologies --- Information Technologies, Health --- Information Technology, Health --- Medical Computer Sciences --- Medical Information Sciences --- Science, Medical Computer --- Technologies, Health Information --- Technology, Health Information --- Psychologic Processes and Principles --- Services, Health --- Health Service --- Service, Health --- Healthcare Evaluation Mechanisms --- Evaluation Mechanism, Healthcare --- Evaluation Mechanisms, Healthcare --- Healthcare Evaluation Mechanism --- Mechanism, Healthcare Evaluation --- Mechanisms, Healthcare Evaluation --- Community Healthcare --- Health Services, Community --- Services, Community Health --- Community Health Care --- Care, Community Health --- Community Health Service --- Community Healthcares --- Health Care, Community --- Health Service, Community --- Healthcare, Community --- Healthcares, Community --- Service, Community Health --- Application, Medical Informatics --- Applications, Medical Informatics --- Informatics Applications, Medical --- Informatics Application, Medical --- Medical Informatics Application --- Information Sciences --- Science, Information --- Sciences, Information --- Health Attitude --- Attitude, Health --- Attitudes, Health --- Health Attitudes --- Health, Attitude to --- Organizations, Consumer --- Consumer Organization --- Organization, Consumer --- Donabedian Model --- Donabedian Triad --- Outcome and Process Assessment --- Structure Process Outcome Triad --- Model, Donabedian --- Triad, Donabedian --- Antemortem Diagnosis --- Diagnoses and Examinations --- Examinations and Diagnoses --- Postmortem Diagnosis --- Antemortem Diagnoses --- Diagnoses --- Diagnoses, Antemortem --- Diagnoses, Postmortem --- Diagnosis, Antemortem --- Diagnosis, Postmortem --- Postmortem Diagnoses --- Disease --- Human Information Processing --- Information Processing, Human --- Ancillary Information Systems --- Data Systems --- Emergency Care Information Systems --- Information Retrieval Systems --- Ancillary Information System --- Data System --- Information Retrieval System --- Information System --- Information System, Ancillary --- Information Systems, Ancillary --- System, Ancillary Information --- System, Data --- System, Information --- System, Information Retrieval --- Systems, Ancillary Information --- Systems, Data --- Systems, Information --- Systems, Information Retrieval --- Prognostic Factors --- Factor, Prognostic --- Factors, Prognostic --- Prognoses --- Prognostic Factor --- Data Files --- Data Linkage --- Data Retrieval --- Data Sources --- Data Storage --- Data Storage and Retrieval --- Information Extraction --- Information Storage --- Machine-Readable Data Files --- Information Retrieval --- Data File --- Data File, Machine-Readable --- Data Files, Machine-Readable --- Data Source --- Extraction, Information --- Files, Machine-Readable Data --- Information Extractions --- Machine Readable Data Files --- Machine-Readable Data File --- Retrieval, Data --- Storage, Data --- Critical Thinking --- Thinking Skills --- Thinking Skill --- Thinking, Critical --- Assessment, Outcomes --- Outcome Measures --- Outcome Studies --- Outcomes Assessment --- Outcomes Research --- Assessment, Outcome (Health Care) --- Assessments, Outcome (Health Care) --- Assessments, Outcomes --- Measure, Outcome --- Measures, Outcome --- Outcome Assessments (Health Care) --- Outcome Measure --- Outcome Study --- Outcomes Assessments --- Research, Outcomes --- Studies, Outcome --- Study, Outcome --- Community Involvement --- Public Participation --- Community Action --- Consumer Involvement --- Action, Community --- Actions, Community --- Community Actions --- Community Involvements --- Consumer Involvements --- Involvement, Community --- Involvement, Consumer --- Involvements, Community --- Participation, Community --- Participation, Consumer --- Participation, Public --- Decision Making, Shared --- Decision Makings, Shared --- Making, Shared Decision --- Makings, Shared Decision --- Shared Decision Making --- Shared Decision Makings --- Patient Activation --- Patient Empowerment --- Patient Engagement --- Patient Involvement --- Patient Participation Rates --- Activation, Patient --- Empowerment, Patient --- Engagement, Patient --- Involvement, Patient --- Participation Rate, Patient --- Participation Rates, Patient --- Participation, Patient --- Patient Participation Rate --- Data Banks as Topic --- Data Bases as Topic --- Databanks as Topic --- Clinical Effectiveness --- Clinical Efficacy --- Patient-Relevant Outcome --- Treatment Efficacy --- Rehabilitation Outcome --- Treatment Effectiveness --- Clinical Effectivenesses --- Effectiveness, Clinical --- Effectiveness, Treatment --- Effectivenesses, Clinical --- Efficacy, Clinical --- Efficacy, Treatment --- Outcome, Patient-Relevant --- Outcome, Rehabilitation --- Outcome, Treatment --- Outcomes, Patient-Relevant --- Patient Relevant Outcome --- Patient-Relevant Outcomes --- Acceptability of Healthcare --- Acceptors of Health Care --- Health Care Utilization --- Nonacceptors of Health Care --- Patient Acceptance of Healthcare --- Acceptability of Health Care --- Health Care Seeking Behavior --- Care Acceptor, Health --- Care Acceptors, Health --- Care Nonacceptor, Health --- Care Nonacceptors, Health --- Health Care Acceptability --- Health Care Acceptor --- Health Care Acceptors --- Health Care Nonacceptor --- Health Care Nonacceptors --- Healthcare Acceptabilities --- Healthcare Acceptability --- Healthcare Patient Acceptance --- Healthcare Patient Acceptances --- Utilization, Health Care --- organization & administration --- diagnosis --- Pharmacy Audit --- Audit, Pharmacy --- Pharmacy Audits --- Health Informatics --- Informatics, Health --- Computational Biology --- Biomedical Technology --- American Recovery and Reinvestment Act --- Psychologic Processes --- Psychological Processes --- Phenomena, Psychological --- Processes, Psychologic --- Processes, Psychological --- Psychological Phenomenas --- Psychological Processe --- Public Health Administration --- Social Work --- Community Health Planning --- Biomedical Engineering --- Public Opinion --- Thought --- Thoughts --- Political Activism --- Patient Care Planning --- Problem Solving --- Refusal to Participate --- Lysholm Knee Score --- Patient Satisfaction --- Perinatal Information System --- Information System, Perinatal --- Perinatal Information Systems --- Citizen Science --- Treatment Outcome. --- Databases as Topic. --- Patient Participation. --- Decision Making. --- United States. --- Credit Assignment --- Assignment, Credit --- Assignments, Credit --- Credit Assignments

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In this report, the authors address how the Centers for Medicare and Medicaid Services (CMS) can improve the methodology or update data used for setting practice expense (PE) rates for payments made under the Medicare Physician Fee Schedule (MPFS). The current system for setting PE payment rates relies, in part, on data collected in the Physician Practice Information (PPI) Survey, which generally reflects information from 2006. Because of changes in the U.S. economy and health care system since that time, there are concerns that continued reliance on measures that use PPI Survey data might result in misvalued PE rates. To the extent that future payment systems use MPFS rates as a starting point, misvalued PE rates might be problematic if they are not updated. The research in this report, which is part of the second phase of a study, can be divided into three broad topics. First, the authors consider how updated PE data could be collected through a new large-scale national survey effort to replace the PPI Survey. Second, the authors consider a new framework for allocating PE, which they developed to better capture variation in PE resources that are required to provide services covered in the MPFS. Finally, the authors continue work begun in Phase I of the project and documented in a previous report, Practice Expense Methodology and Data Collection Research and Analysis, investigating the potential to make use of data collected to set rates in the Outpatient Prospective Payment System (OPPS). Throughout the report, the authors focus primarily on indirect PE, which includes such expenses as administration, rent, and other forms of overhead that cannot be attributed to any specific service.