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Health Care Facilities - FAQs:
Clinical Trials
The National Institutes of Dental and Craniofacial Research (NIDCR) sometimes seeks volunteers with specific dental, oral, and craniofacial conditions to participate in research studies, also known as clinical trials. Researchers may provide study participants with limited free or low-cost dental treatment for the particular condition they are studying. To find out if there are any NIDCR clinical trials that you might fit into, go to "NIDCR Studies Seeking Patients." For a complete list of all federally funded clinical trials, visit ClinicalTrials.gov. To see if you qualify for any clinical trials being conducted at our Bethesda, Maryland, campus, you can call the Clinical Center's Patient Recruitment and Public Liaison Office at 1-800-411-1222.
Dental Schools
Dental schools (American Dental Association) can be a good source of quality, reduced-cost dental treatment. Most of these teaching facilities have clinics that allow dental students to gain experience treating patients while providing care at a reduced cost. Experienced, licensed dentists closely supervise the students. Post-graduate and faculty clinics are also available at most schools.
Dental hygiene schools (American Dental Hygienists' Association) may also offer supervised, low-cost preventive dental care as part of the training experience for dental hygienists.
Bureau of Primary Health Care
The Bureau of Primary Health Care, a service of the Health Resources and Services Administration (1-888-Ask-HRSA), supports federally-funded community health centers across the country that provide free or reduced-cost health services, including dental care.
Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services (CMS) administers three important federally-funded programs: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).
- Medicare is a health insurance program for people who are 65 years and older or for people with specific disabilities. Medicare dental coverage is limited; it does not cover most routine dental care or dentures.
- Medicaid is a state-run program that provides medical benefits, and in some cases dental benefits, to eligible individuals and families. States set their own guidelines regarding who is eligible and what services are covered. Most states provide limited emergency dental services for people age 21 or over, while some offer comprehensive services. For most individuals under the age of 21, dental services are provided under Medicaid.
- CHIP helps children up to age 19 who are without health insurance. CHIP provides medical coverage and, in most cases, dental services to children who qualify. Dental services covered under this program vary from state to state.
CMS (1-800-MEDICARE) can provide detailed information about each of these programs and refer you to state programs where applicable.
State and Local Resources
Your state or local health department may know of programs in your area that offer free or reduced-cost dental care. Call your local or state health department to learn more about their financial assistance programs. Check your local telephone book for the number to call.
United Way
The United Way may be able to direct you to free or reduced-cost dental services in your community. Local United Way chapters can be located on the United Way website.
To find detailed information about the past performance of Medicare and Medicaid certified nursing homes, visit the Nursing Home Compare site. You can search by state, county, city, zip code, and/or facility name.
Learn More:
- Frequently Asked Questions about Nursing Home Compare (Medicare.gov)
The Centers for Medicare & Medicaid offer a detailed checklist for rating different nursing homes visited based upon:
- Quality of Life
- Quality of Care
- Nutrition and Hydration
- Safety
The checklist [PDF - 5 Pages] also elaborates on how to use the information discovered through Nursing Home Compare when visiting nursing homes.
Learn More:
Nursing Homes serve as permanent residences for people who are too frail or sick to live at home or as a temporary facility during a recovering period. However, many people need a nursing home level of care but would prefer to remain in their own home with the help of their family and friends, community services, and professional care agencies. The Medicare program offers limited access to two unique programs for certain beneficiaries who need a comprehensive medical and social service delivery system. The two programs currently available are:
- Program of All-Inclusive Care for the Elderly (PACE) provides detailed information on the PACE program
- Social Managed Care Plan provides detailed information on the Social Managed Care Plan program
There are some people, however, who require less than skilled care, or who require skilled care for only brief periods of time. In most communities, people can choose from a variety of living arrangements that offer different levels of care. Before deciding on a care setting, talk to a doctor or maybe a social worker about your care needs. Most people want to stay in their home for as long as possible. If you are considering staying at home make sure you know the amount of responsibility and work involved. If you cannot live independently, but don't want to live in a nursing home, you may want to consider some of the other alternatives.
- About Other Alternatives: provides more detailed information on other available alternatives.
The Centers for Medicare and Medicaid Services provides a tool to compare certified home health care agencies. You can find the following:
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Home Health Agency Information
Get the address, telephone number and other important information for all Medicare-certified Home Health Agencies in the United States.
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Quality Measures
Learn about how home health agencies provided care for some of their patients receiving care. Quality information can be used to help you compare home health agencies.
Find and compare information about the services and quality of care provided at dialysis facilities in any state. You can also find addresses and phone numbers for each facility at the Centers for Medicare and Medicaid Services' Compare Dialysis Facilities site.
You can look up certified medical suppliers on the Centers for Medicare and Medicaid Services' Supplier Directory site. You can search by State, County, City, Zip Code, and/or supplier name.The primary purpose of this tool is to provide names, addresses, and contact information for suppliers that provide services or products under the Medicare program.
To find a doctor that accepts Medicare and Medicaid payments, you may want to visit the Centers For Medicare and Medicaid Services' Physician Compare. You can search by State, County, City, Zip Code, and doctor's name. This tool will provide you with a list of physicians in the specialty and geographic area you specify, along with detailed physician profiles, maps and driving directions.
Hospital Compare (Centers for Medicare & Medicaid Services) provides information about Medicare participating hospitals that compare quality measures of Heart Attack (AMI), Heart Failure Care, and Pneumonia Care.
There are many other directories that will help you find health professionals, services, and facilities, some of which may serve Medicare or Medicaid payments. A complete list of these directories is available at: http://www.nlm.nih.gov/medlineplus/directories.html
Hospitals that treat sicker patients do not necessarily have higher death rates. All rates have been adjusted to account for differences in patient's health status before they were hospitalized. Sicker patient's who have more health problems may be more at risk to die than healthier patients. Sicker people may also need more specialized care, which may not be available at all hospitals.
It is important to take into account these issues before any ratings are posted. A complex statistical model is used to calculate the risk-adjustment rate which "levels the playing field" by accounting for health risks which are present before the patient actually enters the hospital.
The mortality categories show how individual hospital's risk-adjusted 30-day death rates compare to the national rate. A hospital's performance is reported as
- Better Than The US National Rate,
- No Different Than The US National Rate, or
- Worse Than The US National Rate.
Hospitals are only identified as better or worse than the U.S. national mortality rate if the 95% interval estimate for their risk-standardized mortality rate (RSMR) is completely above or below the U.S. national rate.
Better Than The US National Rate means the hospital has a 30-day risk-adjusted death (mortality) rate lower than the US national rate.
Worse Than The US National Rate means the hospital has a 30-day risk-adjusted death (mortality) rate higher than the U.S. National Rate.
No Different Than The US National Rate means there is no significant difference between the 30-day risk-adjusted death (mortality) rate and the U.S. National Rate.
Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide
- checkups when you're well
- treatment when you're sick
- complete care when you're pregnant
- immunizations and checkups for your children
- dental care and prescription drugs for your family
- mental health and substance abuse care if you need it
Health centers are in most cities and many rural areas. To search for the Health Center in your area, visit http://findahealthcenter.hrsa.gov/
Hospital Compare offers the consumer information on hospitals performance on measures of quality. Some information is based on how well hospitals provided recommended and appropriate care to patients being treated for heart attack, heart failure and pneumonia, or who were receiving surgical care. These types of measures are called process measures. Another type of measure of the quality of care provided by a hospital is the outcome of that care. Hospital Compare began posting Adjusted Death (Mortality) Rates associated with hospitalizations for heart attack and heart failure in June 2007. In July of 2010 Hospital Compare added Imaging Efficiency Measures and Outpatient Measures. The purpose of these measures is to promote high-quality efficient care.
The website can be accessed by going directly to http://www.HospitalCompare.hhs.gov or using the link in the http://www.Medicare.gov website. Once on the Hospital Compare site, users can find hospitals by:
- proximity to a city or ZIP code;
- specific state or county; and
- name.
After selecting the hospital or hospitals of interest, users can select the information about hospitals that they would like to see.
It is important to remember the information posted on this Web site should not be used as a decision making tool alone without consulting with your Doctor and your family regarding your medical care.
In addition to the national average, the Hospital Compare Web site also presents the score representing the performance of the top 10 percent of all hospitals reporting. Often those top hospitals achieve the top score ('100%') on the measure, which means all the top hospitals provide the recommended treatment to their patients every time it is appropriate to do so.
The Hospital Quality Alliance (HQA) is a public-private collaborative that has representation of hospitals and clinicians, consumer groups, purchasers, accrediting bodies and government agencies.
Its members include:
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AARP
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AFL-CIO
- Agency for Healthcare Research and Quality (HHS/AHRQ)
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America's Health Insurance Plans (AHIP)
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American Hospital Association (AHA)
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American Medical Association (AMA)
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American Nurses Association (ANA)
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Association of American Medical Colleges (AAMC)
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Blue Cross and Blue Shield Association (BCBSA)
- Centers for Medicare & Medicaid Services (HHS/CMS)
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Consumer-Purchaser Disclosure Project (CPDP)
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Federation of American Hospitals (FAH)
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General Electric Company (GE)
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The Joint Commission
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National Association of Children's Hospitals and Related Institutions (NACHRI)
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National Association of Public Hospitals and Health Systems (NAPH)
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National Business Coalition on Health (NBCH)
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National Quality Forum (NQF)
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U. S. Chamber of Commerce
This is a known bug in certain versions of Microsoft's Internet Explorer web browser. We are investigating this bug; however, in the interim, here are some ways to get the results to display:
1. Use a browser other than Internet Explorer. Mozilla, Firefox, Safari, and Opera do not have this blank page bug.
2. Configure your scripting settings in Internet Explorer. Please use the detailed instructions below depending on your version of Internet Explorer and your operating system.
Microsoft Internet Explorer 5.x and 6.x (Windows)
1. Select Internet Options from the Tools menu.
2. Click the Security tab.
3. Click Custom Level in Security Level for this Zone.
4. Scroll down to Scripting, near the bottom of the list.
5. Under Active Scripting, choose Disable.
6. Click OK to leave Security Settings. Click OK to leave Internet Options.
7. Close all the browser windows and re-launch the browser so that setting can take an effect.
8. Enable JavaScript once you are done with your browsing experience.
Microsoft Internet Explorer 5.x (Macintosh)
1. Choose Preferences under the Explorer menu.
2. Click Web Content under Web Browser.
3. In Active Content, uncheck the box next to Enable scripting.
4. Enable JavaScript once you are done with your browsing experience.
Hospital Compare is designed to help consumers, patients, their loved ones to make better healthcare decisions. The information on the Web site should be used to:
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Talk to your doctor and other health care providers about the quality of care at hospitals. Some hospitals have more experience or better results treating certain conditions or performing certain procedures. Ask your doctor or health care provider which hospital has the best care and results for your condition. Ask why he or she prefers to use that hospital.
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If your physician is referring you for surgery, ask how well the hospital performs your kind of surgery, as well as about the surgeon who may work with you, and how many surgeries they perform each year. Your physician will want you to be confident about all of your health care decisions.
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Talk to your doctor or health care provider about other patients' experiences with the hospital. Some hospitals survey their patients in regards to hospital satisfaction. Try to get as much information as you are able about what other patients think of the care at the hospital.
- Look at the hospital information on this Web site, as well as other quality information and talk to your doctor about any questions or concerns you have.
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- Ask family or friends about their hospital experiences. Look on the Web site for the Hospital Checklist. It can help you ask important questions.
How we measure 'good care' changes as the experts learn more from research. The change in the quality measures for the treatment of heart attack and heart failure for Left Ventricular Systolic Dysfunction (LVSD) is a change to keep quality measures up-to-date with the most recent evidence about effective treatments.
ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) are medicines used to treat patients with heart failure, and are particularly beneficial for those patients with heart failure or who have had a heart attack and who have decreased function of the left side of the heart (with LVSD). Early treatment with ACE inhibitors and ARBs for patients who have heart failure symptoms or decreased heart function after a heart attack can also reduce risk of death from future heart attacks. ACE inhibitors and ARBs work by limiting the effects of a hormone that narrows blood vessels, and may thus lower blood pressure and reduce the work the heart has to perform. Since the ways in which these two kinds of drugs work are different and may have different side effects, your doctor will decide which drug is most appropriate for you. If you have a heart attack and/or heart failure, and you have decreased heart function, you should get a prescription for ACE inhibitors or ARBs before you leave the hospital. The rates posted on Hospital Compare in December 2005 reflect how well hospitals provide both of these treatments.
For more specific information about the changes, please see below:
The two quality measures that assess the use of ACE-inhibitors for patients with heart failure or who have had a heart attack have been changed to acknowledge the evolving evidence from recent clinical trials. Although many experts believe that ACE inhibitors should remain the first-line method of treating patients with heart failure, the accumulating evidence of therapeutic benefit indicates that ARBs are an acceptable alternative to ACE inhibitors.
The measures reported on Hospital Compare, beginning with the rates posted in December 2005, assess treatment with either of the two medication classes ??? ACE-inhibitors or ARBs -- in patients with heart failure or after an acute heart attack who have impairments in the contractile function of the left side of the heart. All such patients should be treated with either an ACE-inhibitor or an ARB unless there is documentation of a specific reason not to use both classes of drugs.
