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all-payer claims databases

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Journal Article
Journal of Health Politics, Policy and Law (1 February 2017) 42 (1): 5–52.
Published: 01 February 2017
... rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1993) 18 (3): 695–722.
Published: 01 June 1993
... continue without change. All-payer management is prescribed by few of the national employment group bills. Under most proposals, reimbursement rates will continue to differ among payers, hospitals will still shift costs from the less generous to the more generous payers, and recriminations will...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2002) 27 (3): 441–464.
Published: 01 June 2002
... managed care plans can also yield a spillover effect of reducing costs for all patients or payers (Wickizer and Feldstein 1995; Cutler and Sheiner 1998). One of the suggested mechanisms for this spillover effect is that hospitals make less investment in capacity for expensive services, reduc- ing the...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2009) 34 (3): 361–380.
Published: 01 June 2009
... of little significance because the statutory benefits are essentially the same. In particular, although there are multiple payers and providers, there is only one single payment system (tariff), which is applied across the board to all plans and virtually all providers. How do plans which...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2000) 25 (3): 499–526.
Published: 01 June 2000
... injured persons. We queried the database for information on all claims with incident dates in the ten-year period 1984 through 1993 that (1) were assigned obstetrical codes; (2) involved birth-related neurological injury that was classified as severe and permanent...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2004) 29 (1): 11–42.
Published: 01 February 2004
... about 2 percent of all Florida nursing homes, are excluded from the analysis. 17. Just as quality may be affected by payer mix in the nursing home, the quality level may in turn determine the payer mix. Nursing homes with more Medicaid patients may choose to pro- vide lower quality, and lower...
Journal Article
Journal of Health Politics, Policy and Law (1 February 1994) 19 (1): 27–44.
Published: 01 February 1994
... claims being made for them. The physicians I observed seem- ingly told contradictory stories about effectiveness research: it is corrupt, it is utopian; it is ephemeral, it is institutionalized. But all of the stones were about empiricism in a realist undertaking, about finding a place for...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2000) 25 (6): 1083–1120.
Published: 01 December 2000
... Society of Technology Assessment in Health Care (ISTAHC) CD-ROM database, which contains abstracts presented at its annual meetings (1994– 1998) and all abstracts of papers published in the International Journal of Technology Assessment in Health Care (1985–1999). From a total of 2,906 records, 30...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2001) 26 (2): 327–368.
Published: 01 April 2001
... treatments for their patients, now feel increasing pressure to conform to established norms of treatment. Much of that pressure comes from man- aged care organizations (MCOs) and health plans, both private and gov- ernmental, all pursuing an agenda of aggressive cost...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2017) 42 (1): 1–3.
Published: 01 February 2017
... Michael Kinane argues that policy entrepreneurs in many states have “reconfigured the politics of prices” by developing transparency-based policy instruments called All-Payer Claims Databases, which are designed to “empower consumers, purchasers, and states to make informed market and policy choices...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2016) 41 (1): 129–139.
Published: 01 February 2016
... 42 U.S.C. §§ 300b-8-300b-15). Beyond public health programs, governments collect claims data from health insurance companies to create All Payer Claims Databases in order to analyze the cost and, ultimately, the quality of health care (Porter et al. 2014 ). Two years after Edward Snowden's...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2014) 39 (3): 667–677.
Published: 01 June 2014
... New Hampshire's Institute for Health Policy and Practice helped its state's Department of Health and Human Services (DHHS) and Department of Insurance (DOI) as they developed a statewide all-payer claims database (APCD). The institute has since worked with the DOI as it develops and maintains a Health...
Journal Article
Journal of Health Politics, Policy and Law (1 October 2013) 38 (5): 1023–1050.
Published: 01 October 2013
.... Three points were awarded for a state having an all-payer claims database, up to 1 point was given (based on Kaiser categories) for federal hazard preparedness funding, and 1 point was given for state conversion coverage in small firms, state restrictions against balance billing in preferred provider...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2012) 37 (6): 1133–1139.
Published: 01 December 2012
... the national elections in November 2012. Given all the groundwork laid by the VHRI, the General Assembly in 2011 and 2012 (it created a new allpayer claims database as recommended by the VHRI), and the consensus building and planning plus information system investment undertaken by the...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2009) 34 (4): 453–496.
Published: 01 August 2009
... “single payer” as a public agency to process all claims for a common basic package to be carried by existing private insurers (Beauchamp and Rouse 1990) — in apparent contrast to the “all-payer” systems of rate regulation that had been attempted in the past. The term seems to have appeared first in...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1986) 10 (4): 659–674.
Published: 01 August 1986
... controversy over the roles of regulatory and market forces in the battle to control health cost es- calation. The advent of Medicare prospective payment, and growing interest in all-payers rate-setting , have recently overshadowed the “competition versus reg- ulation” issue. Nonetheless, HMOs...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2011) 36 (2): 295–316.
Published: 01 April 2011
... level and assume that payers capture 50 percent of savings for molecules when imported doses are at least 40 percent of U.S. total domestic supply (in doses); 25 percent of savings when imported doses are 6. That is, all formulations and strengths of a given molecule. Danzon et al...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2015) 40 (4): 847–874.
Published: 01 August 2015
... that payers can use to address the market power of “must-have” providers. The economic basis for a challenge would need to be clearly established, as well as a viable legal theory, perhaps based on a monopolization claim. (3) Be wary of discouraging exclusive provider arrangements where the...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1994) 19 (4): 753–771.
Published: 01 August 1994
... All Facilities 1987 I989 Change Fac i I it y Facility 1987 to 1989 Payer and Level of Care Mean Mean I Medicare Patient-Days 934.8 3.416.4. 265.5 Medicaid Patient-Days Skilled Care...
Journal Article
Journal of Health Politics, Policy and Law (1 October 2016) 41 (5): 939–968.
Published: 01 October 2016
... NHC database, 2013 Market conditions (county level) Market concentration Herfindahl–Hirschman Index The sum of the squared market shares of all facilities in the county 0–1 NHC database, 2013 − Market conditions Average county occupancy rate Total no. of occupied beds at the county...