This article presents a system under consideration by the Health Care Financing Administration (HCFA) for incorporating a measure of severity of illness into the Medicare diagnosis-related groups (DRGs). DRG assignment is one of the main factors in determining the payment made for hospital inpatient services furnished to Medicare beneficiaries. Specifically, the formula used to calculate paymen...

The ‘minimal’ payment—a payment method which minimizes the number of coins in a purse—is presented. We focus on a time series of change given back to a shopper repeating the minimal payment. The delay plot shows visually that the set of successive change possesses a fine structure similar to the Sierpinski gasket. We also estimate effectivity of the minimal-payment method by means of the averag...

This paper develops a model to examine the impacts of uncertainty about crop production and irreversibility of program participation on determining land rental payments and least-cost land retirement targeting in the Conservation Reserve Enhancement Program. Results show that under risk aversion only, the marginal cost of abatement and the average land rental payment are less than those under r...

BACKGROUND/AIM Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected cos...

The Japanese medical care system, highly rated internationally, has recently experienced a crisis that has placed a burden on all of its citizens, providers, and payers, due to the expansion of medical expenditures in rapidly aging society with the stagnant economy. To address this, in April 2003, Japan implemented a case-mix payment system, instead of conventional fee-for-service payment, base...

Background and Purpose Despite its low efficacy, aspirin is the most widely used drug for secondary stroke prevention. The reasons why stroke recurs while patients are on aspirin are unknown. We have analyzed a series of patients who had recurrent strokes while on aspirin. Methods Out of 2231 consecutive patients who were admitted to the Tel Aviv Medical Center from May 1988 through December 19...

New Zealand experiences significant health disparities related to both ethnicity and deprivation; the average life expectancy for Maori New Zealanders is 9 years less than for other New Zealanders. The government recently introduced a set of primary care reforms aimed at improving health and reducing disparities by reducing co-payments, moving from fee-for-service to capitation, promoting popul...

This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute.

OBJECTIVE To examine the impact of a government income management program on store sales. DESIGN AND SETTING An interrupted time series analysis of sales data in 10 stores in 10 remote Northern Territory communities during 1 October 2006 to 30 September 2009, which included an 18-month period before income management; a 4-6-month period after the introduction of income management; a 3-month p...

A health care provider chooses medical service quality and cost-reduction e§ort. Both choices are noncontractible. An insurer observes both quality and cost e§ort, and may credibly disclose them to consumers. In prospective payment, the insurer fully discloses care quality, and sets a prospective payment price. In cost reimbursement, the insurer discloses a value index, a weighted average of qu...