OBJECTIVE To determine the effect of joining HMOs (health maintenance organizations) on the inpatient utilization of Medicare beneficiaries. DATA SOURCES We linked enrollment data on Medicare beneficiaries to patient discharge data from the California Office of Statewide Health Planning and Development (OSHPD) for 1991-1995. DESIGN AND SAMPLE A quasi-experimental design comparing inpatient ...

BACKGROUND As healthcare spending continues to increase, reimbursement cuts have become 1 type of healthcare reform to contain costs. Little is known about the long-term impact of cuts in reimbursement, especially under a global budget cap with fee-for-service (FFS) reimbursement, on processes and outcomes of care. The FFS-based reimbursement cuts have been implemented since July 2002 in Taiwan...

OBJECTIVE To evaluate differences in the stage at diagnosis and survival for melanoma between the 2 most common types of Medicare health care delivery systems, fee-for-service (FFS) and managed care (health maintenance organizations [HMOs]), in the United States during the period from January 1, 1985, through December 31, 1994. DESIGN We used a linkage of 2 national databases, ie, the Medicar...

The paper provides theoretical analysis for hospitals’heterogeneity in the response to the change from the the fee-for-service (FFS) system to a per diem prospective payment system with a length-of-stay dependent step-down rate (SDR): hospitals with shorter (longer) average length of stay under FFS have longer (shorter) average length of stay under SDR. We also show that for FFS hospitals with ...

Although Medicare Managed Care (MMC) was introduced as a way to reduce costs, the effect of the program on total Medicare spending is unknown. Current literature has focused on three conflicting sets of findings including spillover effects from managed care which reduce total Medicare spending and positive selection into managed care and overpayments to managed care plans relative to Fee-for-Se...

Since 2002, the healthcare system in Taiwan has implemented a global budgeting scheme in clinics and hospitals with an expenditure cap. The current mode of payment for medical points in Taiwan is primarily through the fee-for-service (FFS) mechanism. This payment mechanism has diminished the quality of services that clinics and hospitals provide to patients. Furthermore, FFS does not grant ince...

BACKGROUND It is widely believed that the method of payment of physicians may affect their clinical behaviour. Although payment systems may be used to achieve policy objectives (e.g. cost containment or improved quality of care), little is known about the effects of different payment systems in achieving these objectives. OBJECTIVES To evaluate the impact of different methods of payment (capi...