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payment reform

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Journal Article
Journal of Health Politics, Policy and Law (1 February 2017) 42 (1): 53–71.
Published: 01 February 2017
... program. The conclusion section of the article will consider the politics of payment reform as social reform. It will address proposals that health care payers and providers lead in addressing the social contributors to ill health and urge payment reformers to appreciate more fully the politics and...
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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 of More
Journal Article
Journal of Health Politics, Policy and Law (1 August 1994) 19 (4): 729–751.
Published: 01 August 1994
... 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...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2018) 43 (6): 1025–1040.
Published: 01 December 2018
... real payment reform” (Guterman 2015 ). They rejoiced that Congress had moved beyond short-term measures and adopted reforms that could “catalyze increased efficiency and greater cost control” (Aaron 2015 : 1977). Now that the SGR is gone, Congress, the Centers for Medicare and Medicaid Services...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2015) 40 (4): 745–760.
Published: 01 August 2015
... savings approach to payment reform. Private payers have introduced total cost of care contracting (TCOC) in several locations. This article questions the consensus that FFS must go. If the fees are too high, then someone needs to “bite the bullet” and reduce fees in key areas. Hoping to control...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2015) 40 (1): 245–255.
Published: 01 February 2015
... managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted...
Journal Article
Journal of Health Politics, Policy and Law (1 August 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
Journal of Health Politics, Policy and Law (1 February 1993) 18 (1): 113–174.
Published: 01 February 1993
...Thomas R. Oliver In 1985, Congress established the Physician Payment Review Commission (PPRC) to help formulate changes in the system used by Medicare to pay for physician services. The recommendations of the PPRC and subsequent legislative action led to fundamental reform. As a new type of...
Journal Article
Journal of Health Politics, Policy and Law (1 April 1995) 20 (2): 303–327.
Published: 01 April 1995
... of their capital costs. At the same time, overall reform points toward more capitation or fixed payments from all payers. This article discusses possible responses to legislative and competitive reforms by hospital management and the resulting effectiveness of the changes. To identify the potential...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2017) 42 (6): 1113–1125.
Published: 01 December 2017
... of care regardless of who pays the bill. In early 2015 we conducted on-site interviews with key stakeholders in five states to explore their strategies for payment and delivery reform. We found that despite these states' similar goals, differences in their statutory authority and purchasing power...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2005) 30 (6): 1003–1026.
Published: 01 December 2005
...Soonman Kwon; Michael R. Reich Korea recently introduced three major health care reforms: in financing (1999), pharmaceuticals (2000), and provider payment (2001). In these three reforms, new government policies merged more than 350 health insurance societies into a single payer, separated drug...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2011) 36 (3): 475.
Published: 01 June 2011
... Medical Association's role in the politics of Medicare physician payment reform and considers how Medicare payment reforms have impacted the entire politics of health care reform. © 2011 by Duke University Press 2011 The Politics of Cost Control and...
Journal Article
Journal of Health Politics, Policy and Law (1 February 1990) 15 (1): 69–99.
Published: 01 February 1990
.... , George J. Schieber, Martha A. Blaxall, and Jon R. Gabel. 1978 . Geographic Variation in Physicians' Fees. Journal of the American Medical Association 240 ( 13 ): 1368 -71. Caldwell , Jacques R. 1989 . Physician Payment Reform: A Practicing Physician's Perspective. Frontiers 6 ( 1...
Journal Article
Journal of Health Politics, Policy and Law (1 April 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 in the...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2003) 28 (2-3): 289–316.
Published: 01 June 2003
... influencing health policy. The essay begins with a review of the reasons for the growth and subsequent decline of physicians' influence. This is followed by a case study of physician payment reform under Medicare, which illustrates the ways in which organized medicine chooses when and when not to cooperate...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2015) 40 (2): 403–419.
Published: 01 April 2015
... net. Although there is some experimentation with payment reform and health information exchange, safety net providers identify significant policy and structural barriers to integrating service delivery. The enhanced Medicaid payments for CHCs and the federal requirement that CHCs retain independent...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1985) 10 (3): 513–532.
Published: 01 June 1985
... emphasis reflects not only the personal predilections of the author, but also the contention that those are the most sensible things to talk about. Copyright © 1985 by Duke University Press 1985 Reforming Medicare Provider Payment Bruce C. Vladeck, United Hospital Fund of New York...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2010) 35 (3): 407–422.
Published: 01 June 2010
... health policy for clients whose patients depended on Medicaid. Reviewing the ambitious Medicaid agenda that she helped lead, Bachrach reflects on expanding eligibility and increasing enrollment, designing and implementing payment reforms, and struggling with how best to rationalize program administration...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1989) 14 (3): 523–547.
Published: 01 June 1989
... case-mix payment in 1983 as part of an overall reimbursement reform aimed at overcoming barriers to access and promoting consistency between payment rates and the intensity of care that nursing homes provided. The system pays all nursing homes within a geographic area the same price for the...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2015) 40 (4): 839–846.
Published: 01 August 2015
... disruption occurring and, relatedly, underestimation of the potential for strategic adaptation by providers. Those adaptations potentially undermine the changes that are introduced, through a process of policy drift. These conclusions are based on comparisons with Medicare's last major payment policy reform...