Download or read book Provider Responses and Financial Incentives in the Health Care System written by Nakcheon Choi and published by . This book was released on 2011 with total page 178 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: The rapid growth of health care expenditures has been a major concern for the U.S. health care system for several decades. Various cost containment policies have been introduced to control price, volume, or both, from either the provider or consumer side. This dissertation examines key elements in understanding providers' responses to financial incentives and contractual relationships with health plans in the health care system. The hospital industry is the largest consumer of resources for health care services and has always been the focus of cost control policy. Understanding the relationship between a hospital's behaviors and its financial condition based on ownership is crucial in constructing any cost containment policy. In Chapter 1, I construct a hospital investment decision model. The model predicts that hospitals invest asymmetrically based on the elasticity of demand with respect to quality, financial condition, and ownership structure. I test the predictions of the model using the 2005 National Inpatient Sample data and the 2000-2004 Centers for Medicare and Medicaid Services hospital cost reports data. A Seemingly Uncorrelated Regression model shows that good and bad financial performances affect the quality of hospital services asymmetrically, and the above asymmetries are observed only in investor-owned hospitals. In Chapter 2, I examine the global budget as a payment system and as a cost containment measure in a static and a dynamic set-up. In a static model, physicians under an optimal budget cap supply higher quality than under the optimal prospective payment system. In a dynamic model, optimal dynamic budgeting gives an incentive for physicians to improve quality relative to the level under a static optimal budget. The results have important implications with respect to budget neutrality under the Medicare program. In Chapter 3, I analyze physician fee variations, focusing on the contractual relationship between the health plans and physicians. Using data from MarketScan Research Database from 2003 to 2006, I estimate the relative effect size and explanatory power of provider type, plan type, and county on variations of physician fees adjusted by the geographic adjustment factor.
Download or read book Improving Healthcare Quality in Europe Characteristics Effectiveness and Implementation of Different Strategies written by OECD and published by OECD Publishing. This book was released on 2019-10-17 with total page 447 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Download or read book Provider Incentives and Healthcare Costs written by Liran Einav and published by . This book was released on 2017 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: We study the design of provider incentives in the post-acute care setting -- a high-stakes but under-studied segment of the healthcare system. We focus on long-term care hospitals (LTCHs) and the large (approximately $13,000) jump in Medicare payments they receive when a patient's stay reaches a threshold number of days. The descriptive evidence indicates that discharges increase substantially after the threshold, and that the marginal patient discharged after the threshold is in relatively better health. Despite the large financial incentives and behavioral response in a high mortality population, we are unable to detect any compelling evidence of an impact on patient mortality. To assess provider behavior under counterfactual payment schedules, we estimate a simple dynamic discrete choice model of LTCH discharge decisions. When we conservatively limit ourselves to alternative contracts that hold the LTCH harmless, we find that an alternative contract can generate Medicare savings of about $2,100 per admission, or about 5% of total payments. More aggressive payment reforms can generate substantially greater savings, but the accompanying reduction in LTCH profits has potential out-of-sample consequences. Our results highlight how improved financial incentives may be able to reduce healthcare spending, without negative consequences for industry profits or patient health.
Download or read book Financial Incentives Healthcare Providers and Quality Improvements written by Jon B. Christianson and published by . This book was released on 2007 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Towards More Appropriate Care written by and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: SUMMARY It is often argued that health care providers (e.g. hospitals, physicians, etc.) are imperfect agents of the patient: over-supplying (or in certain situations under-supplying) health care services when facing a financial advantage to do so.[1] Hence, changing the incentives in provider payment contracts may lead to more appropriate provision of health care. This belief was the motivation for the design of several innovative reimbursement arrangements, such as Medicare’s Hospital Readmission Reduction Program or Maryland’s All-Payer program, created under Affordable Care Act (ACA), and the creation of Accountable Care Organizations.[2] However, the results of these initiatives have been mixed, leading experts to conclude that reaching optimal contract design is more tedious than originally believed.[3] Therefore, it is important to understand what drives providers and under what conditions they respond to financial incentives. Although health care providers’ response to financial stimulus has been empirically shown in an abundance of cases [1, 4], its magnitude is far from uniform and, in certain cases, researchers found no measurable response at all ([5-8]). There is a shortage of comprehensive analyses on exactly what drives providers’ behavior, which hampers the realization of optimal payment designs. In the present dissertation, I attempt to illustrate how providers respond to incentives in various environments and provide recommendations on the optimal payment design in order to obtain high quality and affordable care. My research utilizes examples of policy-reforms and payment design discontinuities in Dutch health care as ‘natural experiments’ that allow me to quantify responses to sudden shifts in the incentive structure. My work focuses primarily on medical specialist care (secondary care) and utilizes claim-level administrative data from Dutch health insurers for the years 2006 to 2018.
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 Incentives in Health Systems written by Guillem Lopez-Casasnovas and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 372 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume contains selected papers from the First European Conference on Health Economics, held in Barcelona on 19-21 September 1989. The meeting was organized by the Spanish Health Economics Association (AES) and chaired by L. Bohigas. The following groups participated: the English Health Economists' Study Group, the Associa
Download or read book Rewarding Provider Performance written by Institute of Medicine and published by National Academies Press. This book was released on 2007-02-17 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.
Download or read book Pay for Performance in Health Care written by Jerry Cromwell and published by RTI Press. This book was released on 2011-02-28 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.
Download or read book Moral Hazard in Health Insurance written by Amy Finkelstein and published by Columbia University Press. This book was released on 2014-12-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice
Download or read book Financial Incentives Hospital Care and Health Outcomes written by Michael M. Batty and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Provider Payment Incentives written by Norma Coe and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This note is part of Quality testing.
Download or read book The Privatization of Health Care Reform written by M. Gregg Bloche and published by Oxford University Press. This book was released on 2002-10-17 with total page 245 pages. Available in PDF, EPUB and Kindle. Book excerpt: Markets, not politics, are driving health care reform in America today. Inventive entrepreneurs have transformed medicine over the past ten years, and no end to this period of rapid change is in sight. Consumer anxieties over managed care are mounting, and medical costs are again soaring. Meanwhile, the federal government remains mostly on the health policy sidelines, as it has since the collapse of the Clinton administration's campaign for health care reform. This book addresses the changes that the market has wrought- and the challenges this transformation poses for courts and regulators. The law that governs the medical marketplace is an incomplete, overlapping patchwork, conceived mainly without medical care specifically in mind. The ensuing confusion and incoherence are a central theme of this book. Fragmentation of health care lawmaking has foreclosed coordinated, system-wide policy responses, and lack of national consensus on many of the central questions in health care policy has translated into legal contradiction and bitter controversy. Written by leading commentators on American health law and policy, this book examines the widely-perceived failings of managed care and the law's relationship to them. Some of the contributors treat law as a cause of trouble; others emphasize the law's potential and limits as a corrective tool when the market disappoints. The first two chapters present contrasting overviews of how the doctrines and decision-makers that constitute health law work together, for better or worse, to constrain the medical marketplace. The next six chapters address particular market developments and regulatory dilemmas. These include the power of state versus federal government in the health sphere, conflict between insureres and patients and providers over medical need, financial rewards to physicians for frugal practice, the role of antitrust law in the organization of health care provision and financing, the future of public hospitals, and the place of investor-owned versus non-profit institutions. Acknowledging the health sphere's complexities, the authors seek remedies that fit this country's legal, political, and cultural constraints and can contribute to reasoned regulatory goverance. Within limits they believe a measure of rationality is possible.
Download or read book Are Incentives Everything written by Varun Gauri and published by World Bank Publications. This book was released on 2001 with total page 21 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper assesses the extent to which provider payment mechanisms can help developing countries address their leading health care problems. It first identifies four key problems in the health care systems in developing countries: 1) public facilities, which provide the bulk of secondary and tertiary health care services in most countries, offer services of poor quality; 2) providers cannot be enticed to rural and urban marginal areas, leaving large segments of the population without adequate access to health care; 3) the composition of health services offered and consumed is sub-optimal; and 4) coordination in the delivery of care, including referrals, second opinions, and teamwork, is inadequate. The paper examines each problem in turn and assesses the extent to which changes in provider payments might address it.
Download or read book Disease Control Priorities in Developing Countries written by Dean T. Jamison and published by World Bank Publications. This book was released on 2006-04-02 with total page 1449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Download or read book EBOOK Diagnosis Related Groups in Europe Moving towards transparency efficiency and quality in hospitals written by Reinhard Busse and published by McGraw-Hill Education (UK). This book was released on 2011-11-16 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector
Download or read book The Economics of Health and Medical Care written by M. Perlman and published by Springer. This book was released on 2016-04-30 with total page 560 pages. Available in PDF, EPUB and Kindle. Book excerpt: Record of Discussion6 Economics of Need: The Experience of the British Health Service; 7 Private Patients in N.H.S. Hospitals: Waiting Lists and Subsidies; 8 Consumer Protection, Incentives and Externalities in the Drug Market; Summary Record of Discussion; 9 Price and Income Elasticities for Medical Care Services; 10 Supplier-Induced Demand: Some Empirical Evidence and Implications; 11 Some Economic Aspects of Mortality in Developed Countries; Summary Record of Discussion; PART THREE: THE IMPACT OF DEMAND FOR HEALTH SERVICES; 12 Health, Hours and Wages
