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Journal Article
Putting The Pieces Together Again: American States and the End of the ACA's Shared Responsibility Payment
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J Health Polit Policy Law (2020) 45 (3): 439–454.
Published: 01 June 2020
...Thomas L. Gais; Michael K. Gusmano Abstract The Tax Cuts and Jobs Act (TCJA) eliminated the ACA's “shared responsibility payment,” which penalized those who failed to comply with the requirement to purchase health insurance. In this article the authors explain efforts in several states to respond...
View articletitled, Putting The Pieces Together Again: American States and the End of the ACA's Shared Responsibility <span class="search-highlight">Payment</span>
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Journal Article
Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance, 1911–1966
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J Health Polit Policy Law (1988) 13 (1): 191–195.
Published: 01 February 1988
...Ellen M. Immergut C. David Naylor, Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance, 1911–1966 (Kingston and Montreal: McGill-Queen's University Press, 1986), 324 pp., $35.00 cloth, $ 15.95 paper. Copyright © 1988 by Duke University Press 1988...
View articletitled, Private Practice, Public <span class="search-highlight">Payment</span>: Canadian Medicine and the Politics of Health Insurance, 1911–1966
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Journal Article
Statewide Payment and Delivery Reform: Do States Have What It Takes?
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J Health Polit Policy Law (2017) 42 (6): 1113–1125.
Published: 01 December 2017
...Judy Feder; Alan R. Weil; Robert Berenson; Rachel Dolan; Nicole Lallemand; Emily Hayes Abstract States' role in payment as well as coverage will be subject to debate as the administration and the Congress decide how to address the Affordable Care Act (ACA) and otherwise reshape the nation's health...
Journal Article
Supporting Transformation through Delivery System Reform Incentive Payment Programs: Lessons from New York State
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J Health Polit Policy Law (2018) 43 (2): 305–323.
Published: 01 April 2018
...Dylan H. Roby; Christopher J. Louis; Mallory M. Johnson Cole; Natalie Chau; Bridgette Wiefling; David C. Salsberry; Evan King; Allen Miller Abstract The New York Delivery System Reform Incentive Payment (DSRIP) waiver was viewed as a prototype for Medicaid and safety net redesign waivers...
View articletitled, Supporting Transformation through Delivery System Reform Incentive <span class="search-highlight">Payment</span> Programs: Lessons from New York State
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for article titled, Supporting Transformation through Delivery System Reform Incentive <span class="search-highlight">Payment</span> Programs: Lessons from New York State
Journal Article
Technocratic Dreams, Political Realities: The Rise and Demise of Medicare's Independent Payment Advisory Board
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J Health Polit Policy Law (2018) 43 (3): 483–510.
Published: 01 June 2018
...Jonathan Oberlander; Steven B. Spivack Abstract Enacted as part of the 2010 Patient Protection and Affordable Care Act, the Independent Payment Advisory Board (IPAB) was hailed by many analysts as a major innovation in US health policy making and cost control. The board promised to put a brake...
View articletitled, Technocratic Dreams, Political Realities: The Rise and Demise of Medicare's Independent <span class="search-highlight">Payment</span> Advisory Board
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Journal Article
No Permanent Fix: MACRA, MIPS, and the Politics of Physician Payment Reform
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J Health Polit Policy Law (2018) 43 (6): 1025–1040.
Published: 01 December 2018
... Reauthorization Act (MACRA). MACRA established value-based metrics for physician payment and financial incentives for doctors to join alternative delivery models like patient-centered medical homes. Throughout the law's initial implementation, the politics of accommodation prevailed, with federal officials...
Journal Article
Prospective Payment Based on Case Mix: Will It Work in Nursing Homes?
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J Health Polit Policy Law (1987) 12 (4): 683–702.
Published: 01 August 1987
...Michael D. Rosko; Robert W. Broyles; William E. Aaronson This article evaluates the potential efficacy of implementing a prospective payment system based on case mix in the nursing home industry. The analysis of structural differences between the nursing home and hospital industries suggests...
Journal Article
Prospective Payment for Psychiatric Services
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J Health Polit Policy Law (1992) 17 (3): 483–508.
Published: 01 June 1992
...Maqbool Dada; William D. White; Houston H. Stokes; Paul Kurzeja The Medicare prospective payment system (PPS) was designed to create financial incentives for providers to contain costs, but it also places them at financial risk. The system includes provisions to mitigate the risk, but, because...
Journal Article
Prospective Payment for Hospital Psychiatric Services: Is It Needed in the 1990s?
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J Health Polit Policy Law (1992) 17 (3): 509–516.
Published: 01 June 1992
...Lee R. Chartock; Robert A. Dorwart Copyright © 1992 by Duke University Press 1992 References Christianson , J. B. , and M. S. Linehan. 1989 . Capitated Payments for Mental Health Care: The Rhode Island Programs. Community Mental Health Journal 25 : 121 -31. Cromwell , J...
Journal Article
The Impact of Prospective Payment: A Multi-Dimensional Analysis of New Jersey's SHARE Program
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J Health Polit Policy Law (1984) 9 (1): 81–101.
Published: 01 February 1984
... evidence suggests that there was cost-shifting in response to this program, which regulated payment for only Blue Cross and Medicaid patients. Structural features of this program and its successor, the New Jersey DRG program, are analyzed; and implications for the Medicare prospective payment system...
View articletitled, The Impact of Prospective <span class="search-highlight">Payment</span>: A Multi-Dimensional Analysis of New Jersey's SHARE Program
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Journal Article
Per Case Prospective Payment for Psychiatric Inpatients: An Assessment and Alternatives
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J Health Polit Policy Law (1986) 11 (1): 83–96.
Published: 01 February 1986
...Richard G. Frank; Judith R. Lave Psychiatric hospitals and clinics are exempted from the Medicare prospective payment system. In this paper we examine the appropriateness of the DRG classification system for psychiatric patients and argue that, using this system as the basis of payment, two types...
View articletitled, Per Case Prospective <span class="search-highlight">Payment</span> for Psychiatric Inpatients: An Assessment and Alternatives
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for article titled, Per Case Prospective <span class="search-highlight">Payment</span> for Psychiatric Inpatients: An Assessment and Alternatives
Journal Article
The Impact of Intra-Drg Severity of Illness on Hospital Profitability: Implications for Payment Reform
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J Health Polit Policy Law (1994) 19 (4): 729–751.
Published: 01 August 1994
... to severity; however the relationship between severity and net revenue per admission was not significant. The results suggest that hospitals with a more severe case mix may not recover the full costs of providing services. Thus payment reform should include adjustments for severity of illness. Copyright ©...
View articletitled, The Impact of Intra-Drg Severity of Illness on Hospital Profitability: Implications for <span class="search-highlight">Payment</span> Reform
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for article titled, The Impact of Intra-Drg Severity of Illness on Hospital Profitability: Implications for <span class="search-highlight">Payment</span> Reform
Journal Article
The Economics of Provider Payment Reform: Are Accountable Care Organizations the Answer?
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J Health Polit Policy Law (2015) 40 (4): 745–760.
Published: 01 August 2015
...Roger Feldman Abstract A remarkable consensus has developed that the fee-for-service (FFS) approach for paying medical providers must be replaced. This payment approach is said to increase the volume of services without improving care coordination. In response to these calls, Medicare and private...
View articletitled, The Economics of Provider <span class="search-highlight">Payment</span> Reform: Are Accountable Care Organizations the Answer?
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Journal Article
Commentary — payment Policy Disruption and Policy Drift
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J Health Polit Policy Law (2015) 40 (4): 839–846.
Published: 01 August 2015
...Miriam J. Laugesen Copyright © 2015 by Duke University Press 2015 Among practitioners and proponents, the accountable care organization (ACO) model is usually characterized as a disruptive innovation in US health care that reflects over two decades of calls for quality-based payments within...
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ACO Participation in Payment Reform Strategies, Percentage within Cluster w...
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in Accountable Care Organizations: The National Landscape
> Journal of Health Politics, Policy and Law
Published: 01 August 2015
Figure 2b ACO Participation in Payment Reform Strategies, Percentage within Cluster with ACO or ACO Provider Group–Level Participation Source : Reprinted with permission from Shortell, Stephen M., Frances M. Wu, Valerie A. Lewis, Carrie H. Colla, and Elliott Fisher. 2014. “A Taxonomy
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Journal Article
J Health Polit Policy Law (2017) 42 (1): 53–71.
Published: 01 February 2017
..., that is, to improve health care and population health while containing cost. These include Maryland's Global Revenue Budget model, bundled payments, and ACOs, and they highlight the extent to which this version of integration is underwritten by savings achieved by providers for the Medicare program. The conclusion...
Journal Article
Oregon's Experiment in Health Care Delivery and Payment Reform: Coordinated Care Organizations Replacing Managed Care
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J Health Polit Policy Law (2015) 40 (1): 245–255.
Published: 01 February 2015
... payments rewarding outcomes and evidence-based practice; increased transparency; and greater community engagement. The CCO model faces several implementation challenges. If successful, it will provide improved health care delivery, better health outcomes, and overall savings. Copyright © 2015 by Duke...
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View articletitled, Oregon's Experiment in Health Care Delivery and <span class="search-highlight">Payment</span> Reform: Coordinated Care Organizations Replacing Managed Care
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in The New Politics of US Health Care Prices: Institutional Reconfiguration and the Emergence of All-Payer Claims Databases
> Journal of Health Politics, Policy and Law
Published: 01 February 2017
Figure 1 Aggregate Hospital Payment-to-Cost Ratio, 1993–2013 Source : AHA ( 2014a ) Note : Medicare and Medicaid trends include payments to disproportionate share hospitals.
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Journal Article
Opportunities and Challenges for Payment Reform: Observations from Massachusetts
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J Health Polit Policy Law (2016) 41 (4): 743–762.
Published: 01 August 2016
...Robert E. Mechanic Abstract Policy makers and private health plans are expanding their efforts to implement new payment models that will encourage providers to improve quality and deliver health care more efficiently. Over the past five years, payment reforms have progressed faster in Massachusetts...
Journal Article
The Politics of Hospital Payment
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J Health Polit Policy Law (1979) 4 (3): 435–463.
Published: 01 June 1979
...Judith Feder; Bruce Spitz This paper analyzes the politics of hospital payment over the last decade. The authors explain how provider interests and judgments became a standard for appropriate hospital payment; the impact of that standard on hospital costs; and the political obstacles to imposing...
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