BACKGROUND In 2004 an allocation formula for primary care services was introduced in England and Wales so practices would receive equitable pay. Modifications were made to this formula to enable local health authorities to pay practices. Similar pay formulae were introduced in Scotland and Northern Ireland, but these are unique to the country and therefore could not be included in this study. ...

To improve the quality of health services at Primary Health Care (FKTP) in implementing National Insurance Program Indonesia, government has issued a performance-based capitation payment (KBK) policy FKTP. This study aims to evaluate Merial clinic from aspects effectiveness, efficiency, facilities and infrastructure, availability human resources, adequacy, legal compliance. performed in-depth i...

The use of Casemix system as providers’ reimbursement method under social health insurance schemes has spread beyond high-income countries. Over the last decade many low and middle-income countries (LMIC) have started to implement Casemix system to replace the conventional yet inefficient fee-for-service as provider payment mechanism. UNU-IIGH launched an international grouper called UNU-CBG in...

BACKGROUND "Bundled payment" is a method in which payments to health care providers are related to the predetermined expected costs of a grouping, or "bundle," of related health care services. The intent of bundled payment systems is to decrease health care spending while improving or maintaining the quality of care. PURPOSE To systematically review studies of the effects of bundled payment o...

BACKGROUND Incorporating behavioral health care into patient centered medical homes is critical for improving patient health and care quality while reducing costs. Despite documented effectiveness of behavioral health integration (BHI) in primary care settings, implementation is limited outside of large health systems. We conducted a survey of BHI in primary care practices participating in the ...

BACKGROUND Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment meth...

The effective delivery of primary care requires more frequent information exchange and communication than the typical office visit allows. Although industry leaders endorse health information technology (IT) to improve health outcomes and reduce costs, there has been less attention devoted to the use of this technology to deliver care. Using Internet-based technologies such as secure messaging,...

BACKGROUND AND OBJECTIVES Our objectives were to determine the distribution of errors and estimate the magnitude of the burden of delayed payments in a large physician group practice. METHODS A 25% random sample (n=775) was taken from all billed records of a physician group practice in the Pacific Northwest that were delayed 6 months or more as of June 30, 2001. The source and specific reason...

Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had ...

We consider a public wireless network with one access point (AP) and several users. The wireless network is setup by a service provider (SP) to enable Internet connections in public areas such as parks, libraries, and cafes. The service provider establishes appropriate pricing schemes to charge the users in order to cover its own cost in the setup and maintenance of the public wireless network....