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.
Publications188 found, 100 shown here
- 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....
- Outpatient prospective payment: uses and progress to dateCarole Cusack
Treo Solutions, Albany, New York, USA
J Ambul Care Manage 25:56-62. 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)...
- 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...
- 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...
- 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.
- 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...
- 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)...
- 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...
- 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...
- 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.
- 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...
- 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 ..
- 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...
- 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...
- 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...
- 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)...
- 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....
- 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...
- 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...
- 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
- 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 ..
- 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...
- 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...
- 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...
- 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 ..
- 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...
- 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
- 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
- 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...
- 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
- 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...
- 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
- 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).
- 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)...
- A closer look at all-patient refined DRGsRichard F Averill
3M Health Information Systems, Wallingford, CT, USA
J AHIMA 73:46-50. 2002
- 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...
- The ABCs of PPS and LTACHsCherilyn G Murer
Murer Group, Joliet, Ill, USA
Rehab Manag 15:52-3. 2002
- 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
- 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...
- 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...
- PPS to draw more attentionJennifer Lubell
Mod Healthc 37:29-30. 2007
- 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....
- CMS ruling targets home healthJennifer Lubell
Mod Healthc 37:14. 2007
- Extra training needed for DRGs. Concerns arise on coding, payment issues for systemJennifer Lubell
Mod Healthc 37:8-9. 2007
- 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...
- 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....
- Surviving Medicare's IPPS changes: what you need to knowRenee Leary
Vineyard Point Associates, LLC, Guilford, CT, USA
Healthc Financ Manage 61:48-55. 2007..To prepare for the full impact of MS-DRG implementation, providers should: educate and communicate; ensure coding accuracy and thoroughness; assess productivity; analyze and evaluate; reassess current procedures; stay current...
- [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...
- 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
- 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)...
- Medicare's big changesMartin Sipkoff
Manag Care 17:29-30, 35-6. 2008
- 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.
- 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
- 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 codes to watch: identifying the DRGs most prone to payment errorKimberly Hrehor
Texas Medical Foundation, Austin, TX, USA
J AHIMA 76:36-40. 2005
- 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...
- Proposed PPS favors rurals. Specialty hospitals expected to take hit in new systemJennifer Lubell
Mod Healthc 36:8-9. 2006
- 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")...
- 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...
- 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....
- 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...
- 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....
- 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.
- The devil's in the dollars. Opposition to new DRGs, coding system based on financial winners, losersTodd Sloane
Mod Healthc 36:33. 2006
- CMS releases inpatient payment rule for fiscal year 2007Kate Traynor
Am J Health Syst Pharm 63:1678-81. 2006
- 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.
- 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...
- 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...
- Changes in reimbursement rates and rules associated with the Medicare Prescription Drug Improvement and Modernization Act. IntroductionPhilip E Johnson
H Lee Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL 33612, USA
Am J Health Syst Pharm 63:S2-6. 2006..Future trends in the Medicare population and drug expenditures, the organizational structure of the Medicare program, and recent changes in Medicare rules and rates for pharmaceutical reimbursement are described...
- 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...
- 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...
- 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...
- 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)...
- Estimating private sector payments for VA specialized inpatient careAnn Hendricks
Health Economics Program, Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial Veterans Health Administration Hospital, 200 Springs Road, Bedford, MA 01730, USA
Med Care 41:II43-51. 2003..To describe methods for estimating what payments to private sector providers might be for specialized inpatient care in the absence of Veterans Health Administration (VA) facilities...
- 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...
- 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...
- 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 ..
- 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...
- 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.
- 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...
- 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...
- 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 ..
- 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...
- Quality of care compliance plans under PPSW A Dombi
National Association for Home Care, Washington, DC, USA
Caring 20:32-6. 2001With the onset of Medicare home health Prospective Payment System (PPS), home care agencies must retool their internal compliance efforts to address the new risk areas...
- [Development of percutaneous endoscopic approach for lumbar disc herniations]Akira Dezawa
Department of Orthopedic Surgery, Teikyo University Mizonokuchi Hospital
Nihon Rinsho 68:1383-90. 2010..In the U.S., outpatient surgery has grown in popularity since Medicare's introduction of prospective payment system of in-hospital treatment in 1983...
- What effect does physician "profiling" have on inpatient physician satisfaction and hospital length of stay?Judith K Zemencuk
Health Services Research and Development Field Program, Ann Arbor VA Center for Practice Management and Outcomes Research, Ann Arbor, Michigan, USA
BMC Health Serv Res 6:45. 2006..As hospital spending continues to grow and as reimbursement for hospital expenses has moved towards the prospective payment system, there is still increasing pressure to reduce costs...
- When payment systems collide: the effect of hospitalization on anemia in renal dialysis patientsMarc N Turenne
Kidney Epidemiology and Cost Center, University of Michigan School of Public Health, 315 W Huron St, Ann Arbor, MI 48103, USA
Med Care 48:296-305. 2010..Different types of providers often face differing financial incentives for providing similar types of care. This may have implications for payment systems that target improvements in care requiring multiple types of providers...
- Optimising drug utilisation in long term careKate L Lapane
Department of Community Health, Brown Medical School, Brown University, Providence, Rhode Island 02912, USA
Pharmacoeconomics 20:143-52. 2002..The recent introduction of a prospective payment system for long-term care in the US has underscored the importance of a regulatory approach to counter-balance ..
- [Using administrative data to assess the impact of length of stay on readmissions: study of two procedures in surgery and obstetrics]S Bahrami
Département d information médicale, Assistance Publique Hopitaux de Paris, Laboratoire d économie et de gestion des organisations de santé, Universite Paris Dauphine, Paris, France
Rev Epidemiol Sante Publique 56:79-85. 2008The prospective payment system for the French short-stay hospitals creates a financial incentive to reduce length of stay. The potential impact of the resulting decrease in length of stay on the quality of healthcare is unknown...
- The effect of the Medicare prospective payment system on the adoption of new technology. The case of cochlear implantsN M Kane
Department of Health Policy and Management, Harvard University School of Public Health, Boston, MA 02115
N Engl J Med 321:1378-83. 1989Since the advent of Medicare's prospective payment system, beneficial but cost-increasing medical advances have been systematically assigned to existing diagnosis-related groups (DRGs) that do not cover the costs of the new technology...
- 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 ..
- Promoting Self-Care with Telehomecare: Impact on OutcomeKathryn Bowles; Fiscal Year: 2007..Reported studies were conducted prior to the introduction of Medicare's prospective payment system for home care and evaluated the use of telehomecare in addition to traditional home visits...
- Payment Systems, Market Factors and Long-term Care HospitalsEMILY SHELTON; Fiscal Year: 2007..for post-acute care (PAC) and how their practices have changed in recent years in response to Medicare's prospective payment system (the LTCH-PPS)...
- RURAL HOSPITAL LINKAGES TO LONG TERM CARE PROVIDERSMary Fennell; Fiscal Year: 1999..factors and policy changes, including an economic downturn in rural areas, the enactment of the Medicare Prospective Payment System, a shift of patients to urban facilities, higher operating expenses for rural hospitals, and a rapidly ..
- Improving Inpatient Psychiatric Payment: Cost and Quality ImplicationsDONALD MICHAEL STEINWACHS; Fiscal Year: 2010Medicare 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...
- Improving Inpatient Psychiatric Payment: Cost and Quality ImplicationsDonald Steinwachs; Fiscal Year: 2007Medicare 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...
- 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. ..
- HEALTH SERVICES RESEARCH TRAININGRichard Hirth; Fiscal Year: 2007....
- 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. ..
- Improving Quality of Care for Nursing Home Residents with DementiaRITA TAMARA KONETZKA; Fiscal Year: 2010..Dementia is a critical health care and health policy issue which promises to become even more important and costly as the population ages. ..
- Optimizing Medication History Value in Clinical Encounters with Elderly PatientsKate Lapane; Fiscal Year: 2007..5. To develop a "tool-kit" resources that include developed intervention products for use by nonphysician providers in other ambulatory settings (e.g. pharmacists in community pharmacy settings). ..
- Tailored DVD to Improve Medication Management for Low Literate Elderly PatientsKate Lapane; Fiscal Year: 2007..To pre-test these interventions as part of a feasibility study within physician offices likely to service low literate geriatric patients...
- The Effect of Hospital Unit Closure & EntryRichard Lindrooth; Fiscal Year: 2005..At the same time, we will measure the effects of entry, which can lead to more competition and specialization in the delivery of medical care, possibly to the detriment of the traditional general hospital. ..
- 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. ..
- 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. ..
- Understanding Disability Among The ElderlyDavid Cutler; Fiscal Year: 2005....
- 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. ..
- 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. ..
- MD/PhD Program in Medicine, Social Sciences and AgingDavid Meltzer; Fiscal Year: 2007..abstract_text> ..
- Harmonizing Data Standards for Primary CareRobert Phillips; Fiscal Year: 2007..This conference will specifically consider how primary care data, captured in a relevant classification scheme, can be analyzed to monitor and provide information about the health of the public and of communities. ..
- Leveraging Medicare Payment & Reporting Policies to Improve Nursing Home QualityDavid Grabowski; Fiscal Year: 2009..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. ..
- 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. ..
- Impact of Depression & Function on Healthcare Use & CostBruce Friedman; Fiscal Year: 2006....
- 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. ..
- 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. ..
- Virtual Recovery SimulationMargaret Stineman; Fiscal Year: 2006..abstract_text> ..
- Post-Acute Costs and Outcomes After Medicare's Reimbursement ChangesMELINDA BUNTIN; Fiscal Year: 2009..It will also be the first to consider the effects of payment changes on multiple important health outcomes. ..
- Reducing Diabetes Disparities Using Community CoachesSheldon Greenfield; Fiscal Year: 2007..If the intervention is effective and feasible, it could serve as model for improving chronic disease care in minority communities in settings with limited resources. ..
- 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....