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Poorly Performing Nursing Homes

Special Focus Facilities are Often Improving, But CMS's Program Could be Strengthened

The Centers for Medicare and Medicaid Serv. (CMS) established the Special Focus Facility (SFF) Program to help address poor nursing home performance. States select a subset of homes as SFFs from a list of the 15 poorest performing homes in each state. States survey SFFs twice as frequently as other homes and there are more robust enforcement, including termination, for SFFs that fail to improve within about 18 months. This report: (1) determined the factors states consider in selecting SFFs and how SFFs differed from other nursing homes; (2) evaluated CMS regional office and state adherence to program guidance and the program's impact on homes' performance; and (3) identified other strategies that were used to improve poorly performing homes.

This report: (1) determined the factors states consider in selecting SFFs and how SFFs differed from other nursing homes; (2) evaluated CMS regional office and state adherence to program guidance and the program's impact on homes' ...

Brand-New Prescription Drug Pricing

Lack of Therapeutically Equivalent Drugs and Limited Competition May Contribute to Extraordinary Price Increases

The growing cost of brand-name prescription drugs (BNPD) -- FDA-approved drug products that typically have patent protection -- is a concern for patients, payers, and providers of health care -- particularly when price increases are large and occur suddenly. A 2008 congressional hearing drew attention to some small market prescription drugs that had an extraordinary price increase -- 100% or more at a single point in time. This report examined extraordinary price increases for BNPD. It examined the: (1) frequency of extraordinary price increases for BNPD from 2000 to 2008; (2) characteristics of the BNPD that had extraordinary price increases; and (3) factors that contributed to the extraordinary price increases experienced by these BNPD. Illustrations.

The growing cost of brand-name prescription drugs (BNPD) -- FDA-approved drug products that typically have patent protection -- is a concern for patients, payers, and providers of health care -- particularly when price increases are large ...