Download or read book Pricing Health Services for Purchasers written by Hugh Waters and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper reviews methodologies and international experience related to costing and pricing health services. Several factors affect the determination of the prices purchasers pay for health services. These include: the method of provider payment; the availability of information on costs, volumes, outcomes, and patient and provider characteristics; methods used to calculate providers' costs; and characteristics of purchasers and providers-including the regulatory environment, provider autonomy, negotiating power, and the degree of competition. The paper focuses on methods for setting levels of payment under different provider payment mechanisms. Line item and global budgets remain the most common reimbursement methods in developing countries. However, many of these countries are implementing mixed payment systems that have greater information demands. The principal payment types used in high-income countries-capitation, payments per case or diagnosis, and fee-for-service-are reviewed here, and implications for low- and middle-income countries discussed. To minimize incentives for under- or over-utilization, prices that purchasers pay for health care services should be related to the unit costs of services. However, establishing the true unit cost of health services is complicated, and detailed data needed to correctly allocate indirect costs to the units of services are not generally available in developing countries. The organizational characteristics of health care providers and their relationships with purchasers strongly influence the way prices for health services are determined. Pertinent characteristics include provider autonomy, provider negotiating power, and the degree of competition. The principal constraint on the development of provider payments systems in developing countries is the limited availability of information on costs, volumes, and patient characteristics. However, international experiences reveal a variety of options for setting prices for health care purchasers in developing countries that are reforming their payment systems.
Download or read book The Role of Purchasers and Payers in the Clinical Research Enterprise written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-14 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt: In a workshop organized by the Clinical Research roundtable, representatives from purchaser organizations (employers), payer organizations (health plans and insurance companies), and other stakeholder organizations (voluntary health associations, clinical researchers, research organizations, and the technology community) came together to explore: What do purchasers and payers need from the Clinical Research Enterprise? How have current efforts in clinical research met their needs? What are purchasers, payers, and other stakeholders willing to contribute to the enterprise? This book documents these discussions and summarizes what employers and insurers need from and are willing to contribute to clinical research from both a business and a national health care perspective.
Download or read book Price setting and regulation in health services written by World Health Organization and published by World Health Organization. This book was released on 2020-03-20 with total page 23 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book For Profit Enterprise in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 1986-01-01 with total page 580 pages. Available in PDF, EPUB and Kindle. Book excerpt: "[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Download or read book The Healthcare Imperative written by Institute of Medicine and published by National Academies Press. This book was released on 2011-01-17 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Download or read book Guide to California Health Care Costs written by and published by . This book was released on 1985 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Price We Pay written by Marty Makary and published by Bloomsbury Publishing USA. This book was released on 2019-09-10 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Download or read book Price Setting and Price Regulation in Health Care Lessons for Advancing Universal Health Coverage written by Barber Sarah L and published by OECD Publishing. This book was released on 2019-06-26 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).
Download or read book Highlights of Guide to California Health Care Costs written by and published by . This book was released on 1985 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Costs and Delivery of Health Services to Older Americans written by United States. Congress. Senate. Special Committee on Aging. Subcommittee on Health of the Elderly and published by . This book was released on 1967 with total page 882 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Purchasing Value in Health Care written by Salisbury Adams and published by . This book was released on 1995 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Designing and Implementing Health Care Provider Payment Systems written by Jack Langenbrunner and published by World Bank Publications. This book was released on 2009-01-01 with total page 348 pages. Available in PDF, EPUB and Kindle. Book excerpt: Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.
Download or read book Public Ends Private Means written by Alexander S. Preker and published by World Bank Publications. This book was released on 2007-01-01 with total page 440 pages. Available in PDF, EPUB and Kindle. Book excerpt: Great progress has been made in recent years in securing better access and financial protection against the cost of illness through collective financing of health care. Managing scarce resources effectively and efficiently is an important part of this story. Experience has shown that, without strategic policies and focused spending, the poor are likely to get left out. The use of purchasing to enhance public sector performance is well-documented in other sectors. Extension to the health sector of lessons from this experience is now successfully implemented in many developing countries. Public.
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Informing Consumers about Health Care Costs written by M. Susan Marquis and published by RAND Corporation. This book was released on 1985 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Future of the Public s Health in the 21st Century written by Institute of Medicine and published by National Academies Press. This book was released on 2003-02-01 with total page 536 pages. Available in PDF, EPUB and Kindle. Book excerpt: The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Download or read book EBOOK Purchasing to Improve Health Systems Performance written by Josep Figueras and published by McGraw-Hill Education (UK). This book was released on 2005-03-16 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Purchasing is championed as key to improving health systems performance. However, despite the central role the purchasing function plays in many health system reforms, there is very little evidence about its development or its real impact on societal objectives. This book addresses this gap and provides: ·A comprehensive account of the theory and practice of purchasing for health services across Europe ·An up-to-date analysis of the evidence on different approaches to purchasing ·Support for policy-makers and practitioners as they formulate purchasing strategies so that they can increase effectiveness and improve performance in their own national context ·An assessment of the intersecting roles of citizens, the government and the providers Written by leading health policy analysts, this book is essential reading for health policy makers, planners and managers as well as researchers and students in the field of health studies. Contributors: Toni Ashton, Philip Berman, Michael Borowitz, Helmut Brand, Reinhard Busse, Andrea Donatini, Martin Dlouhy, Antonio Duran, Tamás Evetovits, André P. van den Exter, Josep Figueras, Nick Freemantle, Julian Forder, Péter Gaál, Chris Ham, Brian Hardy, Petr Hava, David Hunter, Danguole Jankauskiene, Maris Jesse, Ninel Kadyrova, Joe Kutzin, John Langenbrunner, Donald W. Light, Hans Maarse, Nicholas Mays, Martin McKee, Eva Orosz, John Øvretveit, Dominique Polton, Alexander S. Preker, Thomas A. Rathwell, Sabine Richard, Ray Robinson, Andrei Rys, Constantino Sakellarides, Sergey Shishkin, Peter C. Smith, Markus Schneider, Francesco Taroni, Marcial Velasco-Garrido, Miriam Wiley
