Literature DB >> 19174388

Payment reform options: episode payment is a good place to start.

Robert E Mechanic1, Stuart H Altman.   

Abstract

New strategies to control U.S. health spending growth are urgently needed. Although provider payment cuts are likely, cutting fee-for-service (FFS) payments will hurt quality and access. A more sensible approach would be to restructure the delivery system into organized networks of providers delivering reliable, evidence-based care. But restructuring will not occur without payment policy reform. Four policy options are commonly cited: recalibrating FFS, instituting pay-for-performance, creating episode-based payments, and adopting global payments. We argue that episode payments are the most immediately viable approach, and we recommend that payment reforms precede any payment reductions so that new delivery models can gain traction.

Mesh:

Year:  2009        PMID: 19174388     DOI: 10.1377/hlthaff.28.2.w262

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


  23 in total

1.  Reducing potentially avoidable complications in patients with chronic diseases: the Prometheus Payment approach.

Authors:  Francois De Brantes; Amita Rastogi; Michael Painter
Journal:  Health Serv Res       Date:  2010-12       Impact factor: 3.402

2.  Market variations in intensity of Medicare service use and beneficiary experiences with care.

Authors:  Jessica N Mittler; Bruce E Landon; Elliot S Fisher; Paul D Cleary; Alan M Zaslavsky
Journal:  Health Serv Res       Date:  2010-04-06       Impact factor: 3.402

3.  Effects of Changes in Diabetes Pay-for-Performance Incentive Designs on Patient Risk Selection.

Authors:  Hui-Min Hsieh; Shu-Ling Tsai; Lih-Wen Mau; Herng-Chia Chiu
Journal:  Health Serv Res       Date:  2015-07-07       Impact factor: 3.402

4.  Prometheus payment model: application to hip and knee replacement surgery.

Authors:  Amita Rastogi; Beth A Mohr; Jeffery O Williams; Mah-Jabeen Soobader; Francois de Brantes
Journal:  Clin Orthop Relat Res       Date:  2009-06-23       Impact factor: 4.176

5.  Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report.

Authors:  Andrew W Mulcahy; Chris Chan; Samuel Hirshman; Peter J Huckfeldt; Aaron Kofner; Jodi L Liu; Susan L Lovejoy; Ioana Popescu; Justin W Timbie; Peter S Hussey
Journal:  Rand Health Q       Date:  2015-07-15

6.  Payment Reform: Analysis of Models and Performance Measurement Implications.

Authors:  Eric C Schneider; Peter S Hussey; Christopher Schnyer
Journal:  Rand Health Q       Date:  2011-03-01

Review 7.  The perioperative surgical home (PSH): a comprehensive review of US and non-US studies shows predominantly positive quality and cost outcomes.

Authors:  Bita A Kash; Yichen Zhang; Kayla M Cline; Terri Menser; Thomas R Miller
Journal:  Milbank Q       Date:  2014-12       Impact factor: 4.911

8.  Examining variation in Medicare payments and drivers of cost for carotid endarterectomy.

Authors:  Danielle C Sutzko; Elizabeth A Andraska; Andrew A Gonzalez; Apurba K Chakrabarti; Nicholas H Osborne
Journal:  J Surg Res       Date:  2018-04-14       Impact factor: 2.192

9.  Experience with Designing and Implementing a Bundled Payment Program for Total Hip Replacement.

Authors:  Winthrop F Whitcomb; Tara Lagu; Robert J Krushell; Andrew P Lehman; Jordan Greenbaum; Joan McGirr; Penelope S Pekow; Stephanie Calcasola; Evan Benjamin; Janice Mayforth; Peter K Lindenauer
Journal:  Jt Comm J Qual Patient Saf       Date:  2015-09

10.  Determinants of preventable readmissions in the United States: a systematic review.

Authors:  Joshua R Vest; Larry D Gamm; Brock A Oxford; Martha I Gonzalez; Kevin M Slawson
Journal:  Implement Sci       Date:  2010-11-17       Impact factor: 7.327

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