IMPORTANCE Under bundled payment programs, hospitals receive a single payment for all services provided surrounding an episode of care. Because health care providers, such as hospitals and physicians, accept more financial risk under these programs, they will need a better understanding of episode costs to identify areas to target improvements in quality and cost-efficiency. OBJECTIVE To exam...

Key Findings. (1) Based on analysis of 2009 Medicare claims data, more than 70% of rural primary care physicians (PCP) and non-physician practitioners (NPP) qualify for payments under the Primary Care Incentive Payment Program (PCIP) threshold (i.e., meet the > 60% of allowable Medicare charges). (2) The average incentive payment for qualifying rural PCPs would result in an additional $8,000 in...

In 1999, Medicare implemented a resource-based relative value unit (RVU) system for physician practice expense payments, and increased the number of services for which practice expense payments differ by site. Using 1998-2004 data, we examined RVU growth and decomposed that growth into resource-based RVUs, site of service, and service quantity and mix. We found that the number services with sit...

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, every MA plan in the nation is paid more for its enrollees than they would have been expected to cost in traditional fee-for-service Medicare. The authors calculate that payments to MA plans in 2008 will be 12.4 percent greater than the corresponding costs in trad...

CONTEXT The adoption of pay-for-performance mechanisms for quality improvement is growing rapidly. Although there is intense interest in and optimism about pay-for-performance programs, there is little published research on pay-for-performance in health care. OBJECTIVE To evaluate the impact of a prototypical physician pay-for-performance program on quality of care. DESIGN, SETTING, AND PAR...

While efforts to improve the health of the uninsured have focused on demand side policies such as increasing insurance coverage, supply side changes may be equally important Yet there is little direct evidence on the effect of policies designed to increase the supply of Medicaid services to the poor. We provide such evidence by examining the relationship between infant mortality and the ratio o...

Recent years have been quite eventful for interventional pain physicians with numerous changes in the Medicare payment system with a view for the future and what it holds for interventional pain management for 2006 and beyond. On February 8, 2006, President Bush signed the Deficit Reduction Act of 2005, which cuts the federal budget by 39 billion dollars and Medicare and Medicaid by almost 11 b...

Under the Social Security Act the public assistance for which Federal grants are made is defined as "money payments2 to or in behalf of needy persons. In accordance with the intent expressed by Congress in framing the law and with judicial definitions, the Social Security Board has interpreted money payments to mean that "payments must be in cash, checks, or warrants immediately redeemable at p...

Chang Liu, MA, Rosa Baier, MPH, Rebekah Gardner, MD, and Amal Trivedi, MD, MPH  although elecTronic medical recordS (EMRs) may improve quality of care and reduce healthcare spending, uptake remains low in the United States. 8 A 2009 national survey of hospitals found that only 2.9% of hospitals had a comprehensive, electronic system and an additional 7.9%, a basic system. The same year, a phys...

the road to become a practicing physician is an expensive endeavor for everyone. Undergraduate allopathic medical education leaves the average medical student in debt over $150,000. Graduate medical education, necessary for physician licensure and board certification, is very costly. In academic year 2009-2010, the ACGME reported there were approximately 111,000 residents and fellows in ACGME-a...