Over the past decade, reimbursement in the US health care system has undergone rapid transformation. The Affordable Care Act and the Medicare Access and CHIP Reauthorization Act are some of the many changes challenging traditional modes of practice and raising concerns about practitioners' ability to adapt. Recently, physician satisfaction was proposed as an addition to the Triple Aim in acknow...

BY LAUREN DEWITT AND BRAD BALDWIN W ith little more than a year before the mandated shift from the International Classification of Diseases, 9 Revision, (ICD-9) to the International Classification of Diseases, 10 Revision, Clinical Modification and Procedure Coding System, (ICD10-CM and ICD-10-PCS, respectively), on October 1, 2014, all entities covered by the Health Insurance Portability and A...

Issue Expanded Medicaid enrollment under the Affordable Care Act has heightened the importance of states’ roles as principal purchasers of health care for low-income and medically vulnerable populations. Concurrently, the federal government has augmented states’ purchasing tools. Goal To examine the evolution of payment and delivery system reform in 10 ACA Medicaid expansion states. Methods...

Success in online services cannot promise the success in corresponding mobile services. To understand the mobile service adoption behavior under the context of online service transition, this study, taking mobile payment as an example, from a trust transfer perspective, examines users’ acceptance of mobile payment using the TAM (Technology acceptance model). A field survey with 220 mobile payme...

Escalating costs and the growing imbalance between primary and specialty care have increased the urgency of calls for fundamental reform of the health care payment system. At the core of the problem is the fact that the dominant fee-for-service model rewards volume and intensity rather than value. But although the faults in the way we currently pay for health care are obvious, it is much less c...

This article presents a model of the important health-policy dilemmas of risk selection and moral hazard. When providers can increase revenues by selecting favorable risks, capitation or purely prospective payment is unlikely to be optimal. A second best payment system may involve mixed levels of both demandand supply-side cost sharing: consumers may prefer to pay deductibles and co-payments ra...

This paper explores the economic models associated to different mobile-payment systems. We first present the existing experiences and exhibit their distinctive components: new technological possibilities to create direct links between users, new potential intermediaries, new economic models to coordinate the commercial interests of financial and non-financial operators. After a short review of ...

In this commentary, we discuss the advantages and disadvantages of the following incentive-based remuneration systems in dentistry: fee-for-service remuneration, per capita remuneration, a mixed payment system (a combination of fee-for-service remuneration and per capita remuneration) and pay-for-performance. The two latter schemes are fairly new in dentistry. Fee-for-service payments secure hi...

BACKGROUND Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. OBJECTIVE We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health ...