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Reimbursement Issues

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  • Topic: Reimbursement issues
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Physicians' Opinions about Reforming Reimbursement

October 25, 2010 | Journal Article

Most physicians believe that Medicare reimbursements are inequitable but do not agree on how to reform the payment system. Physicians' views may be helpful in optimizing the design of any reimbursement reforms. The researchers of this study solicited their opinions regarding three reform strategies.

Fair Pricing Law Prompts Most California Hospitals To Adopt Policies To Protect Uninsured Patients From High Charges

June 4, 2013 | Journal Article

This article summarizes California’s Hospital Fair Pricing Act, which was passed in 2006 with the intent of protecting low-income uninsured patients from having to pay hospitals’ full billed charges.

Clinical Scholar Finds Medicare Reimbursements Don't Align with Preventive Care Recommendations

January 20, 2011 | Human Capital Blog Post

A newly released study from RWJF Clinical Scholar (2009-2011) Lenard Lesser, M.D., finds that Medicare covers only a fraction of the preventive care services recommended by a government task force, and that health care reform should be able to mend ...

The Impact of Profitability of Hospital Admissions on Mortality

April 1, 2013 | Journal Article

When hospital service line profit goes down, mortality goes up.

Testing PROMETHEUS Payment

September 17, 2012 | Program Result Report

The Health Care Incentives Improvement Institute furthered the development and pilot testing of its Prometheus bundled payment model. Researchers at RAND and the Harvard School of Public Health evaluated the initiative at three pilot sites.

Quality-Based Payment for Medical Groups and Individual Physicians

July 1, 2009 | Journal Article

This survey on quality-based payment found that the prevalence of external performance bonuses paid by insurers to large medical groups is larger than the prevalence of performance bonuses paid by the medical groups to the primary care and specialist physicians.

Post Claims Underwriting and Rescission Practices

January 1, 2009 | Report

Study details regulations and enforcement needed to fill gaps in protecting consumers in insurance markets.

Seizing Opportunities Under the Affordable Care Act for Transforming the Mental and Behavioral Health System

February 1, 2012 | Journal Article

Provisions of the Affordable Care Act offer extraordinary opportunities to insure many more people, reimburse previously unreimbursed services, integrate care using new information technology tools and treatment teams, confront complex chronic comorbidities, and adopt underused evidence-based interventions.

Health Care Financing and Organization Grant Recipient Works to Understand What the Uninsured Pay for Hospital Services

October 7, 2011 | Story

A Profile of Glenn A. Melnick, PhD.

An Emerging Middle Ground?

July 6, 2009 | Report

The report identifies and explores eight areas in which diverse business, medical and consumer interests are beginning to find middle ground and earn the support of bipartisan lawmakers.

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