Download or read book The Effects of Cardiac Specialty Hospitals on the Cost and Quality of Medical Care written by Jason Russell Barro and published by . This book was released on 2005 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The recent rise of specialty hospitals -- typically for-profit firms that are at least partially owned by physicians -- has led to substantial debate about their effects on the cost and quality of care. Advocates of specialty hospitals claim they improve quality and lower cost; critics contend they concentrate on providing profitable procedures and attracting relatively healthy patients, leaving (predominantly nonprofit) general hospitals with a less-remunerative, sicker patient population. We find support for both sides of this debate. Markets experiencing entry by a cardiac specialty hospital have lower spending for cardiac care without significantly worse clinical outcomes. In markets with a specialty hospital, however, specialty hospitals tend to attract healthier patients and provide higher levels of intensive procedures than general hospitals"--National Bureau of Economic Research web site.

Download or read book The Effects of Cardiac Special Hospitals on the Cost and Quality of Medical Care written by Jason R. Barro and published by . This book was released on 2005 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: The recent rise of specialty hospital - typically for-profit firms that are at least partially owned by physicians - has led to substantial debate about their effects on the cost and quality of care. Advocates of specialty hospitals claim they improve quality and lower cost; critics contend they concentrate on providing profitable procedures and attracting relatively healthy patients, leaving (pedominantly nonprofit) general hospitals with a less-remunerative, sicker patient population. We find support for both sides of this debate. Markets experiencing entry by a cardiac specialty hospital have lower spending for cardiac care without significantly worse clinical outcomes. In markets with a specialty hospital, however, specialty hospitals tend to attract healthier patients and provide higher levels of intensive procedures than general hospitals.

Download or read book The Effects of Cardiac Speciality Hospitals on the Cost and Quality of Medical Care written by Jason R. Barro and published by . This book was released on 2005 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Cross Subsidization and the Welfare Impact of Specialty Entry written by Robert S. Huckman and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The growth of the specialty hospital industry has been one of the most important changes to the hospital industry in recent years. Specialty hospitals focus on three specific types of care: cardiac surgery, orthopedic surgery and general surgery. Proponents argue that specialty hospitals are focused factories providing higher quality, lower cost care. General hospitals, on the other hand, suggest that these firms enter the most profitable markets and skim the healthiest (lowest cost) patients leaving them without the profit necessary to pay for indigent and uncompensated care. Given the uncertainty on the issue the Federal Government instituted a moratorium on the construction of new specialty hospitals in 2003. The moratorium was subsequently repealed in August of 2006. We add to recent empirical work on the welfare effects of specialty entry by studying the impact of entry on the ability of competing general hospitals to cross-subsidize unprofitable care. The empirical study of the welfare effect of specialty entry to date has indicated a net welfare gain, with market level spending declining and no change in outcomes (Barro et al. 2006). This approach, however, does not account for the potential welfare impact of transferring profits between firms. Standard economic theory treats profits as welfare enhancing regardless of the firm at which they are obtained. This is unlikely to be true in a setting such as health care where diversified, not-for-profit hospitals can use profits from specific services to cross-subsidize less profitable types of care. We empirically investigate the degree to which entry by specialty hospitals led to reductions in the provision of unprofitable care by general hospitals. Estimating the effect of competition on cross-subsidies is not a straightforward exercise because firm entry is endogenously determined. To account for this we take two approaches. Relying on variation in Certificate-of-Need (CON) laws across states, we model the response of hospitals in states with and without entry restrictions to the 2003 moratorium on specialty entry. We use a difference-in-differences approach in which we assume that the moratorium led to a larger relative reduction in specialty hospital entry in markets without CON than in those with CON. Because CON laws are a strong predictor of specialty hospital entry (GAO 2003) and exogenously determined we can directly estimate the effect that specialty competition has on provision of unprofitable services. Taking this approach a step further, we estimate a triple differences model in which hospitals that offer services mostly likely to be affected by specialty competition (i.e. cardiac surgery or catheterization) are compared across states with differing entry restrictions relative to hospitals not offering these services. To exploit the more detailed market level factors that may affect entry we also estimate a market level entry model. Fitting this model for all markets yields a predicted probability of entry that is used to instrument for the endogenously determined actual entry by specialty hospitals.

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Download or read book Value Based Health Care in Orthopaedics written by Eric C. Makhni and published by Lippincott Williams & Wilkins. This book was released on 2023-12-20 with total page 366 pages. Available in PDF, EPUB and Kindle. Book excerpt: Providing an expert overview of the current structure of health care and how it affects today’s orthopaedic surgeons, Value-Based Health Care in Orthopaedics addresses the healthcare system’s transition from a fee-for-service model to value-based health care. This transition aligns the incentives of all stakeholders, including payers, purchasers, clinicians, and most importantly, patients, by prioritizing health over care, and facilitating competition based on health outcomes and cost. Developed in partnership with the American Academy of Orthopaedic Surgeons (AAOS) and edited by Eric C. Makhni, MD, MBA, FAAOS, Benedict Nwachukwu, MD, MBA, and Kevin J. Bozic, MD, MBA, FAAOS, this unique, authoritative text covers essential information not often covered in medical school or orthopaedic residency training—offering a comprehensive discussion of the principles of value-based health care as applied to orthopaedics.

Download or read book Overview of the Competitive Effects of Specialty Hospitals written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, and International Security and published by Amicus. This book was released on 2005 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: Amicus Readers at level 1 include: a picture glossary, a table of contents, index, websites, and literacy notes located in the back of each book. Additionally, content words are introduced within the text supported by a variety of photo labels.In particular, this title describes common community helpers that a child might see around town. Includes visual literacy activity.

Download or read book Physician owned Specialty Hospitals written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2007 with total page 230 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Understanding Healthcare Economics written by Jeanne Wendel, PHD and published by CRC Press. This book was released on 2017-11-22 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation’s healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today’s healthcare system. The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes. Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed. The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change – and some of the changes – on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.

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 Price Spillovers and Specialization in Health Care written by Ian McCarthy and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Specialty hospitals tend to negotiate higher commercial insurance payments, even for relatively routine procedures with comparable clinical quality across hospital types. How specialty hospitals can maintain such a price premium remains an open question. In this paper, we examine a potential (horizontal) differentiation effect in which patients perceive specialty hospitals as sufficiently distinct from other hospitals, so that specialty hospitals effectively compete in a separate market from general acute care hospitals. We estimate this effect in the context of routine pediatric procedures offered by both specialty children's hospitals as well as general acute care hospitals, and we find strong empirical evidence of a differentiation effect in which specialty children's hospitals appear largely immune to competitive forces from non-children's hospitals.

Download or read book Health Care Policy In East Asia A World Scientific Reference In 4 Volumes written by and published by World Scientific. This book was released on 2019-11-25 with total page 1278 pages. Available in PDF, EPUB and Kindle. Book excerpt: During the past three decades, health care systems in the East Asian regions of China, Japan, South Korea, and Taiwan have undergone major changes. Each system has its unique achievements and challenges. Global health care policymakers are increasingly interested in understanding the changes that have taken place in these four systems. This four-volume reference set is designed to help health care professionals, academics, policymakers, and general readers gain a good grasp of the background and latest developments in the health care systems of China, Japan, South Korea, and Taiwan. This reference set provides an in-depth comparative health policy analysis and discussion of health care reform strategies in each of these systems. One unique feature of this set is that each volume has been edited by a leading scholar who has been deeply involved in the development of the health care system in that particular region. Each of these editors also has invited both scholars and practitioners to provide a first-hand description and analysis of key health care reform issues in that system. The many examples provided in each volume demonstrate how findings of evidence-based policy research can be implemented into policy practice.Volume 1 describes and discusses China's ambitious and complex journey of health care reform since 2009. The Chinese government has achieved universal health insurance coverage and has embarked on reforms of the service delivery system and provider payment methods that are aimed at controlling health expenditure growth and improving efficiency. This volume includes pilot and social experiments initiated by the government and researchers and their evaluations that have guided the formulation of health reform policies. It provides information on how to make reforms work at the local and provincial levels. The findings detailed in this volume will contribute to a global knowledge base in health care reforms.Volume 2 provides a comprehensive review and evaluation of the Japanese health care system. Japan has a long history of health care system development and provision of universal health coverage, with a mature and well-developed health care system among East Asian countries. However, due to increases in health care costs, economic stagnation and the country's rapidly aging population, Japan has undergone significant health care reform during the last two decades, both in the delivery as well as financing of health services in its hospital sector, medical technology sector and long-term care insurance. Despite these challenges and reforms, health outcomes among the Japanese population have been progressively among the best in the world. This volume shows how policy research can lead to policy analysis, implementation and assessment. It also provides valuable lessons learnt for mutual learning among other health care systems.Volume 3 offers a comprehensive review of the developments in South Korea's national health insurance system since 1989 in terms of financing, delivery systems, and outcomes. The volume analyzes the efficiency of cost and service delivery by public sectors versus private sectors. It points out areas of challenge to future Korean health care reform. Chapter authors in this volume are leading experts involved in Korean health care policy implementation.Volume 4 reviews the development and achievements of Taiwan Health Insurance since 1995. Because of its continuous reform in payment, services delivery, and pharmaceutical technology, Taiwan has been considered a model example of universal health insurance among global health systems. This volume shows the processes used to translate policy research findings into policy changes. While the health care reform in Taiwan is ongoing, the Taiwan example provides a real-world and practical understanding of health care system changes.In summary, this four-volume set makes an outstanding contribution to health care system reform and policy research, based on solid scholarly work. It also introduces policy researchers and academic communities to current debates about health systems, health financing, and universal health coverage. This reference volume is a must for anyone keen on East Asia's health care system reform dynamics and changing scene.

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 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 Volume outcome and Its Impact on U S Health Care Markets written by Harald Seider and published by Nomos Verlagsgesellschaft Mbh & Company. This book was released on 2006 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: The direction of causality matters for policy procedure. If volume causes outcome, then policies supporting centralization of procedures in a few facilities may make sense. Specialty hospitals may have the benefit of producing better outcomes. Antitrust analysis of hospital mergers should probably consider any improved outcomes when evaluating the impact of the merger. Accordingly, the author analyzes the causality of the volume-outcome relationship for coronary artery bypass grafts (CABGs) and finds that volume might play the crucial role for hospitals quality. This finding makes minimum volume requirements a reasonable policy which is shown by a simulation on Californian data. However, the primary focus of the finding lies in US Antitrust application. Due to a causative volume-outcome relationship, a hospital merger may have welfare enhancing effects despite possible price increases. Patients will be better off as long as the quality improvement outweighs the loss of welfare due to the price increase. This is shown by a standard merger case simulation as well as a real merger, which took place in California in 1999. Results suggest that the presence of a volume-outcome relationship might serve as an efficiency defense at Antitrust trials.

Download or read book The Major Cause of Rising Health Care Cost with Decreasing Quality A Scarcity of Primary Care Physicians written by Fred W. Lafferty, MD and published by Page Publishing Inc. This book was released on 2016-01-26 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since 2000, the author has observed the soaring costs of health care in the United States which has accompanied a decline in quality of care for the average citizen. This has been the result of the intrusions of Medicare since 1985, the profit motivated private health insurance companies, the development of large corporate hospital chains, and the irresponsible increased cost of medications by the pharmaceutical industry. In 1985, Medicare mandated what physicians could charge with a clumsy coding system, which essentially socialized medicine. This system heavily favored the procedure driven specialties to the detriment of the primary care doctor. During the past thirty years, the percentage of American Medical School graduates entering primary care has diminished from thirty-five to five percent resulting in a scarcity of family physicians. Despite America's outstanding medical schools, academic physicians, and technology, the United States ranks from fifteenth to thirty seventh among the industrialized nations of the world in quality of care and longevity of its population. Regardless of Obamacare's promise to provide healthcare to most US citizens, it will fail unless at least fifty percent of America's physicians enter primary care as in Europe. Our fault lies with allowing the Medicare bureaucrats unrestricted power since 1985.

Download or read book Strategies to Improve Cardiac Arrest Survival written by Institute of Medicine and published by National Academies Press. This book was released on 2015-09-29 with total page 291 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.