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Delivery System Reform Incentive Payment Program

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Journal Article
J Health Polit Policy Law (2018) 43 (2): 305–323.
Published: 01 April 2018
... programs with the CMS Triple Aim is the Section 1115 Medicaid demonstration waiver. Recently, these waivers have been used to improve care delivery and align quality and cost in Medicaid programs. Existing Delivery System Reform Incentive Payment (DSRIP) waivers provide an important example and blueprint...
Journal Article
J Health Polit Policy Law (2019) 44 (5): 789–806.
Published: 01 October 2019
...Sujoy Chakravarty; Kristen Lloyd; Jennifer Farnham; Susan Brownlee Abstract The Delivery System Reform Incentive Payment (DSRIP) program, an increasingly utilized payment strategy to foster population health management by hospitals and outpatient providers, may sometimes generate financial...
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Journal Article
J Health Polit Policy Law (1987) 12 (2): 237–252.
Published: 01 April 1987
... implementation of reform a less risky proposition. Use incentives to encourage behavior changes. Incentives and the way they are used can contribute to behavior changes and, therefore, implementation and program success. New York, for example, developed an all-payer system to align provider...
Journal Article
J Health Polit Policy Law (1982) 7 (1): 54–79.
Published: 01 February 1982
...) programs; and payment limitations under the Medicare and Medicaid programs. These programs seek to contain costs by directly regulating or setting the prices of health care services, and by creating incentives for health care facilities to operate at lower cost. PSRO and utilization review...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 745–760.
Published: 01 August 2015
... the entire spectrum of care. The TCOC system uses FFS payments, but it links fees to the rate of growth in the total cost of care for a patient, regardless of where the care is provided. Blue Cross and Blue Shield of Massachusetts launched its Alternative Quality Contract (AQC) as a statewide program...
Journal Article
J Health Polit Policy Law (2011) 36 (3): 591–596.
Published: 01 June 2011
... by outcome measures. The ideal structure is modeled on the Kaiser and Geisinger care-­delivery systems, large multispecialty group practices that have been in existence for years. Reform legislation offers some subsidies and Medicare reimbursement enhancements for organiza- tions that obtain the ACO...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 839–846.
Published: 01 August 2015
..., the similarities across these two payment reform periods provide lessons for the ongoing implementation process. Some reformers frame ACOs as disruptive policies that will help reshape the US health care system for the twenty-first century. For example, Christopher Whaley, H. E. Frech III, and Richard M...
Journal Article
J Health Polit Policy Law (2009) 34 (5): 747–776.
Published: 01 October 2009
... the organizational dimension. On balance, however, advocates such as the Medicare Pay- ment Advisory Commission see the problem as one of inefficient payment systems that might inhibit delivery system reform, whereas our results suggest that attention should be paid to the organization of delivery, since...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 761–796.
Published: 01 August 2015
... of providers in the current health care delivery system and reward quality, encourage better outcomes, and lower health care costs, the Affordable Care Act (ACA) includes major delivery system and payment reforms that establish accountable care organizations (ACOs) within Medicare's fee-for-service (FFS...
FIGURES
Journal Article
J Health Polit Policy Law (2021) 46 (4): 627–639.
Published: 01 August 2021
... health delivery quality improvement payment innovation Since the 1980s Medicare has been instrumental in advancing care delivery system and payment methods for the entire health system. At its very inception in 1966, the new Medicare program was directly responsible for desegregating hospitals...
Journal Article
J Health Polit Policy Law (2015) 40 (3): 531–574.
Published: 01 June 2015
..., their distinctive, transformative approaches to reform, and their endorsement at the federal level as mechanisms for improving cost, quality, and access. Ultimately, we chose three policies for assessment: (1) expansion of noninstitutional options; (2) payment and delivery system integration; and (3) incentive...
Journal Article
J Health Polit Policy Law (2003) 28 (2-3): 341–354.
Published: 01 June 2003
... programs. The era of dual accountability is ending, as the insur- ance sector redefines itself as accountable only to its individual enrollees, and not as responsible for reform of the delivery system, income redis- tribution from healthy to sick, or any of the other social goals that enthused the first...
Journal Article
J Health Polit Policy Law (2014) 39 (4): 941–946.
Published: 01 August 2014
... has not (Gray 2013 ). In theory, Oregon's program is superior; any spending in excess of immutable benchmarks will result in automatic financial penalties for CCOs and the state. However, until Oregon's global payment system extends to the much larger private insurance marketplace, the absence...
Journal Article
J Health Polit Policy Law (2014) 39 (4): 901–917.
Published: 01 August 2014
..., Massachusetts established a Delivery System Transformation Initiative (DSTI) as part of its 2012–14 Medicaid 1115 waiver. This program provides substantial incentive payments for successful completion of specific delivery reform initiatives to help safety net providers prepare to transition from fee-for-service...
FIGURES
Journal Article
J Health Polit Policy Law (2005) 30 (4): 751–764.
Published: 01 August 2005
.... In terms of improving quality of care, the 1997 Japanese long-term care insurance reform initiatives (initially passed in 1997 and implemented in 2000) introduced a system of assessment with the purpose of improving quality of care. (This program is discussed in more detail later in this essay...
Journal Article
J Health Polit Policy Law (2005) 30 (4): 764–770.
Published: 01 August 2005
... necessary (the quality problem). The root cause of these system failures is money: fi nancial incentives are at odds with good clinical and organizational practice. Cutler’s proposal for ensuring universal access is to expand eligibility for the Federal Employee Benefi ts Program to all citizens...
Journal Article
J Health Polit Policy Law (1982) 7 (2): 488–501.
Published: 01 April 1982
... problematical. Ultimately, the entire notion of an entitlement to health care systems may be at stake. Recent experiences in implementing and administering system reforms caution us to imagine the consequences of partial successes, of achieving 50 or 60 or 75 percent of a program’s stated goals...
Journal Article
J Health Polit Policy Law (2016) 41 (4): 743–762.
Published: 01 August 2016
... and efficiency improvements. As a result, providers' incentives to reengineer care could be limited unless employers choose PPO products that have strong financial incentives for consumers to seek care in efficient integrated health systems. It is unknown whether PPO payment reforms will drive delivery...
Journal Article
J Health Polit Policy Law (1989) 14 (4): 691–705.
Published: 01 August 1989
..., it would be at the sacrifice of much larger awards for many more children, since the tort system compensates pain and suffering while the program does not. Even if a child fails to recover from the tort system, other sources of compen- sation exist, payments that the Virginia law subtracts from...
Journal Article
J Health Polit Policy Law (1995) 20 (3): 615–652.
Published: 01 June 1995
... efficient mode of health care delivery. To provide incentives to sick- ness funds to promote efficiency and to contain costs, the retrospective reimbursement system had to be replaced by a prospective payment sys- tem. The critical question was whether sickness funds would be allowed to maintain...