co-opting physicians to regulate fee-for-service (ffs) payment is more feasible and simpler to administer than capitation, diagnosis-related groups (drgs) and pay-for-performance. the key lies in designing and revising the fee schedule, which not only defines and sets the fee for each item, but also the conditions of billing. adherence to these regulations must be strictly audited in order to c...

Professor Naoki Ikegami’s “Fee-for-service payment – an evil practice that must be stamped out” summarizes many of the failings of alternatives to fee-for-service (FFS) payment systems. His article also offers several suggestions for improving FFS systems. However, even powerful arguments against many of the alternatives to FFS, does not make a convincing argument for FFS systems. In addition, ...

professor naoki ikegami’s “fee-for-service payment – an evil practice that must be stamped out” summarizes many of the failings of alternatives to fee-for-service (ffs) payment systems. his article also offers several suggestions for improving ffs systems. however, even powerful arguments against many of the alternatives to ffs, does not make a convincing argument for ffs systems. in addition, ...

BACKGROUND Medicare managed care enrollees who disenroll to fee-for-service (FFS) historically have worse health and higher costs than continuing enrollees and beneficiaries remaining in FFS. OBJECTIVE To examine disenrollment patterns by analyzing Medicare payments following disenrollment from Medicare Advantage (MA) to FFS in 2007. Recent growth in the MA program, introduction of limits on ...

CONTEXT Since 2000, the Centers for Medicare & Medicaid Services (CMS) has been collecting information on beneficiaries' experiences with health care for Medicare managed care (MMC) and traditional fee-for-service (FFS) Medicare. OBJECTIVES To compare beneficiary experiences with managed care and FFS arrangements throughout the country and to assess the stability of those differences over tim...

ost experts who examine America’s persistent healthcare cost and quality problems identify fee-for-service (FFS) reimbursement as an key contributor to the system’s chronic ills. Under FFS, doctors and hospitals are paid more for doing more, not for delivering better outcomes. The economic incentives under FFS actually discourage quality improvement because care that “gets it right the first ti...

This work focuses on the B2B interaction between a service requester and a service provider in a healthcare environment. The requester is the primary caregiver responsible for managing the health of a population of patients. When a patient requires advanced care outside the requester’s expertise, the requester refers the patient to a provider and pays for the referral services. Treatment may su...

INTRODUCTION Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate completeness of capture of disease cases for Manitoba physicians paid by fee-for-service (FFS) and no...

This study examines associations between caregivers' satisfaction with children's Medicaid-funded behavioral health care plans and the likelihood that children with severe emotional disturbance receive mental health services. Data are from a multisite study of managed care versus fee-for-service (FFS) settings. In multivariate logistic regression analyses controlling for demographic, environmen...