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Usual, Customary And Reasonable
Usual, customary, and reasonable (UCR) is an American method of generating health care prices, described as "more or less whatever doctors decided to charge". According to Steven Schroeder, Wilbur Cohen inserted UCR into the Social Security Act of 1965 "in an unsuccessful attempt to placate the American Medical Association". Health insurers determine what they deem to be "usual, customary and reasonable" and pay only a percentage of that. Under an early version of this system based on Resource-Based Relative Value Units, physician services were largely considered to be misvalued, with evaluation and management services being undervalued and procedures overvalued. Third-party payers (public and private health insurance) advocated for an improved model instead of the UCR fees that led to "some egregious distortions". In the mid-1980s, U.S. health care "payments for doing procedures had far outstripped payments for diagnosis". For example, "doctors who spent an hour making a complex ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Care Prices
Health care prices in the United States, United States of America describes market and non-market factors that determine pricing, along with possible causes as to why prices are higher than other countries. Compared to other OECD countries, U.S. healthcare costs are one-third higher or more relative to the size of the economy (GDP). According to the Centers for Disease Control and Prevention, CDC, during 2015 health expenditures per-person were nearly $10,000 on average, with total expenditures of $3.2 trillion or 17.8% Gross domestic product, GDP. Proximate reasons for the differences with other countries include: higher prices for the same services (i.e., higher price per unit) and greater use of healthcare (i.e., more units consumed). Higher administrative costs, higher per-capita income, and less government intervention to drive down prices are deeper causes. While the annual inflation rate in healthcare costs has declined in recent decades; it still remains above the rate of ec ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Aff (Millwood)
''Health Affairs'' is a monthly peer-reviewed healthcare journal established in 1981 by John K. Iglehart; since 2014, the editor-in-chief is Alan Weil. It was described by ''The Washington Post'' as "the bible of health policy". Abstracting and indexing The journal is indexed and abstracted in PubMed/MEDLINE, EBSCO databases, ProQuest databases, LexisNexis, Current Contents/Health Sciences and Behavioral Sciences, and SwetsWise Online Content. Narrative Matters ''Narrative Matters'' is a personal-essay section. It was established in 1999 with Fitzhugh Mullan (George Washington University) as its original editor. During its history, ''Narrative Matters'' has published over 160 policy narratives on a wide range of topics by well-known writers including Julia Alvarez, Alexander McCall Smith, and Abraham Verghese, by distinguished medical professionals and academics, as well as by patients. In 2006, the Johns Hopkins University Press The Johns Hopkins University Press (also ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Steven A
Stephen or Steven is a common English first name. It is particularly significant to Christians, as it belonged to Saint Stephen ( grc-gre, Στέφανος ), an early disciple and deacon who, according to the Book of Acts, was stoned to death; he is widely regarded as the first martyr (or "protomartyr") of the Christian Church. In English, Stephen is most commonly pronounced as ' (). The name, in both the forms Stephen and Steven, is often shortened to Steve or Stevie. The spelling as Stephen can also be pronounced which is from the Greek original version, Stephanos. In English, the female version of the name is Stephanie. Many surnames are derived from the first name, including Stephens, Stevens, Stephenson, and Stevenson, all of which mean "Stephen's (son)". In modern times the name has sometimes been given with intentionally non-standard spelling, such as Stevan or Stevon. A common variant of the name used in English is Stephan ; related names that have found some curr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Wilbur Cohen
Wilbur Joseph Cohen (June 10, 1913 – May 17, 1987) was an American social scientist and civil servant. He was one of the key architects in the creation and expansion of the American welfare state and was involved in the creation of both the New Deal and Great Society programs. Early life and career Cohen was born in Milwaukee, Wisconsin, to Bessie (''née'' Rubenstein) and Aaron Cohen. He was known to by several nicknames. He was once dubbed "The Man Who Built Medicare" and John F. Kennedy tagged him "Mr. Social Security", although it was Frances Perkins, the first woman Secretary of Labor (under FDR), who was the architect of social security. ''The New York Times'' called him "one of the country's foremost technicians in public welfare." ''Time'' portrayed him as a man of "boundless energy, infectious enthusiasm, and a drive for action." He was a leading expert on Social Security and a member of Americans for Democratic Action. After graduating from the University of Wisco ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Social Security Act Of 1965
The Social Security Amendments of 1965, , was legislation in the United States whose most important provisions resulted in creation of two programs: Medicare and Medicaid. The legislation initially provided federal health insurance for the elderly (over 65) and for financially challenged families. History Many politicians were involved in drafting the final bill that was introduced to the United States Congress in March 1965. On July 30, 1965 President Lyndon B. Johnson signed the bill into law. The concept of national health insurance began in the early 20th century in the United States and then came to prominence during the Truman administration following World War II. Between 1958 and 1964, controversy grew and a bill was drafted. The signing of the act, as part of Johnson's Great Society, began an era with a greater emphasis on public health issues. Medicare and Medicaid became the country's first public health insurance programs. The legislation was vigorously opposed by ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
American Medical Association
The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's stated mission is "to promote the art and science of medicine and the betterment of public health." The Association also publishes the ''Journal of the American Medical Association'' (JAMA). The AMA also publishes a list of Physician Specialty Codes which are the standard method in the U.S. for identifying physician and practice specialties. The American Medical Association is governed by a House of Delegates as well as a board of trustees in addition to executive management. The organization maintains the AMA Code of Medical Ethics, and the AMA Physician Masterfile containing data on United States Physicians. The ''Current Procedural Terminology'' coding system was first published in 1966 and is maintained by the Association. It has also publi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Archives Of Internal Medicine
''JAMA Internal Medicine'' is a monthly peer-reviewed medical journal published by the American Medical Association. It was established in 1908 as the ''Archives of Internal Medicine'' and obtained its current title in 2013. It covers all aspects of internal medicine, including cardiovascular disease, geriatrics, infectious disease, gastroenterology, endocrinology, allergy, and immunology. The editor in chief is Rita F. Redberg (University of California, San Francisco). According to ''Journal Citation Reports'', the journal's 2021 impact factor is 44.409, ranking it 7th out of 172 journals in the category "Medicine, General & Internal". Naming history Abstracting and indexing The journal is abstracted and indexed in Index Medicus/MEDLINE/PubMed. See also * List of American Medical Association journals A ''list'' is any set of items in a row. List or lists may also refer to: People * List (surname) Organizations * List College, an undergraduate division of the Jew ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Resource-based Relative Value Scale
Resource-based relative value scale (RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs). RBRVS assigns procedures performed by a physician or other medical provider a '' relative value'' which is adjusted by geographic region (so a procedure performed in Manhattan is '' worth'' more than a procedure performed in Dallas). This value is then multiplied by a fixed ''conversion factor,'' which changes annually, to determine the amount of payment. RBRVS determines prices based on three separate factors: physician work (54%), practice expense (41%), and malpractice expense (5%).''Medicare physician fees geographic adjustment indices are valid in design, but data and methods need refinement.'' Washington, DC: Government Accountability Office, March 2005. (Publication no. GAO-05-119.) The procedure codes and their associated RVUs are made publ ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare Payment Advisory Commission
The Medicare Payment Advisory Commission (MedPAC) is an independent, non-partisan legislative branch agency headquartered in Washington, D.C. MedPAC was established by the Balanced Budget Act of 1997 (P.L. 105–33). The BBA formed MedPAC by merging two predecessor commissions, the Prospective Payment Assessment Commission (ProPAC), established in 1983, and the Physician Payment Review Commission (PPRC), which formed in 1985. The commission's 17 members bring diverse expertise in the financing and delivery of health care services. Commissioners are appointed to three-year terms (subject to renewal) by the Comptroller General of the United States and serve part-time. Its primary role is to advise the US Congress on issues affecting the administration of the Medicare program. Specifically the commission's mandate is to advise the US Congress on payments to private health plans participating in Medicare and health providers serving Medicare beneficiaries. MedPAC is also relied on b ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Prescription Costs
Medication costs, also known as drug costs are a common health care cost for many people and health care systems. Prescription costs are the costs to the end consumer. Medication costs are influenced by multiple factors such as patents, stakeholder influence, and marketing expenses. A number of countries including Canada, parts of Europe, and Brasil use external reference pricing External reference pricing (ERP), also known as international reference pricing, is the practice of regulating the price of a medication in one country, by comparing with the price in a "basket" of other reference countries. It contrasts with ''i ... as a means to compare drug prices and to determine a base price for a particular medication. Other countries use pharmacoeconomics, which looks at the cost/benefit of a product in terms of quality of life, alternative treatments (drug and non-drug), and cost reduction or avoidance in other parts of the health care system (for example, a drug may reduce the ne ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Government Accountability Office
The U.S. Government Accountability Office (GAO) is a legislative branch government agency that provides auditing, evaluative, and investigative services for the United States Congress. It is the supreme audit institution of the federal government of the United States. It identifies its core "mission values" as: accountability, integrity, and reliability. It is also known as the "congressional watchdog". Powers of GAO The work of the GAO is done at the request of congressional committees or subcommittees or is mandated by public laws or committee reports. It also undertakes research under the authority of the Comptroller General. It supports congressional oversight by: * auditing agency operations to determine whether federal funds are being spent efficiently and effectively; * investigating allegations of illegal and improper activities; * reporting on how well government programs and policies are meeting their objectives; * performing policy analyses and outlining options for ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
American Dental Association
The American Dental Association (ADA) is an American professional association established in 1859 which has more than 161,000 members. Based in the American Dental Association Building in the Near North Side of Chicago, the ADA is the world's largest and oldest national dental association and promotes good oral health to the public while representing the dental profession. The ADA publishes a monthly journal of dental related articles named the ''Journal of the American Dental Association''. Overview The American Dental Association was founded August 3, 1859, at Niagara Falls, New York,American Dental Association . ''Baltimore Sun''. August 9, 1859. p. 4. by twenty-six dentists who represented various dental societies in the United States. Today, the ADA has more than 152,000 members, 55 constituent (state-territor ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
