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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-based...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2018) 43 (3): 401–425.
Published: 01 June 2018
... 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 holds plans and providers...
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
... 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 payment methodology by the end of...
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 emerged...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2016) 41 (4): 743–762.
Published: 01 August 2016
... residents enrolled in health plans were covered under risk-based payment models tied to global budgets. But the expansion of payment reform in Massachusetts slowed between 2012 and 2015 because some commercial enrollment shifted from risk-based health maintenance organization products to fee-for-service...
Journal Article
Journal of Health Politics, Policy and Law (1 April 1982) 7 (2): 407–420.
Published: 01 April 1982
..., 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 ceiling...
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
... 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 examined. Prospective...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1987) 12 (4): 683–702.
Published: 01 August 1987
... 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. Kane , R. L...
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
... 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- sions without region and OPD, the 5 percent value increases to 8 percent...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1994) 19 (4): 729–751.
Published: 01 August 1994
... 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, previous studies of hospital profits have not applied...
Journal Article
Journal of Health Politics, Policy and Law (1 June 2018) 43 (3): 483–510.
Published: 01 June 2018
...), 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 that would generate...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1985) 10 (3): 513–532.
Published: 01 June 1985
... 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 discharge patients too early, to underprovide needed...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2017) 42 (6): 1113–1125.
Published: 01 December 2017
... 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 Medicare and Medicaid Services (CMS), we identified...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1992) 17 (3): 509–516.
Published: 01 June 1992
...- 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 1982 costs. Ten years later, actual average...