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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.

The Impact of Profitability of Hospital Admissions on Mortality

April 1, 2013 | Journal Article

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

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.

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 ...

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.

PROMETHEUS Payment Reform Quarterly Newsletter, Issue 6

June 21, 2010 | Book

The sixth issue of the PROMETHEUS Payment® project’s newsletter provides brief updates on the program’s latest work to lead a revolution in health care payment and the way providers and insurers conduct business.

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.

PROMETHEUS Payment Reform Quarterly Newsletter, Issue 5

December 27, 2009 | Book

The fifth issue of the PROMETHEUS Payment project's quarterly newsletter provides updates on the program's work to ignite a transformation in health care payment and the way providers and insurers conduct business.

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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