Planning a Demonstration of Per-case Reimbursement for Inpatient Physician Services Under Medicare


Book Description

It has been proposed that Medicare pay for inpatient physicians' services on a per-case basis, giving physicians an incentive to economize on services delivered in the hospital. This report outlines the design of a possible demonstration of a system of per-case payment and considers the following key issues in developing such a design: (1) selecting the options most attractive to demonstrate, (2) participation in the demonstration, (3) setting payment rates, (4) site selection, and (5) evaluation of the demonstration. The demonstration would seek to determine how alternative methods of paying physicians would affect costs, beneficiary access and financial liability, and health status outcomes or quality of care.




The Medicare Handbook


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Medicare Laboratory Payment Policy


Book Description

Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.




Crossing the Quality Chasm


Book Description

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.










Health Services Research


Book Description

Looks at the theory and practice of privatization internationally through case studies of the US, Canada, New Zealand, Great Britain, West Germany, France, Sweden and Chile. Among the sectors of health care examined are public and private hospitals, mental health care, prepaid health plans. and the multinational pharmaceutical industry. A report from the Foundation for Health Services Research. Commissioned essays by leading scholars provide an account of what health services research aims to do, what the breadth of the effort has been, and what the research has accomplished. Volume editor Ginzberg (director, Conservation of Human Resources, Columbia U.) introduces the subject with an overview of health services research and its relation to health policy and concludes with thoughts on future research needs. Annotation copyrighted by Book News, Inc., Portland, OR




Becoming a New Teaching Hospital


Book Description

This guide is designed to assist hospitals that are thinking of becoming new teaching hospitals and medical schools seeking to develop education partnerships with non-teaching hospitals to understand the basic principles of the Medicare payments available to support the added costs associated with being a teaching hospital.--Publisher's note.




Medical and Dental Expenses


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