...Rickard F. Pfizenmayer This article examines the role of collective physician participation in the third-party reimbursement system. It critiques the Havighurst-Kissam analysis of the antitrust implications of professionally-developed relative value guides and using lessons derived from the only...

... University 1984 Origins of the “Third Psychiatric Revolution”: The Community Mental Health Centers Act of 1963 David A. Rochefort, Northeastern University Abstract. In recent decades the community mental health movement has achieved a dramatic reduction in the census...

...Kenneth I. Kaitin Milton Silverman, Mia Lydecker, and Philip R. Lee. Bad Medicine: The Prescription Drug Industry in the Third World . Stanford, CA: Stanford University Press, 1992. 358 pp. $29.95 cloth. Copyright © 1994 by Duke University Press 1994 922 Journal of Health Politics...

... who lack third-party coverage, modernizing the treatment system, developing new patterns of practice that use existing resources more efficiently, and developing a plan for treating intravenous drug users infected with the AIDS virus. In the private sector, the advent of working- and middle-class...

... characteristics. Overall, during a single nursing home episode only 10 percent of nursing home patients who entered as private payers received Medicaid at discharge. Roughly one-third of nursing home patients remained on Medicaid throughout their stay, and another third remained private payers throughout their...

..., those models most politically feasible, the present medical care system with universal third party financing, and public utility process controls with universal third party financing, are the ones most likely to aggravate present cost-quality difficulties. Therefore, the recommended procedure for...

... planning programs are embedded in past social policy developments and institution-building, it is necessary to first compare the two countries' compulsory health insurance schemes. This is followed by a general profile of each health care system. A third section examines the formulation and implementation...

..., minimizing risks borne by third-party payers, constraining cost increases, and improving the functioning of markets. This article examines one source of the economizing model, the work of several early and persistently prominent economists of health care, especially Mark Pauly, Martin Feldstein, and Joseph...

... whether and how SBHCs can best integrate with existing resources to fill unmet local needs. Furthermore, despite the cautions of experts that third-party reimbursement (via traditional fee-for-service insurance or participation in health maintenance organizations) cannot cover clinic expenses and is...

... was one of the control over what was provided by the plans and who would pay for the costs of care. We posit that labor was never able to achieve an important role in the control of the third-party payer, and in the antilabor environment of the 1980s this proved detrimental to labor's interests...

... five forms of community benefit that might be associated with nonprofit forms of managed care. Using data from a national survey of firms providing third-party utilization review services in 1993, we test for ownership-related differences in these five dimensions. The results suggest that ownership...

... politically, a dimension that includes their political participation, their relationships to parties and electoral coalitions, the images they present to other political actors, and the legacy of public policies that affect them. Second, the groups have different medical and social needs. Third, the groups...

... programs of third-party payers, both public and private. Copyright © 1997 by Duke University Press 1997 References Annas , G. J. 1994 . Asking the Courts to Set the Standard of Emergency Care: The Case of Baby K. New England Journal of Medicine 330 ( 21 ): 1542 -1545. Capron , A...

... misconceived. The first rests on the false assumption that the health care system includes a workable division of responsibility regarding access that assigns obligations concerning access to managed care organizations. The second and third criticisms wrongly assume that we in the United States have taken the...

..., continuation of these activities is more likely to be a function of third-party payment policies than of proprietary versus nonprofit hospital ownership. Copyright © 1987 by Duke University Press 1987 References American Hospital Association and Urban Institute. 1982 . Survey of Hospitals' Care to...

...Kenneth E. Thorpe By 1983, four states had received waivers from the Health Care Financing Administration and adopted experimental reimbursement programs covering all third-party payers. In general, these programs were designed to moderate cost growth as well as to promote a number of broader...

... situations arising when certain institutions are considered for exclusion from or inclusion in third-party payment programs. Selective contracting in local areas can potentially decrease duplication of services, reduce cost to purchasers, and lower expected mortality and morbidity for some patient groups...

..., but IP As are growing three times faster than PGPs and are likely to dominate the HMO industry in the near future. The literature indicates that a small proportion of an IPA physician's practice is capitated, but such practices often are as much as one-third capitated. And while the literature...

... development; and a model of increasing inefficiency, in which consumers have weak incentives to search out efficient suppliers. Earlier statistical support for the third model has weakened, which provides some evidence that the regulatory and competitive initiatives of the last decade are having their...