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Reimbursement Issues

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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.

The Impact of Profitability of Hospital Admissions on Mortality

April 1, 2013 | Journal Article

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

The Financial Benefit to Hospitals from State Expansion of Medicaid

March 19, 2013 | Issue Brief

This report looks at whether hospitals stand to gain more revenue under the ACA's Medicaid expansion compared with if no states expand Medicaid eligibility.

Report of the National Commission on Physician Payment Reform

March 4, 2013 | Issue Brief

The National Commission on Physician Payment Reform studies new ways to improve patient outcomes, while reining in costs.

Observational Intensity Bias Associated With Illness Adjustment

February 21, 2013 | Journal Article

Researchers raise significant questions about the risk adjustment that Medicare and others apply to insurance claims data.

Child FIRST Develops an Evidence-Based Early Childhood Intervention

February 5, 2013 | Program Result Report

Child First is a home-based early childhood intervention that works with the most vulnerable very young children and their families to reduce serious emotional disturbance, developmental and learning problems, and abuse and neglect.

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.

Insurer's New Program Will Raise Reimbursements for Primary Care Providers

February 7, 2012 | Human Capital Blog Post

In late January, the nation’s second-largest health insurer announced a new initiative designed to improve care and reduce costs by raising reimbursements for primary care. WellPoint will provide additional revenue to primary care providers for “non ...

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.

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