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All-payer Rate Setting
All-payer rate setting is a price setting mechanism in which all third parties pay the same price for services at a given hospital. It can be used to increase the market power of payers (such as private and/or public insurance companies) versus providers, such as hospital systems, in order to control costs. All-payer characteristics are found in most developed economies with multi-payer healthcare systems, including France, Germany, Japan, and the Netherlands. The U.S. state of Maryland also uses such a model. The All-payer rate setting have been proposed in the United States as a healthcare reform measure. The proposal for a public option (a voluntary, publicly sponsored insurance plan similar to Medicare) has been cited as indirectly sharing some of the same goals as all-payer rate-setting systems. Maryland Since the late 1970s, Maryland has operated an all-payer system for hospital services. An independent commission establishes the rate structure for each hospital. Tha ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Market Power
In economics, market power refers to the ability of a theory of the firm, firm to influence the price at which it sells a product or service by manipulating either the supply or demand of the product or service to increase economic profit. In other words, market power occurs if a firm does not face a perfectly elastic demand curve and can set its price (P) above marginal cost (MC) without losing revenue. This indicates that the magnitude of market power is associated with the gap between P and MC at a firm's profit maximising level of output. The size of the gap, which encapsulates the firm's level of market dominance, is determined by the residual demand curve's form. A steeper reverse demand indicates higher earnings and more dominance in the market. Such propensities contradict Perfect competition, perfectly competitive markets, where market participants have no market power, P = MC and firms earn zero economic profit. Market participants in perfectly competitive markets are cons ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Diagnosis-related Group
Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management, and John D. Thompson, MPH, of the Yale School of Public Health.Fetter RB, Shin Y, Freeman JL, Averill RF, Thompson JD (1980) Case mix definition by diagnosis related groups. Medical Care 18(2):1–53 The system is also referred to as "the DRGs", and its intent was to identify the "products" that a hospital provides. One example of a "product" is an appendectomy. The system was developed in anticipation of convincing Congress to use it for reimbursement, to replace "cost based" reimbursement that had been used up to that point. DRGs are assigned by a "grouper" program based on ICD (International Classification of Diseases) diagnoses, procedures, age, sex, discharge ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Single-payer Health Care
Single-payer healthcare is a type of universal healthcare, in which the costs of essential healthcare for all residents are covered by a single public system (hence "single-payer"). Single-payer systems may contract for healthcare services from private organizations (as is the case in Canada) or may own and employ healthcare resources and personnel (as is the case in the United Kingdom). "Single-payer" describes the mechanism by which healthcare is paid for by a single public authority, not a private authority, nor a mix of both. Description Within single-payer healthcare systems, a single government or government-related source pays for all covered healthcare services.Medical Subject Headings thesaurus, National Library of Medicin"Single-Payer System" Year introduced: 1996, (From Slee and Slee, Health Care Reform Terms, 1993, p. 106) Governments use this strategy to achieve several goals, including universal healthcare, decreased economic burden of health care, and improved hea ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fee-for-service
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health care quality is mixed, without conclusive proof that these programs either succeed or fail. Similarly, when patients are shielded from paying ( cost-sharing) by health insurance coverage, they are incentivized to welcome any medical service that might do some good. Fee-for-services raises costs, and discourages the efficiencies of integrated care. A variety of reform efforts have been attempted, recommended, or initiated to reduce its influence (such as moving towards bundled payments and capitation). In capitation, physicians are not incentivized to perform procedures, including necessary ones, because they are not paid anything extra for performing them. FFS i ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Capitation (healthcare)
Capitation is a payment arrangement for health care service providers. It pays a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care. The amount of remuneration is based on the average expected health care utilization of that patient, with payment for patients generally varying by age and health status. Types There are differing arrangements in different healthcare systems. Capitation in the USA Primary capitation is a relationship between a managed care organization and primary care physician, in which the physician is paid directly by the organization for those who have selected the physician as their provider. Secondary capitation is a relationship arranged by a managed care organization between a physician and a secondary or specialist provider, such as an X-ray facility or ancillary facility such as a durable medical equipment supplier whose secondary provider is also paid capitation based on that PCP's enrolled m ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Citizens Budget Commission
Citizenship is a membership and allegiance to a sovereign state. Though citizenship is often conflated with nationality in today's English-speaking world, international law does not usually use the term ''citizenship'' to refer to nationality; these two notions are conceptually different dimensions of collective membership. Generally citizenships have no expiration and allow persons to work, reside and vote in the polity, as well as identify with the polity, possibly acquiring a passport. Though through discriminatory laws, like disfranchisement and outright apartheid, citizens have been made second-class citizens. Historically, populations of states were mostly subjects, while citizenship was a particular status which originated in the rights of urban populations, like the rights of the male public of cities and republics, particularly ancient city-states, giving rise to a civitas and the social class of the burgher or bourgeoisie. Since then states have expanded the s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
New York State Archives
The New York State Archives is a unit of the Office of Cultural Education within the New York State Education Department, with its main facility located in the Cultural Education Center on Madison Avenue in Albany, New York, United States. The New York State Library and the New York State Museum are also located in the Cultural Education Center. Organization The New York State Archives was established in 1971 to preserve and make accessible recorded evidence documenting New York State's history, governments, events, and peoples from the 17th century to the present. Full operations began in 1978 when the organization's storage and research facility opened in the Cultural Education Center. Collections The Archives preserves and provides access to over 270 million documents dating from the period of Dutch and British colonial rule during the 17th and 18th centuries through the modern day. The State Archives preserves records from the legislative, judicial, and executive branch ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
191st New York State Legislature
The 191st New York State Legislature, consisting of the New York State Senate and the New York State Assembly, met from January 4, 1995, to December 31, 1996, during the first and second years of George Pataki's governorship, in Albany. Background Under the provisions of the New York Constitution of 1938 and the U.S. Supreme Court decision to follow the One man, one vote rule, re-apportioned in 1992 by the Legislature, 61 Senators and 150 assemblymen were elected in single-seat districts for two-year terms. Senate and Assembly districts consisted of approximately the same number of inhabitants, the area being apportioned contiguously without restrictions regarding county boundaries. At this time there were two major political parties: the Republican Party and the Democratic Party. The Conservative Party, the Independence Party, the Liberal Party, the Right to Life Party, the Tax Cut Now Party, the Libertarian Party and the Socialist Workers Party also nominated tick ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Charity Care
In the United States, charity care is health care provided for free or at reduced prices to low income patients. The percentage of doctors providing charity care dropped from 76% in 1996–97 to 68% in 2004–2005. Potential reasons for the decline include changes in physician practice patterns and increasing financial pressures. In 2006, Senate investigators found that many hospitals did not inform patients that charity care was available. Some for-profit hospitals provided as much charity care as some non-profit hospitals. Investigators also found non-profit hospitals charging poor, uninsured patients more than they did patients with health insurance. Hospitals must provide some charity care if they wish to maintain non-profit status. One estimate put the cost of uncompensated care for 2004 at $41 billion, of which $34.6 billion was funded through a patchwork of government programs. Over half of all government reimbursement for uncompensated care comes from the federal gov ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Graduate Medical Education
Graduate medical education (GME) refers to any type of formal medical education, usually hospital-sponsored or hospital-based training, pursued after receipt of the M.D. or D.O. degree in the United States This education includes internship, residency, subspecialty and fellowship programs, and leads to state licensure and board certification. Graduate medical education is part of what's known as the continuum of medical education, following undergraduate medical education (UME)—the training that leads to the M.D. or D.O. degree—and preceding continuing medical education Continuing medical education (CME) is continuing education (CE) that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications ... (CME). Teaching approaches The medical curriculum aims to train graduates to be versatile physicians capable of preventive, promotive, curative, and reha ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Care Reform Act
Health has a variety of definitions, which have been used for different purposes over time. In general, it refers to physical and emotional well-being, especially that associated with normal functioning of the human body, absent of disease, pain (including mental pain), or injury. Health can be promoted by encouraging healthful activities, such as regular physical exercise and adequate sleep, and by reducing or avoiding unhealthful activities or situations, such as smoking or excessive Stress (biology), stress. Some factors affecting health are due to Agency (sociology), individual choices, such as whether to engage in a high-risk behavior, while others are due to Social structure, structural causes, such as whether the society is arranged in a way that makes it easier or harder for people to get necessary healthcare services. Still, other factors are beyond both individual and group choices, such as genetic disorders. History The meaning of health has evolved over time. In k ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
New York State Library
The New York State Library is a research library in Albany, New York, United States. It was established in 1818 to serve the state government of New York and is part of the New York State Education Department. The library is one of the largest in the world by number of items held, with over 20 million cataloged items in 2011. The library and its sister institutions, the New York State Museum and New York State Archives, are housed in the Cultural Education Center, which is part of the Empire State Plaza, a large complex of state government offices in downtown Albany. The New York State Library was formerly located in the New York State Capitol and then across Washington Avenue in the New York State Education Building. An annex containing books, journals, and newspapers is still located in the basement of the Education Building. The library undertook an effort to discard some of these items in 2014. Organization Research Library History The New York State Library was ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
