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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.

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.

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.

Coverage When it Counts

May 1, 2009 | Report

This report suggests a new method for developing benchmarks to illustrate some types and costs of medical care consumers might need under a variety of scenarios, and for evaluating health insurance protection using these benchmarks.

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.

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.

Reducing Payment for Imaging in Referring Doctor's Facility Does Not Reduce Utilization

August 31, 1998 | Program Result Report

From 1994 to 1996, researcher teams at the University of Virginia and the Primary Care Outcomes Research Institute (PCORI) at the New England Medical Center conducted two distinct but parallel studies.

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