Impact Of Medicare Prospective Payment On The Quality Of Medical Care
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Impact Of Medicare Prospective Payment On The Quality Of Medical Care
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Author : Kathleen N. Lohr
language : en
Publisher: Rand Corporation
Release Date : 1985
Impact Of Medicare Prospective Payment On The Quality Of Medical Care written by Kathleen N. Lohr and has been published by Rand Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 1985 with Social Science categories.
Under the prospective payment system (PPS) introduced in 1983, hospitals are to be paid for each Medicare admission on the basis of a price per case set in advance, thus giving hospitals and other providers incentives for delivering care that are radically different from those of cost-reimbursement financing. This report identifies major issues relating to quality of care, sketches conceptual and practical aspects of carrying out appropriate studies of these issues, and outlines a quality-of-care research agenda. It emphasizes changes in hospital care that are most likely to occur secondary to PPS, those likely to have the most direct impact on patients' outcomes, and changes that can be defined, detected, and measured with relative ease. Certain themes for future research efforts are stressed: (1) the overall research agenda must be strong enough to detect clinically meaningful impacts on patient outcomes and to be able to assign those impacts to PPS; (2) outcomes other than death must be examined; (3) interpreting the impacts of PPS requires understanding the clinical circumstances of Medicare patients; (4) developing better outcome measures is essential; (5) targeting impact studies on high-priority topics will be unavoidable; and (6) a full picture of the effects of PPS requires a long-term perspective, extending beyond FY 1987.
Medicare S Prospective Payment System
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Author :
language : en
Publisher:
Release Date : 1985
Medicare S Prospective Payment System written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1985 with Medicare categories.
The Effects Of The Drg Based Prospective Payment System On Quality Of Care For Hospitalized Medicare Patients
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Author : Rand Corporation
language : en
Publisher:
Release Date : 1991
The Effects Of The Drg Based Prospective Payment System On Quality Of Care For Hospitalized Medicare Patients written by Rand Corporation and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1991 with Diagnosis related groups categories.
To control rising health care costs, the federal government, in 1983, established a prospective payment system (PPS) to reimburse hospitals for inhospital care of Medicare patients. PPS changed the way Medicare reimbursed hospitals from a cost or charge basis to a prospectively determined fixed-price system in which hospitals are paid according to the diagnosis-related group (DRG) into which a patient is classified. This report constitutes the executive summary of an evaluation of the impact of the DRG-based PPS system. Six conditions were selected for the evaluation: congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident, and depression. The authors used both explicit and implicit measures to assess quality of care. Two key policy conclusions emerge from the findings: (1) at least through the middle of 1986, PPS did not interrupt a long-term trend toward better hospital care; and (2) PPS has had a detrimental effect on patients' stability at discharge. The authors recommend that physicians, hospitals, and professional review organizations undertake a more systematic assessment of a patient's readiness to leave the hospital, and that clinically detailed data on sickness at admission, processes, discharge status, and outcomes continue to be collected regularly as long as PPS is in place.
Impact Of The Medicare Prospective Payment System For Hospitals
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Author : Stuart Guterman
language : en
Publisher:
Release Date : 1986
Impact Of The Medicare Prospective Payment System For Hospitals written by Stuart Guterman and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1986 with Hospitals categories.
Quality Of Care Under Medicare S Prospective Payment System Appendix
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Author : United States. Congress. Senate. Special Committee on Aging
language : en
Publisher:
Release Date : 1986
Quality Of Care Under Medicare S Prospective Payment System Appendix written by United States. Congress. Senate. Special Committee on Aging and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1986 with Diagnosis related groups categories.
The Effects Of The Drg Based Prospective Payment System On Quality Of Care For Hospitalized Medicare Patients
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Author :
language : en
Publisher: Rand Corporation
Release Date : 1992
The Effects Of The Drg Based Prospective Payment System On Quality Of Care For Hospitalized Medicare Patients written by and has been published by Rand Corporation this book supported file pdf, txt, epub, kindle and other format this book has been release on 1992 with Diagnosis related groups categories.
In 1983, in an effort to control rising health care costs, the federal government established a prospective payment system (PPS) to reimburse hospitals for inhospital care of Medicare patients. Under PPS, hospitals are paid an amount based largely on flat rates per admission calculated for each of approximately 470 diagnosis-related groups (DRGs). This new payment system has been somewhat successful at slowing the upward spiral of Medicare costs. However, because PPS presents incentives to decrease lengths of stay and to substitute lower-cost services and procedures, patients, physicians, and policymakers are concerned that, despite the introduction of monitoring by professional review organizations, the quality of health care given Medicare patients may have declined under PPS. This report assesses the quality of inhospital care for Medicare patients age 65 and over, before and after the implementation of PPS, and estimates the effects of the PPS intervention on quality of care, by comparing quality of care now with the best estimate of what it would have been without PPS. Specifically, the authors describe the study's design, sampling, and fieldwork; discuss changes in sickness at admission following the introduction of PPS; consider measurements of the quality of care using explicit criteria before and after implementation of the PPS; compare changes in quality of care between 1981 and 1986 for five diseases as measured by implicit review; and discuss PPS and impairment at discharge.
Medicare Prospective Payment And The Shaping Of U S Health Care
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Author : Rick Mayes
language : en
Publisher: JHU Press
Release Date : 2006-12-20
Medicare Prospective Payment And The Shaping Of U S Health Care written by Rick Mayes and has been published by JHU Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006-12-20 with Medical categories.
This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system. Mayes and Berenson draw from interviews with more than sixty-five major policy makers—including former Treasury secretary Robert Rubin, U.S. Representatives Pete Stark and Henry Waxman, former White House chief of staff Leon Panetta, and former administrators of the Health Care Financing Administration Gail Wilensky, Bruce Vladeck, Nancy-Ann DeParle, and Tom Scully—to explore how this payment system worked and its significant effects on the U.S. medical landscape in the past twenty years. They argue that, although managed care was an important agent of change in the 1990s, the private sector has not been the major health care innovator in the United States; rather, Medicare’s transition to PPS both initiated and repeatedly intensified the economic restructuring of the U.S. health care system.
Quality Of Care Under Medicare S Prospective Payment System
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Author : United States. Congress. Senate. Special Committee on Aging
language : en
Publisher:
Release Date : 1986
Quality Of Care Under Medicare S Prospective Payment System written by United States. Congress. Senate. Special Committee on Aging and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1986 with Diagnosis related groups categories.
Impact Of The Medicare Hospital Prospective Payment System
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Author :
language : en
Publisher:
Release Date : 1984
Impact Of The Medicare Hospital Prospective Payment System written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1984 with Hospitals categories.
New Medical Devices
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 1988-01-01
New Medical Devices written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1988-01-01 with Medical categories.
In the past 50 years the development of a wide range of medical devices has improved the quality of people's lives and revolutionized the prevention and treatment of disease, but it also has contributed to the high cost of health care. Issues that shape the invention of new medical devices and affect their introduction and use are explored in this volume. The authors examine the role of federal support, the decision-making process behind private funding, the need for reforms in regulation and product liability, the effects of the medical payment system, and other critical topics relevant to the development of new devices.