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value-based payment

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Journal Article
Journal of Health Politics, Policy and Law (1 October 2018) 43 (5): 739–765.
Published: 01 October 2018
... productive inefficiency is a more tractable concept than waste. We then review the literature on the efficiency of health providers. We discuss the evidence on whether supply- and demand-side policies, such as value-based payment and cost sharing, can raise efficiency, finding that many of these policies...
Journal Article
Journal of Health Politics, Policy and Law (1 October 2016) 41 (5): 1033–1045.
Published: 01 October 2016
...-based purchasing may not be to patients or even payers, but to policy makers seeking a morally justifiable alternative to politically contested regulatory policies. Copyright © 2016 by Duke University Press 2016 value-based purchasing pay-for-performance payment reform Medicare Value...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2018) 43 (3): 401–425.
Published: 01 June 2018
... case study. Over the past ten years, Medicare has increasingly moved toward value-based purchasing, in which fee-for-service payments are supplemented to incentivize higher-quality and lower-cost care. The transition of Medicare from a payment system largely based on quantity to a system that...
Journal Article
Journal of Health Politics, Policy and Law (1 December 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
Journal of Health Politics, Policy and Law (1 February 1990) 15 (1): 69–99.
Published: 01 February 1990
.... Holahan , John F. , and Lynn M. Etheredge. 1986 . Medicare Physician Payment Reform. Washington, DC: The Urban Institute. Hsiao , William C. , Peter Braun, Edmund R. Becker, and Stephen R. Thomas. 1987 . The Resource-Based Relative Value Scale. Journal of the American Medical Association 256...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2018) 43 (2): 305–323.
Published: 01 April 2018
... community partners. One of the key ideals involved in this process for the finance teams was to ensure alignment of the funds flow methodology and contracting process with the goals of the New York State Value-Based Roadmap, which focuses on shifting 80–90 percent of managed care payments into a value-based...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2018) 43 (1): 5–18.
Published: 01 February 2018
... drugs will require close coordination among manufacturers, payers, and regulators. Copyright © 2018 by Duke University Press 2018 Medicaid best-price rule pharmaceutical pricing value-based payment outcome-based pricing Even in today's polarized political landscape, a consensus has...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2016) 41 (4): 743–762.
Published: 01 August 2016
.../ . Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds . 2015 . Annual Report. Washington, DC . Burwell Sylvia M. 2015 . “ Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care .” New England Journal of Medicine...
Journal Article
Journal of Health Politics, Policy and Law (1 April 1982) 7 (2): 407–420.
Published: 01 April 1982
... Administration, Duke University Press 1982 Cost-Based Reimbursement and Prospective Payment: Reassessing the Incentives Richard W. Foster, University of Chicago Abstract. Prospective payment is distinguished from the imposition of a regula- tory ceiling on hospital costs. While a regulatory...
Journal Article
Journal of Health Politics, Policy and Law (1 August 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...
Journal Article
Journal of Health Politics, Policy and Law (1 February 1984) 9 (1): 81–101.
Published: 01 February 1984
... empirical findings are described, structural analysis of this particular PP program’s strengths and weaknesses is presented. Finally, the implications of that analysis for present prospective payment programs, particularly those based on the methodology of diagnosis-related groups (DRGs), are...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1987) 12 (4): 683–702.
Published: 01 August 1987
... Research and Health Care Technology Assessment. Kane , R. L. 1986 . Outcome-Based Payment: A New Beginning? Health Progress ( April ): 36 -70. Kane , R. L. , R. M. Bell, and S. Z. Riegler. 1986 . Value Preferences for Nursing Home Outcomes. The Gerontologist 26 ( 3 ): 303 -308...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1992) 17 (3): 483–508.
Published: 01 June 1992
... . Hospital Payment Effects on Acute Inpatient Care for Mental Disorders. Archives of General Psychiatry 42 : 552 -55. Siegel , Carole , K. Jones, E. Laska, M. Meisner, and S. Lin. 1992 . A Risk-based Prospective Payment System That Integrates Patient, Hospital and National Costs. Journal of...
Journal Article
Journal of Health Politics, Policy and Law (1 February 1993) 18 (1): 113–174.
Published: 01 February 1993
... Health and Human Services regarding the development of a resource-based relative value scale for physician services (PPRC 1991a: 407). 124 Journal of Health Politics, Policy and Law Table 3 Stages in Physician Payment Reform, 1984-1996...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1984) 8 (4): 660–685.
Published: 01 August 1984
... discounts than without them. Therefore, based on coefficients from the regressions presented in Table 2, we estimate that if the discounts in effect in 1979 would have somehow disappeared, total payments to hospitals would have risen by up to 5 percent. Using DIS coefficients from profit regres...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1994) 19 (4): 729–751.
Published: 01 August 1994
... may receive windfall profits. Thus the impact of severity of illness on hospital profitability is important as long as prospective, case- based payment methods, including Medicare’s, fail to adjust for differ- ences in illness severity. Although consequential policy implications exist...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2018) 43 (3): 483–510.
Published: 01 June 2018
... (Diagnosis-Related Groups), RBRVS (Resource-Based Relative Value Scale), and the SGR (Sustainable Growth Rate). They promised to set prospective limits on Medicare spending (DRGs), base program payments on expert judgment of relative costs (RBRVS), and create spending growth targets tied to economic indexes...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1985) 10 (3): 513–532.
Published: 01 June 1985
... it becomes messier and less elegant. There is nothing wrong with PPS that cannot be fixed, if we want to fix it. As a penultimate point on PPS, it is necessary to address the concern that DRG- based payments will encourage hospitals to avoid admitting relatively sicker pa- tients, to...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2017) 42 (6): 1113–1125.
Published: 01 December 2017
... of authority states possess, the specific approaches they have taken, and the strengths and limitations of their efforts as they pursue payment and delivery reforms. Based on prior knowledge, a review of the literature, and State Innovation Model (SIM) proposals submitted to the Centers for...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1992) 17 (3): 509–516.
Published: 01 June 1992
... from cost-related reimbursement to pro- spective payment as greatly as the general health delivery system (Gibson and Namerow 1988). The TEFRA payment system established incentives for cost control in the context of a fair payment system based on a mental health care facility’s own...