OBJECTIVE To discuss the usefulness of health care information technology (HIT) in assisting care providers minimize uncertainty while simultaneously increasing efficiency of the care provided. STUDY DESIGN An ongoing study of HIT, performance measurement (clinical and production efficiency) and their implications to the payment for care represents the design of this study. Since 2006, all Ma...

OBJECTIVE This paper provides a comprehensive overview of hospital payment systems based on diagnosis-related groups (DRGs) in low- and middle-income countries. It also explores design and implementation issues and the related challenges countries face. METHODS A literature research for papers on DRG-based payment systems in low- and middle-income countries was conducted in English, French an...

As part of the Deficit Reduction Act of 2005, Congress required the Secretary of Health and Human Services (HHS) to identify conditions that (1) are high cost or high volume or both, (2) result in the assignment of a case to a diagnosis-related group that has a higher payment when present as a secondary diagnosis, and (3) could reasonably have been prevented through the application of evidence-...

INNOVATIVE MODELS OF PAYMENT AND CARE DELIVERY are increasingly being used to expand access, improve quality, and reduce medical costs. Although traditional fee-for-service medicine favors doing more than is necessary, newer payment models aim to realign incentives to decrease utilization and increase efficiency. However, little consideration has been given to how fee-for-service reimbursement ...

Medicare has begun to implement a new payment system for physician services; the system's cornerstone is a resource-based relative value scale (RBRVS) that divides physician services into three components--physician work, practice expense, and malpractice insurance--and calculates a relative value for each component. The relative values for the components are adjusted for geographic differences...

Section 1886(e)(4) of the Social Security Act requires the Secretary of the Department of Health and Human Services to update the rates of individual diagnosis-related groups under the prospective payment system beginning in fiscal year 1986, taking into account the recommendations of the Prospective Payment Assessment Commission (1985a and b). Section 1886(e)(4) of the Act reads as follows: "(...

INTRODUCTION The environmental degradation following crude oil exploration in the Niger Delta has resulted in poverty for local rural dwellers. For those who are ill, if herbal treatments and/or self-medication with orthodox drugs are unsuccessful, the only alternative is expensive medical treatment in clinics. Surgical patients in a rural clinic may have to stay beyond than the normal 7 days i...