prospective payment system
Summary: A system wherein reimbursement rates are set, for a given period of time, prior to the circumstances giving rise to actual reimbursement claims.
Publications221 found, 100 shown here
- Outpatient prospective payment: uses and progress to dateCarole Cusack
Treo Solutions, Albany, New York, USA
J Ambul Care Manage 25:56-62. 2002....
- Prospective rates for episodes of home health carePaul L Grimaldi
State Healthcare Division of Affiliated Computer Services, Inc, Rockville, MD, USA
J Health Care Finance 28:63-75. 2002....
- Expansion of Medicare's definition of post-acute care transfersJerry Cromwell
Health Care Financ Rev 24:95-113. 2002In October 1998, the definition of a transfer in Medicare's hospital prospective payment system was expanded to include several post-acute care (PAC) providers in 10 high-volume PAC diagnosis-related groups (DRGs)...
- The origins, development, and passage of Medicare's revolutionary prospective payment systemRick Mayes
University of Richmond Department of Political Science, 28 Westhampton Way, Richmond, VA 23173, USA
J Hist Med Allied Sci 62:21-55. 2007..and passage of the single most influential postwar innovation in medical financing: Medicare's prospective payment system (PPS)...
- Creaming, skimping and dumping: provider competition on the intensive and extensive marginsR P Ellis
Economics Department, Boston University, MA, USA
J Health Econ 17:537-55. 1998..Prospectively paid providers cream low severity patients and skimp high severity ones. If there is dumping of high severity patients, then there will also be skimping...
- Effects of the DRG-based prospective payment system operated by the voluntarily participating providers on the cesarean section rates in KoreaKwangsoo Lee
Department of Hospital Management, College of Medicine, Eulji University, Jung ju Yongdu 2dong 143 5, Daejeon, South Korea
Health Policy 81:300-8. 2007This study explored the effects of the diagnosis-related group (DRG)-based prospective payment system (PPS) operated by voluntarily participating organizations on the cesarean section (CS) rates, and analyzed whether the participating ..
- The effect of financial pressure on the quality of care in hospitalsYu Chu Shen
Health Policy Center, The Urban Institute, 2100 M Street NW, Washington, DC 20037, USA
J Health Econ 22:243-69. 2003..The financial pressure variables are: fiscal pressure from the Prospective Payment System (PPS) for inpatient care, and changes in health maintenance organization (HMO) penetration at the county ..
- How much do hospitals cost shift? A review of the evidenceAustin B Frakt
VA Boston Healthcare System, Boston, MA, USA
Milbank Q 89:90-130. 2011....
- "Quicker and sicker" under Medicare's prospective payment system for hospitals: new evidence on an old issue from a national longitudinal surveyXufeng Qian
Moody s Investors Services, New York
Bull Econ Res 63:1-27. 2011Medicare's prospective payment system for hospitals (PPS), introduced in the USA in 1983, replaced cost reimbursement with a system of fixed rates which created incentives for hospitals to control costs...
- Changes in the status of hospitalized stroke patients since inception of the prospective payment system in 1983Susan M Schmidt
Department of Nursing, Xavier University, Cincinnati, OH 45207 7351, USA
Arch Phys Med Rehabil 83:894-8. 2002To describe epidemiologically the changes in acute-care delivery services for stroke victims since the inception of the 1983 prospective payment system (PPS).
- Early trends from the Study to Evaluate the Prospective Payment System Impact on Small Dialysis Organizations (STEPPS)Steven M Brunelli
Renal Division and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
Am J Kidney Dis 61:947-56. 2013Launched in January 2011, the prospective payment system (PPS) for the US Medicare End-Stage Renal Disease Program bundled payment for services previously reimbursed independently...
- Trends and regional variations in hospital utilization and quality during the first two years of the prospective payment systemS DesHarnais
Department of Health Policy and Administration, University of North Carolina, Chapel Hill 27599 7400
Inquiry 25:374-82. 1988..model, we studied utilization and quality-of-care trends for the years preceding implementation of the prospective payment system (PPS) and the two years following its implementation...
- Cost accounting to determine prices: how well do prices reflect costs in the German DRG-system?Jonas Schreyögg
Department of Health Care Management, Berlin University of Technology, Strasse des 17 Juni 145, 10623 Berlin, Germany
Health Care Manag Sci 9:269-79. 2006..Although cost data accuracy has improved over the last few years there are still a number of challenges that need to be addressed...
- Association of hospital ownership with patient transfers to outpatient care under a prospective payment system in TaiwanHerng Ching Lin
Taipei Medical University, School of Health Care Administration, 250 Wu Hsing St, Taipei, Taiwan
Health Policy 69:11-9. 2004Case payment, a prospective payment system akin to diagnosis-related groups (DRGs) has in-built incentives for hospitals to transfer inpatients to their own ambulatory care units following early discharge...
- The impact of the prospective payment system for skilled nursing facilities on therapy service provision: a transaction cost approachJacqueline S Zinn
Temple University, Philadelphia, PA 19122, USA
Health Serv Res 38:1467-85. 2003To examine skilled nursing facilities (SNFs) "make-or-buy" decisions with respect to rehabilitation therapy service provision in the 1990s, both before and after implementation of Medicare's Prospective Payment System (PPS) for SNFs.
- Rehabilitation therapy in skilled nursing facilities: effects of Medicare's new prospective payment systemChapin White
Economics of Aging Program, National Bureau of Economic Research, Cambridge, Massachusetts, USA
Health Aff (Millwood) 22:214-23. 2003In 1998 the Centers for Medicare and Medicaid Services (CMS) began phasing in a new prospective payment system (PPS) for Medicare payments to skilled nursing facilities (SNFs)...
- Redesigning Medicare inpatient PPS to adjust payment for post-admission complicationsRichard F Averill
3M Health Information Systems, Wallingford, CT 06492, USA
Health Care Financ Rev 27:83-93. 2006Under the Medicare diagnosis-related group (DRG) based inpatient prospective payment system (IPPS), payments to hospitals can increase when a post-admission complication occurs...
- Case-mix payment in Japanese medical careShinichi Okamura
Department of Medical Informatics and Decision Sciences, Gunma University Hospital, 3 39 15 Showa Machi, Maebashi, Gunma 371 8511, Japan
Health Policy 74:282-6. 2005..For the expansion of this system, ongoing program refinement, reflecting the results of data analysis, is indispensable...
- Medicare payment for selected adverse events: building the business case for investing in patient safetyChunliu Zhan
Agency for Healthcare Research and Quality, Rockville, Maryland, USA
Health Aff (Millwood) 25:1386-93. 2006This study estimates that Medicare extra payments under the hospital prospective payment system (PPS) range from about $700 per case of decubitus ulcer to $9,000 per case of postoperative sepsis in the five types of adverse events ..
- Did the introduction of a prospective payment system for nursing home stays reduce the likelihood of pharmacological management of secondary ischaemic stroke?Kate L Lapane
Department of Community Health, Brown Medical School, Providence, Rhode Island, USA
Drugs Aging 23:61-9. 2006Since 1998, a prospective payment system (PPS) for Medicare services provided by nursing homes in the US has been in operation. Concerns have been expressed that the PPS may affect the quality of care delivered to residents...
- Inter-DRG resource dynamics in a prospective payment system: a stochastic kernel approachAnurag Sharma
Centre for Health Economics, Monash University, Clayton 3800, Victoria, Australia
Health Care Manag Sci 12:38-55. 2009..dynamics across Diagnosis Related Groups (DRGs) of elective surgery patients, in a continuing Prospective Payment System (PPS)...
- Development of a simulation program for estimating hospital incomes under the prospective payment systemToshikazu Abe
Division of Information Science and Biostatistics Niigata University Graduate School of Medical and Dental Sciences, Asahimachi Dori 1, Niigata 951 8520, Japan
Comput Methods Programs Biomed 80:271-6. 2005A prospective payment system based on diagnosis procedure combination (DPC/PPS) was introduced to acute care hospitals in Japan in April 2003...
- Potential impact of the new medicare prospective payment system on reimbursement for traumatic brain injury inpatient rehabilitationJeanne M Hoffman
Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA
Arch Phys Med Rehabil 84:1165-72. 2003To evaluate the potential impact of the new Medicare prospective payment system (PPS) on traumatic brain injury (TBI) rehabilitation.
- Hospital case payment systems in EuropeReinhard Busse
Health Care Manag Sci 9:211-3. 2006..The editorial sets the policy scene, and argues that DRG systems must be seen both as a technical reimbursement method and as a fundamental incentive mechanism within the health system...
- Patient casemix classification for medicare psychiatric prospective paymentEdward M Drozd
RTI International, 411 Waverley Oaks Rd, Suite 330, Waltham, MA 02452 8414, USA
Am J Psychiatry 163:724-32. 2006For a proposed Medicare prospective payment system for inpatient psychiatric facility treatment, the authors developed a casemix classification to capture differences in patients' real daily resource use.
- A closer look at all-patient refined DRGsRichard F Averill
3M Health Information Systems, Wallingford, CT, USA
J AHIMA 73:46-50. 2002
- Developing a Medicare prospective payment system for inpatient psychiatric careJudith R Lave
Department of Health Policy and Management, Center for Research on Health Care, University of Pittsburgh, USA
Health Aff (Millwood) 22:97-109. 2003..Refinement Act (BBRA) of 1999, the secretary of health and human services was mandated to implement a prospective payment system (PPS) for psychiatric inpatient facilities that were exempt from the Medicare inpatient PPS...
- Application of functional independence measure-function related groups and resource utilization groups-version III systems across post acute settingsT B Eilertsen
University of Colorado Health Sciences Center, Center on Aging Research Section, Denver 80206, USA
Med Care 36:695-705. 1998..The present study evaluated alternative patient classification systems for skilled nursing facility and rehabilitation facility patients...
- Medicare prospective payment reforms and hospital utilization. Temporary or lasting effects?A Muller
Department of Health Services Administration, University of Arkansas, Little Rock 72204
Med Care 31:296-308. 1993..The Medicare reimbursement reforms appear to remain effective in reducing hospital utilization, but at a reduced rate...
- The effect of Medicare's prospective payment system on discharge outcomes of skilled nursing facility residentsWalter P Wodchis
Toronto Rehabilitation Institute, Queen Elizabeth Centre, 130 Dunn Ave, Toronto, Ontario M6K 2R7
Inquiry 41:418-34. 2004..payment method for Medicare (Part A) skilled nursing facility (SNF) care from a cost-based system to a prospective payment system (PPS)...
- Effects of payment incentives, hospital ownership and competition on hospitalization decisions for ambulatory surgical proceduresSudha Xirasagar
University of South Carolina, Department of Health Services Policy and Management, Columbia, SC, USA
Health Policy 76:26-37. 2006....
- Challenges and opportunities for Medicare's original prospective payment systemChantal Worzala
Medicare Payment Advisory Commission MedPAC, Washington, DC, USA
Health Aff (Millwood) 22:175-82. 2003..To successfully navigate these issues, policymakers and program administrators need accurate and timely information...
- Trends in inpatient rehabilitation stroke outcomes before and after advent of the prospective payment system: a systematic reviewSuzanne Rinere O'Brien
University of Rochester Medical Center, School of Nursing, Rochester, New York, USA
J Neurol Phys Ther 34:17-23. 2010..In order to examine the influence of the prospective payment system (PPS), which was instituted in 2002, particular attention was paid to the pre-PPS to post-PPS period...
- What happened to PEPP? QIOs plan for hospital payment monitoring programRenato Estrella
IPRO, Lake Success, NY, USA
J AHIMA 74:43-8; quiz 49-50. 2003
- Trends in Medicare home health care use: 1997-2001Christopher M Murtaugh
Center for Home Care Policy and Research, Visiting Nurse Service of New York, USA
Health Aff (Millwood) 22:146-56. 2003..major overhaul in Medicare payment for home health care with an interim payment system (IPS) preceding a prospective payment system (PPS)...
- Overview: Medicare post-acute care since the Balanced Budget Act of 1997Philip G Cotterill
Centers for Medicare and Medicaid Services, Office of Research, Development, and Information, 7500 Security Boulevard, C3 21 28, Baltimore, MD 21244 1850, USA
Health Care Financ Rev 24:1-6. 2002
- Assessing the RUG-III resident classification system for skilled nursing facilitiesChapin White
Harvard University, USA
Health Care Financ Rev 24:7-15. 2002..Receipt of special treatments such as intravenous medications and respiratory therapy is strongly associated with high residual costs (p < 0.01). Modifications to the RUG-III system can increase its variance explanation...
- [Development of classification and payment system of in patient hospital admissions in the United States: introduction of Medicare Severity Diagnosis-Related Groups (MS-DRGs) and the Present On Admission (POA) indicator]Massimo Maurici
Dipartimento di Sanita Pubblica, Universita degli Studi di Roma Tor Vergata
Ig Sanita Pubbl 63:691-701. 2007..The authors describe the main characteristics of the new MS-DRG system and POA indicator and their potential impact on Italian Public Health system...
- Paying hospitals on the basis of nursing intensity: policy and political considerationsPaul B Ginsburg
Center for Studying Health System Change
Policy Polit Nurs Pract 9:118-20. 2008..the role of nurses in hospitals and the intensity of nursing resources used in care are more likely to be influenced by quality reporting and pay for performance than by incorporating nursing intensity into a prospective payment system.
- Hospital inpatient prospective payment system: incorporating new technologyJeffrey M Durthaler
Outcomes Research Group, US Medical Division, Eli Lilly and Company, Indianapolis, IN 46285, USA
Am J Health Syst Pharm 60:S15-20. 2003New technologies in the impatient prospective payment system are discussed...
- Medicare changes to the hospital inpatient prospective payment systems: commentary on the implications for the hospital-based wound care clinicianLee Ann Krapfl
Mercy Medical Center, Dubuque, IA 52001, USA
J Wound Ostomy Continence Nurs 35:61-2. 2008
- The ABCs of PPS and LTACHsCherilyn G Murer
Murer Group, Joliet, Ill, USA
Rehab Manag 15:52-3. 2002
- Straight talk. New approaches in healthcare. Be aware: Medicare's Ambulatory Payment Classification poses significant risks in both lost revenue and noncomplianceAdriana van der Graf
Mod Healthc 33:41-4. 2003
- Measuring function for Medicare inpatient rehabilitation paymentGrace M Carter
Health Care Financ Rev 24:25-44. 2003..present the rules used to construct administratively simple, homogeneous, resource use groups that provide reasonable incentives for access and quality care and that determine payments under the new IRF prospective payment system (PPS).
- Medicare's big changesMartin Sipkoff
Manag Care 17:29-30, 35-6. 2008
- 2008 refinements to the Medicare Home Health Prospective Payment SystemPamela Teenier
Medicare Operations, Gentiva Health Services, Corpus Christi, TX 78418, USA
Home Healthc Nurse 26:181-4. 2008On January 1, 2008, Centers for Medicare and Medicaid Services (CMS) implemented refinements to the Prospective Payment System (PPS)...
- Transfer trauma. Hospitals oppose CMS plan to include more DRGs in controversial policyJeff Tieman
Mod Healthc 33:24-5. 2003
- Hospital-based and freestanding skilled nursing facilities: any cause for differential Medicare payments?Korbin Liu
Urban Institute, Washington, DC 20037, USA
Inquiry 40:94-104. 2003..for hospital-based and freestanding skilled nursing facilities (SNFs) were eliminated by the SNF prospective payment system initiated in 1998...
- Room for improvement: gastrointestinal disorders and payment errorsKathy M Terry
Federal Health Care Assessment, IPRO, Lake Success, NY 11042 1002, USA
J Community Health 33:111-6. 2008....
- The clinician's role in Medicare prospective payment: Part 1--Basic termsPamela Teenier
Medicare Operations, Gentiva Health Services, Corpus Christi, TX, USA
Home Healthc Nurse 22:526-8. 2004
- Prospective per diem rates for skilled nursing carePaul L Grimaldi
State Healthcare Division of Affiliated Computer Services, Inc, Rockville, MD, USA
J Health Care Finance 28:49-62. 2002..1998, Medicare's cost-related reimbursement method for skilled nursing facility care was replaced with a prospective payment system that includes a case-mix adjustment based on the Resource Utilization Groups to which Medicare residents ..
- Prospective payments in a regional trauma center: the case for recognition of the transfer patient in diagnostic related groupsJason A London
Division of Trauma General Surgery, Harborview Medical Center, Department of Surgery, University of Washington, Seattle, Washington 98104, USA
J Trauma 60:390-5; discussion 395-6. 2006....
- Is your organization's wage index accurate?Thomas M Schuhmann
Cost Report Data Resources, LLC, Louisville, KY, USA
Healthc Financ Manage 61:74-80. 2007....
- Proposed PPS favors rurals. Specialty hospitals expected to take hit in new systemJennifer Lubell
Mod Healthc 36:8-9. 2006
- PPS to draw more attentionJennifer Lubell
Mod Healthc 37:29-30. 2007
- The devil's in the dollars. Opposition to new DRGs, coding system based on financial winners, losersTodd Sloane
Mod Healthc 36:33. 2006
- Adjustment of inpatient care reimbursement for nursing intensityJohn M Welton
College of Nursing, Medical University of South Carolina, Charleston, SC, USA
Policy Polit Nurs Pract 7:270-80. 2006The Centers for Medicare and Medicaid Services has begun an ambitious recalibration of the inpatient prospective payment system, the first since its introduction in 1983...
- CMS releases inpatient payment rule for fiscal year 2007Kate Traynor
Am J Health Syst Pharm 63:1678-81. 2006
- Nursing intensity and hospital paymentDavid M Keepnews
Policy Polit Nurs Pract 7:237-9. 2006
- Staying ahead in a changing regulatory environmentPaul Allen
Johns Hopkins Health System, Baltimore, USA
Healthc Financ Manage 60:109-10. 2006
- Did recent changes in Medicare reimbursement hit teaching hospitals harder?R Tamara Konetzka
The University of Chicago, Department of Health Studies, 5841 S Maryland Avenue, MC2007, Chicago IL 60637, USA
Acad Med 80:1069-74. 2005....
- A primer for understanding diagnosis-related groups and inpatient hospital reimbursement with nursing implicationsLaura Beaty
Memorial Hermann Southwest Hospital, Houston, TX 77074, USA
Crit Care Nurs Q 28:360-9. 2005..Nurses can play roles that greatly impact the final DRG for each inpatient medical record...
- CMS ruling targets home healthJennifer Lubell
Mod Healthc 37:14. 2007
- Physical rehabilitation following medicare prospective payment for skilled nursing facilitiesWalter P Wodchis
Toronto Rehabilitation Institute, Queen Elizabeth Centre, 130 Dunn Ave, Toronto, Ontario, M6K 2R7
Health Serv Res 39:1299-318. 2004To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents.
- The use of ambulatory patient groups for regulation of hospital ambulatory surgery revenue in MarylandGraham Atkinson
J Ambul Care Manage 31:17-23. 2008..This article describes the policy rationale for this system, the analysis that was performed, and the methods that will be used to control the revenue per case and compare the relative charges of the hospitals...
- Extra training needed for DRGs. Concerns arise on coding, payment issues for systemJennifer Lubell
Mod Healthc 37:8-9. 2007
- Rural implications of Medicare's post-acute-care transfer payment policyJulie A Schoenman
NORC Walsh Center for Rural Health Analysis, NORC at the University of Chicago, Bethesda, MD 20814, USA
J Rural Health 21:122-30. 2005..from selected diagnosis-related groups (DRGs) to a skilled nursing facility, home health care, or a prospective payment system (PPS)-excluded facility...
- Variation in patient routine costliness in U.S. psychiatric facilitiesJerry Cromwell
RTI, 411 Waverley Oaks Road, Suite 330, Waltham, Massachusetts 02452 8414, USA
J Ment Health Policy Econ 8:15-28. 2005..Budget Refinement Act of 1999 included a Congressional mandate to develop a patient-level case mix prospective payment system (PPS) for all Medicare beneficiaries treated in PPS-exempt psychiatric facilities...
- The clinician's role in Medicare prospective payment: part 4--Medicare adjustmentsPamela Teenier
Medicare Operations, Gentiva Health Services, Corpus Christi, TX, USA
Home Healthc Nurse 23:331-4. 2005
- Reshuffling the DRG deck. New cardiac DRGs praised for more equitable reimbursements while post-acute-transfer changes are generating some worriesMatthew DoBias
Mod Healthc 35:6-7, 16, 1. 2005..Tom Watson, left, a partner with accounting firm BKD, which specializes in healthcare reimbursement, says it's unlikely the changes will put any hospitals out of business, but they will feel a pinch...
- Cost containment and infusion servicesKathy Kokotis
Resources, Inc, Crown Point, Indiana 46307, USA
J Infus Nurs 28:S22-32; quiz S33-6. 2005The implementation of the Medicare Prospective Payment System (MPPS) has placed pressure on healthcare organizations to decrease patient length of stay without adversely affecting outcomes...
- Counter intelligence?Barbara Straub Williams
Powers, Pyles, Sutter and Verville, PC, Washington, DC, USA
Healthc Financ Manage 59:42-4, 46. 2005..Providers should: Pay particular attention to the period in which the bed count is applied. Not rely solely on the definition of available beds in the Provider Reimbursement Manual...
- The codes to watch: identifying the DRGs most prone to payment errorKimberly Hrehor
Texas Medical Foundation, Austin, TX, USA
J AHIMA 76:36-40. 2005
- Recalibrating Medicare payments for inpatient carePaul B Ginsburg
Center for Studying Health System Change, Washington, DC, USA
N Engl J Med 355:2061-4. 2006
- The problem with diagnosis related group 475Douglas R Gracey
Mayo Clinic, Rochester, MN 55905, USA
Chest 122:299-301. 2002The reimbursement of hospital Part A cost by Medicare under the original prospective payment system (PPS) created serious financial problems for hospitals in many areas but was especially serious in patients receiving mechanical ..
- Medicare's fee schedule for hospital outpatient carePaul L Grimaldi
State Healthcare Division of Affiliated Computer Science Services, Inc, Rockville, MD, USA
J Health Care Finance 28:14-31. 2002Medicare's hospital outpatient prospective payment system (OPPS) went live on August 1, 2000, after a decade of developmental work...
- Evaluating the organizational effectiveness of APC implementation effortsRajan Patel
Ernst and Young, LLP, Boston, Massachusetts, USA
Healthc Financ Manage 56:suppl 34-6, 38, 40. 2002To optimize revenue under the Medicare outpatient prospective payment system's new coding-based ambulatory payment classifications (APCs), healthcare providers need to ensure several key steps are taken at the organizational level...
- Prospective payment for nursing homes increased therapy provision without improving community discharge ratesE Hutt
Center on Aging Research Section, University of Colorado Health Sciences Center, Denver, Colorado 80206, USA
J Am Geriatr Soc 49:1071-9. 2001OBJECTIVES: To determine the impact of the prospective payment system (PPS) for skilled nursing facilities (SNFs) on therapy use and community discharge rates...
- Déjà vu. When it comes to prospective payment, home health agencies can learn from the experiences of acute care hospitals with DRGsPatricia B Dray
3M Health Information Systems, Wallingford, CT, USA
Health Manag Technol 23:44-6, 50. 2002
- How DRGs hurt academic health systemsP A Taheri
Division of Trauma Burn and Emergency Surgery, University of Michigan Health System, Ann Arbor, USA
J Am Coll Surg 193:1-8; discussion 8-11. 2001..The application of our proposed reimbursement methodology better distributes risk between payers and providers, and reduces adverse selection and incentive problems ("moral hazard")...
- The effects of a low-cost intervention program on hospital costsJ E Billi
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor
J Gen Intern Med 7:411-7. 1992..Audits of quality of care detected no significant difference between groups. CONCLUSION: This low-intensity intervention reduced length of stay and charges, even under the cost-constrained context of the prospective payment system.
- Clinical laboratory employment and workload patternsK R Karni
Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, USA
Clin Lab Sci 10:250-7. 1997..The impact of managed care together with the Prospective Payment System, a government initiative of 1983, profoundly affected health care institutions and their personnel...
- The impact of esophageal candidiasis on hospital charges and costs across patient subgroupsKuo B Tong
Quorum Consulting, Inc, San Francisco, CA 94108, USA
Curr Med Res Opin 24:167-74. 2008..Assess the impact of esophageal candidiasis on US hospital inpatient charges, length of stay (LOS), and costs across clinically relevant subgroups...
- Hospital-physician arrangements and hospital financial performanceT L Mark
Project HOPE Center for Health Affairs, Bethesda, MD, USA
Med Care 36:67-78. 1998The introduction of the Medicare Prospective Payment System and the more recent rise of managed care plans have greatly increased the importance of effective hospital financial management...
- Taiwan's 1995 health care reformT L Chiang
Institute of Public Health and Center for Health Policy Research, National Taiwan University, Taipei
Health Policy 39:225-39. 1997..health services, the scheme enters contracts with health care providers and has been developing a prospective payment system. Meanwhile, the scheme uses a uniform fee schedule and makes all payments through a public single-payer ..
- [DRGs in psychiatric hospital financing exemplified by Hungary. A model for Germany?]E Maylath
Medizinischer Dienst, Krankenversicherung Hamburg
Gesundheitswesen 62:633-45. 2000..incorporated in the reform of the German health sector has been the introduction of a per case prospective payment system for hospitals with the exception of admissions to psychiatric care...
- Determinants of hospital length of stayL R Lutjens
Kirkhof School of Nursing, Grand Valley State University, Allendale, MI
J Nurs Adm 23:14-8. 1993..To correct these variations, the Tax Equity and Fiscal Responsibility Act and its concomitant prospective payment system based on DRGs was implemented...
- Restructuring in response to case mix reimbursement in nursing homes: a contingency approachJacqueline Zinn
Department of Risk, Insurance and Healthcare Management, Temple University, Philadelphia, PA, USA
Health Care Manage Rev 33:113-23. 2008..nursing facility reimbursement changed from cost-based to case mix adjusted payments under the Medicare Prospective Payment System for the costs of all skilled nursing facility care provided to Medicare recipients...
- Performance of freestanding inpatient rehabilitation hospitals before and after the rehabilitation prospective payment systemJon M Thompson
Health Services Administration Program, James Madison University, Harrisonburg, Virginia, USA
Health Care Manage Rev 35:36-45. 2010..reimbursed by Medicare under a cost-based system; but in 2002, Medicare implemented a rehabilitation prospective payment system (PPS)...
- Reimbursement trends for outpatient interventional radiology procedures: comparison of hospital and freestanding physician office sites of serviceAdam D Talenfeld
Section of Vascular and Interventional Radiology, Mount Sinai Medical Center, New York, NY, USA
J Am Coll Radiol 6:417-27. 2009..The aim of this study was to compare trends in reimbursement rates between hospital outpatient departments and freestanding physician offices for commonly performed interventional radiology procedures from 2006 through 2010...
- Impact of prospective payment and discharge location on the outcome of hip fractureM B Gerety
University of Texas Health Sciences Center, San Antonio
J Gen Intern Med 4:388-91. 1989..review of a consecutive series of cases before and after the reference date of implementation of the prospective payment system (PPS). SETTING: Academic, tertiary-care hospital...
- Components of Medicare reimbursementWilliam Malatestinic
U S Medical Division, Eli Lilly and Company, Indianapolis, IN 46285, USA
Am J Health Syst Pharm 60:S3-7. 2003..The statutory charge of Medicare is to ensure adequate reimbursement through a Prospective Payment System (PPS) to cover the costs for providing a given service to Medicare beneficiaries...
- Effect of locale on health status and direct care time of rural versus urban home health patientsC E Adams
College of Nursing, Home Care Department, Medical University of South Carolina, Charleston, South Carolina, USA
J Nurs Adm 31:244-51. 2001..The study purpose was to determine if health status differed between rural versus urban home health patients and to identify if locale was a significant predictor of home health direct care time...
- From the emergency department to the general hospital: hospital ownership and market factors in the admission of the seriously mentally illJay J Shen
Department of Health Care Administration and Policy, School of Public Health, University of Nevada at Las Vegas, USA
J Healthc Manag 53:268-79; discussion 279-80. 2008..care system, making private health insurance coverage of the SMI more equitable, revising Medicare prospective payment system to better reimburse the treatment of the SMI, and allowing not-for-profit hospitals to count care of the ..
- Impact of an all-inclusive diagnosis-related group payment system on inpatient utilizationT J Menke
Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center, Houston, TX 77030, USA
Med Care 36:1126-37. 1998..This study estimates the effect of a prospective payment system based on diagnosis-related groups (DRGs) nationwide in the Department of Veterans Affairs.
- Have procompetitive changes altered hospital provision of indigent care?E S Campbell
Department of Economics, East Carolina University, Greenville, NC 27858 4353
Health Econ 2:281-9. 1993..Some examples include the advent of Medicare's Prospective Payment System, growth in managed care options, relaxation of states' Certificate of Need (CON) regulations, and court ..
- The occupational mix adjustment to the Medicare hospital wage index: why the rural impact is less than expectedKristin L Reiter
North Carolina Rural Health Research and Policy Analysis Center, Cecil G Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 7411, USA
J Rural Health 24:148-54. 2008..A recent change to Medicare prospective payment system reimbursement--the occupational mix adjustment (OMA) to the wage index--has attracted a great deal of ..
- Medicare-the development of publicly financed health insurance: Medicare's impact on the nation's health care systemRobert R Kulesher
Department of Health Services and Information Management, School of Allied Health Sciences, East Carolina University, Greenville, NC 27858 4353, USA
Health Care Manag (Frederick) 24:320-9. 2005..The prospective payment system, imposed on hospitals in 1987 and later on nursing homes, home health agencies, and other services, has ..
- Vulnerability of rural hospitals to Medicare outpatient payment reformP E Mohr
Project HOPE Center for Health Affairs, 7500 Old Georgetown Road, Suite 600, Bethesda, MD 20814, USA
Health Care Financ Rev 21:1-18. 1999Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals...
- Finding relief from TEFRA cost limitsC J Fletcher
Arthur Anderson, Miami, FL, USA
Healthc Financ Manage 50:22-5. 1996..rate increases for inpatient care delivered by healthcare providers excluded from Medicare's prospective payment system. Costs beyond these limits normally are not reimbursed...
- IMRT (intensity modulated radiation therapy): progress in technology and reimbursementR Young
Martin Memorial Cancer Center, Martin Memorial Health Systems, Stuart, Florida, USA
Radiol Manage 23:20-6, 28, 30 passim; quiz 33-5. 2001..New IMRT reimbursement codes have been issued under the pass-through provisions of Medicare's Outpatient Prospective Payment System (OPPS), which authorize special or increased reimbursement levels for promising new developments in ..
- Improving Inpatient Psychiatric Payment: Cost and Quality ImplicationsDONALD MICHAEL STEINWACHS; Fiscal Year: 2010DESCRIPTION (provided by applicant): Medicare Prospective Payment System (PPS) for inpatient hospital care has used Diagnostic Related Groups (DRG) to pay "per case" since its implementation in 1983, except for psychiatric disorders...
- Evaluating Payment Reform and Provider Practices to Improve Health Outcomes in ChMarc Turenne; Fiscal Year: 2013..This may be especially true in a prospective payment system (PPS), involving a "bundled" payment to providers for a relatively broad set of services, that may not ..
- Cost of an Evidence Based Depression Care Management Intervention in Home HealthYuhua Bao; Fiscal Year: 2010..incremental payments associated with the CAREPATH intervention under the current Medicare home health prospective payment system (PPS) and compare these payments to the cost of the intervention...
- ECONOMICS OF HOSPITAL CAPITAL EXPENDITURESJOHN SILVERS; Fiscal Year: 1993..So far capital costs have not responded to Medicare Prospective Payment System [PPS] to the degree shown by operating costs...
- RESOURCE USE AND PATIENT OUTCOMES IN MEDICARE HOME CARERichard Fortinsky; Fiscal Year: 2006..Medicare home care reimbursement today is governed by a prospective payment system (PPS), and quality of Medicare home care is increasingly focused on maximizing patient outcomes through ..
- TAMI: Technology Assisted Management of IncontinenceDavid Boone; Fiscal Year: 2009..the public may demand that nursing homes provide high quality of care to elder residents, the current prospective payment system does not sufficiently reimburse facilities to hire and retain appropriate staffing levels...
- TIMING PROPHYLACTIC SURGERY FOR DIVERTICULITISRobert Richards; Fiscal Year: 2000..This study will consider only direct medical costs. Hospital costs will be estimated using the Prospective Payment System. Physician costs will be assessed using the Medicare Fee Schedule...
- Outcomes of the Nursing Home Prospective Payment SystemPatrick Murray; Fiscal Year: 2002..services to newly admitted nursing home patients following the implementation of the Nursing Home (NH) Prospective Payment System (PPS) 2...
- Payment Systems, Market Factors and Long-term Care HospitalsEMILY SHELTON; Fiscal Year: 2007..care (PAC) and how their practices have changed in recent years in response to Medicare's prospective payment system (the LTCH-PPS)...
- AMBULATORY CARE RISK INDEXHERBERT FILLMORE; Fiscal Year: 1992..the APGS, which are the most likely candidate for a Congressionally mandated outpatient Medicare prospective payment system, use only the principal diagnosis and occasionally, a pediatric/adult split to classify medical visits...
- New Evidence on the Persistence of High Health SpendingRichard Hirth; Fiscal Year: 2009..We will provide an example of how such estimates can inform the evaluation of risk-adjustment and reinsurance as mechanisms to improve the functioning of small group health insurance markets. ..
- HOSPITALIZATION OF NURSING FACILITY RESIDENTSJoan Buchanan; Fiscal Year: 2002..The validity of our profiling tool will be assessed through Comparison with other NT quality indicators (from the MDS) thought to be related to hospitalization and by an analysis of mortality rates. ..
- Effectiveness of TEACH ResearchDavid Meltzer; Fiscal Year: 2008..unreadable] [unreadable] [unreadable]..
- 19th Annual Health Economics ConferenceDavid Meltzer; Fiscal Year: 2008..The 19th annual Health Economics conference hopes to build upon the rich tradition established by the preceding Annual Health Economics Conferences. [unreadable] [unreadable] [unreadable]..
- Safety Net Hospitals and Minority Access to Health CareGloria Bazzoli; Fiscal Year: 2009..It is important for policy makers, the public, and the health industry to know what this might mean for access to care if the loss of financial support results in further safety net contraction. ..
- HEALTH PLAN RESPONSES TO MEDICARE HMO PREMIUM PAYMENTSRANDALL ELLIS; Fiscal Year: 2001..Results will also be useful to policy makers in understanding how recent Medicare reforms have altered HMO premiums, competition, benefit features and the resulting Medicare enrollments. ..
- Hospital Finances and the Quality of Hospital CareGloria Bazzoli; Fiscal Year: 2004..does public policy that affects hospital payments, especially the 1997 Balanced Budget Act and its revisions, influence hospital decisions about quality-related resources and processes and the care their patients receive? ..
- Leveraging Medicare Payment & Reporting Policies to Improve Nursing Home QualityDavid C Grabowski; Fiscal Year: 2010..Thus, the information derived from this study has the potential to make important research and policy-relevant contributions aimed at improving the quality of care for all nursing home residents. ..
- A MULTI-CENTER TRIAL OF ACADEMIC HOSPITALISTSDavid Meltzer; Fiscal Year: 2003..Specific Aim number 3- To assess the effects of hospitalists on housestaff and medical student education and satisfaction. This will be accomplished by surveys administered to medical students and housestaff. ..
- Virtual Recovery SimulationMargaret Stineman; Fiscal Year: 2006..abstract_text> ..
- Selection and the Quality Impact of Nursing Home OwnershipDavid C Grabowski; Fiscal Year: 2010..By examining this relationship using a novel empirical strategy, this study provides an opportunity to improve the quality of care for the millions of Americans receiving care in the nursing home setting. ..
- Do amputees benefit from comprehensive rehabilitation services?Margaret Stineman; Fiscal Year: 2008..abstract_text> ..
- Cost-Effectiveness of Prostate Cancer Screen/TreatmentDavid Meltzer; Fiscal Year: 2003..3. To assess how the cost-effectiveness of prostate cancer screening and treatment will be affected by the appropriate inclusion of future medical and non-medical costs in cost- effectiveness analysis. ..
- Effects of Hospitalists in Medicare DataDavid Meltzer; Fiscal Year: 2008..unreadable] [unreadable] [unreadable]..
- Collaborative Clinical Culture and Quality of CareSheldon Greenfield; Fiscal Year: 2003..The results of this study will provide insight into whether HCTs are associated with high staff morale and high quality of care. ..
- Harmonizing Data Standards for Primary CareRobert Phillips; Fiscal Year: 2007..unreadable] [unreadable] [unreadable] [unreadable]..
- A Pilot Survey to Measure Disability in the Elderly PopulationDavid Cutler; Fiscal Year: 2006..This research is critical for researchers, and for policy-makers who seek to understand why disability is changing and what implications those changes will have for longevity and medical spending. ..
- CONTROLLED TRIAL OF SERTRALINE FOR DEPRESSION AFTER TBICharles Bombardier; Fiscal Year: 2004..Secondary hypotheses to be tested include whether sertraline leads to greater improvement in neuropsychological test performance, post-concussive symptoms and self-reported health status as measured by the SF 36. ..
- Impact of Depression & Function on Healthcare Use & CostBruce Friedman; Fiscal Year: 2006....
- Understanding Disability Among The ElderlyDavid Cutler; Fiscal Year: 2005....
- Measurement & Use of Utilities in Ovarian Cancer CEADeborah Dobrez; Fiscal Year: 2003..abstract_text> ..
- UTILIZATION AND COST OF HEALTH SERVICES BY CDUsW Bradford; Fiscal Year: 2003....
- QUALITY OF LIFE AND TREATMENT FOR BRAIN TRAUMAJason Doctor; Fiscal Year: 2003....