Over the past two years, states across the country have been struggling to cope with rising Medicaid expenditures and, in some cases, significant budget shortfalls. They have sought to cut Medicaid spending by limiting benefits, increasing costsharing, and slowing provider payment increases. A number of states have also tightened Medicaid eligibility standards or have delayed planned eligibilit...

OBJECTIVE To examine the long-term impact of Medicare payment reductions on patient outcomes for Medicare acute myocardial infarction (AMI) patients. DATA SOURCES Analysis of secondary data compiled from 100 percent Medicare Provider Analysis and Review between 1995 and 2005, Medicare hospital cost reports, Inpatient Prospective Payment System Payment Impact Files, American Hospital Associati...

This paper proposes Medicare payment reform built on the fee-for-service system, with incentive payments to eligible provider organizations determined by their rate of increase in cost per patient compared to the overall growth rate in the community. By planning and monitoring how care patterns are altered to achieve greater efficiency, policy-makers can align the incentives of Medicare and the...

Recent advances in consumer research have shown that the billing schedule has a significant impact on consumer decisions and consumption patterns. The strategy of devising different billing schedules to influence a customer’s purchase decision (or choice of consumption pattern) is well accepted, and should be effective as long as billing schedules are exactly the same as the perceived payment o...

The purpose of this project was to evaluate practice type and geographical differences in methods of payment accepted for children's dental services. A survey was mailed to 2000 general dentists and 1000 pediatric dentists randomly selected to provide representation from the 50 United States. Dentists were asked to specify the type of practice and the state in which they primarily practice. The...

Managed health care plans and providers in the US and elsewhere sell their services to multiple payers. For example, the three largest groups of purchasers from health plans in the US are employers, Medicaid plans, and Medicare, with the first two accounting for over 90% of the total enrollees. In the case of hospitals, Medicare is the largest buyer, but it alone only accounts for 40% of the to...

Central bank spending on the operation of inter-bank funds transfer systems may range from below one million to nearly a billion US dollars annually. This paper examines how such costs are incurred and recovered to pursue payment systems efficiency in different countries and under alternative policy approaches. The key findings suggest the following. First, strong scale economy effects were fou...