In this article, the determinants of physician assignment rates under the Medicare program are examined separately for medical, surgical, laboratory, and radiology services. Data for this study include copies of all Medicare claims submitted by over 1,200 Colorado general practitioners, internists, and general surgeons during the periods both before and after they experienced a substantial chan...

The purpose of this study is to compile trends for physician reimbursement, hospital inpatient and outpatient reimbursement the 10 most common orthopaedic sports surgeries based on national payment amounts. Current Procedural Terminology (CPT) codes Medicare Severity–Diagnosis Related Group (MS-DRG) were identified. Utilizing CPT codes, Physician Fee Schedule (MPFS) was utilized obtain amount r...

BACKGROUND Subsidizing healthcare costs through insurance schemes is crucial to overcome financial barriers to health care and to avoid high medical expenditures for patients in China. The health insurance could decrease financial risk by less out-of-pocket (OOP) payment, but not promise the protection equity. With the growth of New Cooperative Medical Scheme (NCMS) financing and coverage since...

On January 25, 2012, Medicare (CMS) held a meeting to consider issues related to the current management of carotid arterial disease. One of the most important of these issues is whether or not Medicare should expand reimbursement for carotid artery stenting (CAS) to include patients with asymptomatic and low or standard surgical risk symptomatic carotid stenosis. Opinions vary widely regarding ...

The implementation of a universal health insurance (UHI) model is a key political policy in Ireland. The objective here was to determine the understanding of general practitioners (GPs) and patients regarding UHI, its implementation and impact on both sets of stakeholders. Postal questionnaire to GPs, and opportunistic survey sampling of patients in two different GP practices were carried out. ...

An important aspect of the perceived problem with medical malpractice litigation is the manner in which malpractice claims are resolved.' Following the first medical malpractice crisis in the mid-1970s and the more recent difficulties with insurance costs and availability, the majority of states enacted legislation affecting the procedures used to resolve malpractice claims. 2 Procedural reform...

This paper reports preliminary findings from the National Hospital Rate-Setting Study regarding the effects of State prospective reimbursement (PR) programs on measures of payroll costs and employment in hospitals. PR effects were estimated through reduced-form equations, using American Hospital Association Annual Survey data on over 2,700 hospitals from 1969 through 1978. These tests suggest t...

Firstly, a game model is established under unconstrained market conditions to illustrate the basic evolutionary rule of the market of e-commerce payment method. It is concluded that the establishment of e-commerce payment market is not normative under the unconstrained market conditions, which shows the importance of the introduction of the third party payment for the establishment of standardi...

Introduction Both Romania and Turkey started the implementation of case-mix systems as a tool to be used for acute inpatient care reimbursement by the public insurance system, in the context of inflationist, non-transparent and non-equitable reimbursements at the time. Romania used the HCFA DRG system for the initial phases (2000–2005), and it is currently using the AR DRG system for full reimb...