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

Kathleen N. Lohr
Impact of Medicare Prospective Payment on the Quality of Medical Care Book PDF

Author : Kathleen N. Lohr
Publisher : Rand Corporation
Page : 69 pages
File Size : 41,7 Mb
Release : 1985
Category : Social Science
ISBN : 0833006533

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Impact of Medicare Prospective Payment on the Quality of Medical Care by Kathleen N. Lohr Pdf

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

Anonim
Medicare s Prospective Payment System Book PDF

Author : Anonim
Publisher : Unknown
Page : 44 pages
File Size : 51,8 Mb
Release : 1985
Category : Medicare
ISBN : IND:30000112693548

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Medicare's Prospective Payment System by Anonim Pdf

The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients

Rand Corporation
The Effects of the DRG based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients Book PDF

Author : Rand Corporation
Publisher : Unknown
Page : 32 pages
File Size : 45,7 Mb
Release : 1991
Category : Diagnosis related groups
ISBN : IND:30000009572284

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The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients by Rand Corporation Pdf

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.

Quality of Care Under Medicare's Prospective Payment System: Appendix

United States. Congress. Senate. Special Committee on Aging
Quality of Care Under Medicare s Prospective Payment System Appendix Book PDF

Author : United States. Congress. Senate. Special Committee on Aging
Publisher : Unknown
Page : 794 pages
File Size : 54,7 Mb
Release : 1986
Category : Diagnosis related groups
ISBN : LOC:00185830299

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Quality of Care Under Medicare's Prospective Payment System: Appendix by United States. Congress. Senate. Special Committee on Aging Pdf

The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients

Anonim
The Effects of the DRG based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients Book PDF

Author : Anonim
Publisher : Rand Corporation
Page : 343 pages
File Size : 42,5 Mb
Release : 1992
Category : Diagnosis related groups
ISBN : 0833012207

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The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients by Anonim Pdf

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

Rick Mayes,Robert A. Berenson
Medicare Prospective Payment and the Shaping of U S Health Care Book PDF

Author : Rick Mayes,Robert A. Berenson
Publisher : JHU Press
Page : 274 pages
File Size : 42,7 Mb
Release : 2006-12-20
Category : Medical
ISBN : 9780801888878

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Medicare Prospective Payment and the Shaping of U.S. Health Care by Rick Mayes,Robert A. Berenson Pdf

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.

Medicare

Institute of Medicine,Committee to Design a Strategy for Quality Review and Assurance in Medicare
Medicare Book PDF

Author : Institute of Medicine,Committee to Design a Strategy for Quality Review and Assurance in Medicare
Publisher : National Academies Press
Page : 462 pages
File Size : 44,6 Mb
Release : 1990-02-01
Category : Medical
ISBN : 9780309042307

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Medicare by Institute of Medicine,Committee to Design a Strategy for Quality Review and Assurance in Medicare Pdf

Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of careâ€"how it is defined, measured, and improvedâ€"and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students.

Post-hospital Care

United States. General Accounting Office
Post hospital Care Book PDF

Author : United States. General Accounting Office
Publisher : Unknown
Page : 184 pages
File Size : 55,6 Mb
Release : 1986
Category : Ambulatory surgery
ISBN : UOM:39015022612363

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Post-hospital Care by United States. General Accounting Office Pdf

Crossing the Quality Chasm

Institute of Medicine,Committee on Quality of Health Care in America
Crossing the Quality Chasm Book PDF

Author : Institute of Medicine,Committee on Quality of Health Care in America
Publisher : National Academies Press
Page : 360 pages
File Size : 43,5 Mb
Release : 2001-08-19
Category : Medical
ISBN : 9780309072809

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Crossing the Quality Chasm by Institute of Medicine,Committee on Quality of Health Care in America Pdf

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.

National Health Expenditures, 1982

Robert M. Gibson,Daniel R. Waldo,Katharine R. Levit
National Health Expenditures 1982 Book PDF

Author : Robert M. Gibson,Daniel R. Waldo,Katharine R. Levit
Publisher : Unknown
Page : 32 pages
File Size : 54,8 Mb
Release : 1983
Category : Medicaid
ISBN : UOM:39015029227843

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National Health Expenditures, 1982 by Robert M. Gibson,Daniel R. Waldo,Katharine R. Levit Pdf

New Medical Devices

Institute of Medicine,National Academy of Engineering
New Medical Devices Book PDF

Author : Institute of Medicine,National Academy of Engineering
Publisher : National Academies Press
Page : 203 pages
File Size : 40,8 Mb
Release : 1988-01-01
Category : Medical
ISBN : 9780309038478

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New Medical Devices by Institute of Medicine,National Academy of Engineering Pdf

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.