Making Capitation Work

Making Capitation Work PDF Author: Gloria G. Mayer
Publisher: Delmar Pub
ISBN: 9780834206779
Category : Social Science
Languages : en
Pages :

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Book Description
This important resource helps health care providers understand capitation, the increasingly dominant reimbursement system within health care. It covers everything from management of medical utilization & costs to ongoing legal issues for integrated delivery systems, to managing capitation & risk contracting; & is an indispensable resource in this tumultuous health care environment.

Making Capitation Work

Making Capitation Work PDF Author: Gloria G. Mayer
Publisher: Delmar Pub
ISBN: 9780834206779
Category : Social Science
Languages : en
Pages :

Get Book Here

Book Description
This important resource helps health care providers understand capitation, the increasingly dominant reimbursement system within health care. It covers everything from management of medical utilization & costs to ongoing legal issues for integrated delivery systems, to managing capitation & risk contracting; & is an indispensable resource in this tumultuous health care environment.

Health Economics in Development

Health Economics in Development PDF Author: Philip Musgrove
Publisher: World Bank Publications
ISBN: 9780821355701
Category : Medical
Languages : en
Pages : 456

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Book Description
This publication contains a collection of papers which span 21 years of the author's thought and experiences regarding the subject on health economics, working at the Pan American Health Organization, the World Health Organization and the World Bank. The papers consider a range of topics including: the connection between public health and economics; the issue of equity in health; effectiveness and efficiency, particularly in relation to communicable diseases and malnutrition; health financing; how the burden of ill health is measured; the roles of the state and the market in health. The empirical material refers to a variety of specific health problems or interventions, including: smoking, polio, malaria, immunisation and various forms of malnutrition.

The Future of Nursing 2020-2030

The Future of Nursing 2020-2030 PDF Author: National Academies of Sciences Engineering and Medicine
Publisher:
ISBN: 9780309685061
Category :
Languages : en
Pages :

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Book Description
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.

Medicare HMOs

Medicare HMOs PDF Author: Richard Kronick
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 260

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Book Description
The lure of reduced costs & improved health outcomes has spurred the Medicare managed care movement. But will these desired outcomes be achieved? This book explores the role of HMOs in Medicare & the implications it has on the health of the chronically ill. Includes suggested strategies for oversight & regulation of Medicare HMOs.

Crossing the Quality Chasm

Crossing the Quality Chasm PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309132967
Category : Medical
Languages : en
Pages : 359

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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.

Medicare Laboratory Payment Policy

Medicare Laboratory Payment Policy PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309183618
Category : Medical
Languages : en
Pages : 261

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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.

Spending Wisely

Spending Wisely PDF Author: Alexander S. Preker
Publisher: World Bank Publications
ISBN: 0821359185
Category : Health & Fitness
Languages : en
Pages : 434

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Book Description
This publication examines how public spending on health care can be made more efficient and equitable in developing countries, focusing on strategic purchasing and contracting of services from non-governmental providers. It is divided into six sections under the headings of: the conceptual framework; how to make strategic purchasing pro-poor; purchasing health services; purchasing inputs; supply, demand and markets; legal and regulatory issues.

Transition to Diagnosis-Related Group (DRG) Payments for Health

Transition to Diagnosis-Related Group (DRG) Payments for Health PDF Author: Caryn Bredenkamp
Publisher: World Bank Publications
ISBN: 1464815216
Category : Medical
Languages : en
Pages : 69

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Book Description
This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.

EBOOK: Purchasing to Improve Health Systems Performance

EBOOK: Purchasing to Improve Health Systems Performance PDF Author: Josep Figueras
Publisher: McGraw-Hill Education (UK)
ISBN: 0335225004
Category : Medical
Languages : en
Pages : 322

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Book Description
Purchasing is championed as key to improving health systems performance. However, despite the central role the purchasing function plays in many health system reforms, there is very little evidence about its development or its real impact on societal objectives. This book addresses this gap and provides: ·A comprehensive account of the theory and practice of purchasing for health services across Europe ·An up-to-date analysis of the evidence on different approaches to purchasing ·Support for policy-makers and practitioners as they formulate purchasing strategies so that they can increase effectiveness and improve performance in their own national context ·An assessment of the intersecting roles of citizens, the government and the providers Written by leading health policy analysts, this book is essential reading for health policy makers, planners and managers as well as researchers and students in the field of health studies. Contributors: Toni Ashton, Philip Berman, Michael Borowitz, Helmut Brand, Reinhard Busse, Andrea Donatini, Martin Dlouhy, Antonio Duran, Tamás Evetovits, André P. van den Exter, Josep Figueras, Nick Freemantle, Julian Forder, Péter Gaál, Chris Ham, Brian Hardy, Petr Hava, David Hunter, Danguole Jankauskiene, Maris Jesse, Ninel Kadyrova, Joe Kutzin, John Langenbrunner, Donald W. Light, Hans Maarse, Nicholas Mays, Martin McKee, Eva Orosz, John Øvretveit, Dominique Polton, Alexander S. Preker, Thomas A. Rathwell, Sabine Richard, Ray Robinson, Andrei Rys, Constantino Sakellarides, Sergey Shishkin, Peter C. Smith, Markus Schneider, Francesco Taroni, Marcial Velasco-Garrido, Miriam Wiley

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies PDF Author: OECD
Publisher: OECD Publishing
ISBN: 9264805907
Category :
Languages : en
Pages : 447

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Book Description
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.