In recent years there has been strong interest in episode-of-care (EOC) payment for physicians and hospitals as a replacement for fragmented, fee-for-service reimbursement. Medicare’s DRG method for hospitals can be interpreted as the nation’s first bundled payment, though it covers neither physician services nor post-acute services administered after discharge. Medicare’s Acute Care Episode (A...

As the number of Medicare beneficiaries receiving care under at-risk capitation arrangements increases, the method for setting payment rates will come under increasing scrutiny. A number of modifications to the current adjusted average per capita cost (AAPCC) methodology have been proposed, including an adjustment for prior utilization. In this article, we propose use of a utilization adjustmen...

In an attempt to control rapid growth in hospital costs, beginning in the mid-1970s several states implemented rate-setting programs to regulate hospital payments. In seven states, rate-setting was in effect for a substantial period of time (14 years or more). While most of these programs were discontinued by the mid-1990s, two are still active. In five of the seven states, the rates of increas...

UNLABELLED In the face of the progressive implementation of the Affordable Care Act (ACA), a significant regulatory regime, and the Merit-Based Incentive Payment System (MIPS), the Centers for Medicare and Medicaid Services (CMS) released its proposed 2017 hospital outpatient department (HOPD) and ambulatory surgery center (ASC) payment rules on July 14, 2016, and the physician payment schedule...

Although regional variations in Medicare spending are known, it is not clear whether regional variations exist in hospital charges for total joint arthroplasty. Data from Centers for Medicare and Medicaid Services (CMS) on Diagnosis Related Groups 469 and 470 (Major Joint with and without Major Complicating or Comorbid Condition) from 2011 were analyzed for variation by region. Drastic variatio...

In this article, we review five health care cost-containment efforts from 1971 to the present and summarize key research findings on the effects of each on cost, quality, and access. These efforts include the Nixon Economic Stabilization Program (ESP), Carter-era hospital cost-containment efforts, Medicare hospital and physician payment, and State hospital ratesetting programs. The purpose of t...

AIMS To survey methods for cost control of out-of-hours laboratory services in district general hospitals in England and Wales. METHODS A questionnaire was distributed to 66 district general hospital laboratories in England and Wales. RESULTS The response rate was 61%. Most laboratories for which budgetary information was provided had on-call costs ranging between 10-21% of staff costs. Nin...

Mobile payment system has made it easy for people to do financial transaction. However, its security is still a concern. It needs to protect the data transferred between parties involved in the system. In this paper, we investigate the possibility use of elliptic curve cryptography to secure the data transferred in a payment system.