[Federal Register: August 23, 2006 (Volume 71, Number 163)]
[Notices]
[Page 49460-49461]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr23au06-81]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-5035-N]
Medicare Program; Senior Risk Reduction Demonstration
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Notice.
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SUMMARY: This notice informs interested parties of an opportunity to
apply to participate in a risk reduction/health management
demonstration project. This notice also contains information on how to
obtain the complete solicitation and supporting information.
DATES: Applications will be considered timely if we receive them on or
before November 21, 2006.
[[Page 49461]]
ADDRESSES: Mail applications for the Senior Risk Reduction
Demonstration to--Centers for Medicare & Medicaid Services, 7500
Security Boulevard, Baltimore, Maryland 21244-1850.
Medicare Demonstrations Program Group, Mail stop S3-02-01,
Attention: Pauline Lapin.
FOR FURTHER INFORMATION CONTACT: Pauline Lapin, (410) 786-6883 or
Sidney Trieger, (410) 786-6613.
SUPPLEMENTARY INFORMATION:
I. Background
The aging of the population, the prevalence of chronic disease, and
the rapidly rising cost of health care in the United States provides a
sense of urgency and immediacy for finding innovative solutions that
would improve the health and well-being of seniors and prevent or delay
debilitating and costly disease onset.
Recent research suggests that well-structured risk reduction
programs can achieve significant improvements in a population's health
risk profile. Successful programs are founded on solid behavior change
theory, use tailored interventions, are personalized and sufficiently
intensive, and are delivered with adequate social supports. In 2001,
CMS commissioned RAND, and RAND prepared, a report on risk reduction
programs entitled, ``The Evidence Report and Evidence Based
Recommendations: Health Risk Appraisals and Medicare.'' This report
concluded that effective risk reduction programs, beginning with the
administration of a Health Risk Appraisal (HRA) and including evidence-
based and tailored behavior change through follow-up interventions,
exert a beneficial effect on behavioral, physiological, and general
health status outcomes. Other supportive studies have shown that
multicomponent health promotion programs that engage participants in
self-care activities and increase their involvement in health care
decision-making can achieve long-term behavior changes and health risk
reductions in large populations.
Also, evidence is mounting that successful risk reduction programs
may produce a positive return on investment. Based on this evidence,
the RAND report concluded that health promotion and disease prevention
programs using HRAs and ongoing tailored interventions may be cost
beneficial. Experts agree that the approach used in risk reduction
programs is promising for Medicare beneficiaries and should be tested
in a demonstration project.
II. Provisions of the Notice
The purpose of the notice is to inform interested parties of an
opportunity to implement a risk reduction/health management program as
part of the Medicare Senior Risk Reduction Demonstration. The goal of
this demonstration project is to determine whether risk reduction
programs (also referred to as health promotion, health management,
demand management, and disease prevention programs) that have been
developed and tested in the private sector can also be tailored to, and
work well with, Medicare beneficiaries to improve their health and
reduce avoidable health care utilization. The specific aims are to--
Determine whether a senior risk reduction service provided
by Medicare will--
--Be viewed positively by beneficiaries.
--Be accepted by beneficiaries.
--Achieve high participation rates.
--Reduce health risk factors, improve health behaviors, improve
functioning, and prevent disability.
Produce cost savings for the Medicare program.
Applicants must be willing to accept a 10 percent withhold of their
fee each year, and as much as a 15 percent withhold over the course of
the demonstration should Medicare expenditures for the intervention
group exceed those of the control group by more than 5 percent after
the first 18 months of the demonstration.
We intend to use a competitive application process to select up to
five existing health promotion, disease prevention, health management,
or risk reduction organizations to participate in the demonstration
project. Interested parties can obtain complete solicitation and
supporting information on the CMS Web site at http://www.cms.hhs.gov/DemoProjectsEvalRpts
[fxsp0]/downloads/Senior--Risk--[fxsp0]Reduction--
Solicitation.pdf.
We anticipate that we will make final award decisions by April 1,
2007, and that project implementation activities would begin July 1,
2007.
III. Collection of Information Requirements
The document does impose information collection and recordkeeping
requirements. However, since we believe there are less than 10
potential respondents, of which CMS will be selecting 5 applicants to
participate in the demonstration, this collection is exempt from the
PRA as stipulated under 5 CFR 1320.3(c)(4).
Authority: Section 402(a)(1)(B) of the Social Security
Amendments of 1967, Pub. L. No. 90-248, as amended, 42 U.S.C. 1395b-
1(a)(1)(B) and (a)(2).
(Catalog of Federal Domestic Assistance No. 93.773 Medicare--
Hospital Insurance Program; and No. 93.774, Medicare--Supplementary
Medical Insurance Program).
Dated: July 20, 2006.
Mark B. McClellan,
Administrator, Centers for Medicaid & Medicare Services.
[FR Doc. 06-7120 Filed 8-21-06; 4:00 pm]
BILLING CODE 4120-01-M