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Author: United States
Publisher:
ISBN:
Category : Budget
Languages : en
Pages : 384
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Author: United States
Publisher:
ISBN:
Category : Budget
Languages : en
Pages : 384
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Author: U. S. Department of Health and Human Services
Publisher: CreateSpace
ISBN: 9781491249963
Category : Medical
Languages : en
Pages : 110
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Book Description
In 1990, after a decade of rapid cost growth, Congress made two major changes to the Medicare program in an attempt to control expenditures for physicians' services. It implemented a fee schedule and a payment update system for physicians' services. The goal of this fee schedule was to set relative payment rates that would reflect the time, effort, and expense of providing each listed service. The goal of the payment update system, called the Volume Performance System (VPS), was to limit increases in physician fees by linking them to historical rates of increase in the volume of physicians' services. This system led to high rates of growth in the early 1990s, and was criticized for distorting relative payment levels in its use of different updates for surgery versus primary care payments, for setting unrealistic expenditure targets (because of relying on historical trends and legislated reductions), and for relying on two-year old data to set targets. In 1997, Congress established a new system for determining the annual update for Medicare payment rates for physicians' services. This system, known as the Sustainable Growth Rate (SGR) system, seeks to constrain costs by tying increases in physician payments to real per capita growth in the gross domestic product (GDP). In implementing the SGR, Congress agreed, in principle, that a system that would allow expenditures for physicians' services to grow at the same rate as the economy as a whole was affordable and reasonable. However, the SGR system is now under criticism by health care providers, members of Congress, and the Medicare Payment Advisory Commission (MedPAC), who are calling for its revision. Intensifying the debate is the fact that for the year 2002, the fee paid per unit of physician service decreased by 5.4 percent. This decrease is the result of a number of factors including the slowing economy and errors made in estimating expenditures in prior years. The major problem with the SGR system, its critics maintain, is that, in setting fees, it does not directly consider changes in the actual costs of providing physician services to the Medicare population. Such changes are driven by a confluence of progress in medical technology, changes in provider productivity, and changes in the health of beneficiaries in the traditional Medicare fee for service (FFS) program. Other systems used by Medicare to update payment rates implicitly include allowances for such changes. With Medicare physician payments currently exceeding $40 billion per year, the payment update factor has important implications for the Medicare budget, as well as other possible consequences. Too small an update might limit beneficiary access to care, “unfairly” penalize physicians, or create incentives to funnel treatment to other types of services having no expenditure target. In the longer term, inadequate payment updates might discourage the development and adoption of new technologies for treating Medicare patients. In light of these concerns, Congress mandated a study of sources of changes in FFS Medicare expenditures for physicians' services. The tasks we undertook in response to the Congressional mandate were the following: Describe the processes used to update payment rates for Medicare physicians' services; Analyze national trends in expenditures for physicians' services; and Disaggregate the changes in Medicare expenditures for physicians' services into the components specified in the legislation, to the extent possible.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030946921X
Category : Medical
Languages : en
Pages : 161
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The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Author: National Academies of Sciences Engineering and Medicine
Publisher:
ISBN: 9780309685061
Category :
Languages : en
Pages :
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The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309183618
Category : Medical
Languages : en
Pages : 261
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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.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133181
Category : Medical
Languages : en
Pages : 536
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Book Description
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359
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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.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309144337
Category : Medical
Languages : en
Pages : 852
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Book Description
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 44
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