Literature DB >> 16091408

When the price isn't right: how inadvertent payment incentives drive medical care.

Paul B Ginsburg1, Joy M Grossman.   

Abstract

Unintended overpayment of some services, in combination with other market factors, is driving increased use of expensive care, which in turn could be an important driver of health care cost trends. Reimbursement systems are highly dependent on provider charge data that rarely provide accurate and up-to-date indicators of relative costs. As a result, newer services, in which productivity is increasing over time, tend to be more lucrative. As the largest payer, and one whose reimbursement policies are followed by private insurers and Medicaid programs, Medicare can address this issue by taking steps to make its prospective payment rates reflect relative costs more accurately.

Mesh:

Year:  2005        PMID: 16091408     DOI: 10.1377/hlthaff.w5.376

Source DB:  PubMed          Journal:  Health Aff (Millwood)        ISSN: 0278-2715            Impact factor:   6.301


  14 in total

1.  Adjusting case mix payment amounts for inaccurately reported comorbidity data.

Authors:  Jason M Sutherland; Jeremy Hamm; Jeff Hatcher
Journal:  Health Care Manag Sci       Date:  2010-03

2.  Hospital Financial Conditions and the Provision of Unprofitable Services.

Authors:  Hsueh-Fen Chen; Gloria J Bazzoli; Hui-Min Hsieh
Journal:  Atl Econ J       Date:  2009-09-01

3.  An economic history of Medicare part C.

Authors:  Thomas G McGuire; Joseph P Newhouse; Anna D Sinaiko
Journal:  Milbank Q       Date:  2011-06       Impact factor: 4.911

4.  Strategic Provider Behavior Under Global Budget Payment with Price Adjustment in Taiwan.

Authors:  Bradley Chen; Victoria Y Fan
Journal:  Health Econ       Date:  2014-08-12       Impact factor: 3.046

5.  Good neighbors: how will the patient-centered medical home relate to the rest of the health-care delivery system?

Authors:  Hoangmai H Pham
Journal:  J Gen Intern Med       Date:  2010-06       Impact factor: 5.128

6.  Markets and medical care: the United States, 1993-2005.

Authors:  Joseph White
Journal:  Milbank Q       Date:  2007-09       Impact factor: 4.911

7.  Variation in charges for emergency department visits across California.

Authors:  Renee Y Hsia; Yaa Akosa Antwi
Journal:  Ann Emerg Med       Date:  2014-05-31       Impact factor: 5.721

8.  The Effect of Network-Level Payment Models on Care Network Performance: A Scoping Review of the Empirical Literature.

Authors:  Thomas Reindersma; Sandra Sülz; Kees Ahaus; Isabelle Fabbricotti
Journal:  Int J Integr Care       Date:  2022-04-01       Impact factor: 5.120

9.  Fundamental reform of payment for adult primary care: comprehensive payment for comprehensive care.

Authors:  Allan H Goroll; Robert A Berenson; Stephen C Schoenbaum; Laurence B Gardner
Journal:  J Gen Intern Med       Date:  2007-03       Impact factor: 5.128

10.  Analysis of variation in charges and prices paid for vaginal and caesarean section births: a cross-sectional study.

Authors:  Renee Y Hsia; Yaa Akosa Antwi; Ellerie Weber
Journal:  BMJ Open       Date:  2014-01-15       Impact factor: 2.692

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