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Author: Jon R. Gabel
Publisher:
ISBN:
Category : Medical care, Cost of
Languages : en
Pages : 20
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Book Description
Author: Jon R. Gabel
Publisher:
ISBN:
Category : Medical care, Cost of
Languages : en
Pages : 20
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Book Description
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: 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: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133203
Category : Medical
Languages : en
Pages : 212
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Book Description
Hidden Cost, Value Lost, the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country of maintaining so many people without health insurance. The book explores the potential economic and societal benefits that could be realized if everyone had health insurance on a continuous basis, as people over age 65 currently do with Medicare. Hidden Costs, Value Lost concludes that the estimated benefits across society in health years of life gained by providing the uninsured with the kind and amount of health services that the insured use, are likely greater than the additional social costs of doing so. The potential economic value to be gained in better health outcomes from uninterrupted coverage for all Americans is estimated to be between $65 and $130 billion each year.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213
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Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309169054
Category : Medical
Languages : en
Pages : 296
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Book Description
Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.
Author: Miriam Laugesen
Publisher: Harvard University Press
ISBN: 0674545168
Category : Business & Economics
Languages : en
Pages : 286
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Book Description
Introduction: The house of medicine and medical prices -- The enduring influence of the house of medicine over prices -- The science of work and payment reform -- How doctors get paid -- Conflicts of interest and problems of evidence -- Complexity, agency capture, and the game of codes -- Fixing medical prices
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages :
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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.
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.
