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Transition To Diagnosis Related Group Drg Payments For Health
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Book Synopsis Transition to Diagnosis-Related Group (DRG) Payments for Health by : Caryn Bredenkamp
Download or read book Transition to Diagnosis-Related Group (DRG) Payments for Health written by Caryn Bredenkamp and published by World Bank Publications. This book was released on 2019-12-19 with total page 69 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
Book Synopsis EBOOK: Diagnosis-Related Groups in Europe: Moving towards transparency, efficiency and quality in hospitals by : Reinhard Busse
Download or read book EBOOK: Diagnosis-Related Groups in Europe: Moving towards transparency, efficiency and quality in hospitals written by Reinhard Busse and published by McGraw-Hill Education (UK). This book was released on 2011-11-16 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector
Book Synopsis Diagnosis Related Groups (DRGs) and the Medicare Program by :
Download or read book Diagnosis Related Groups (DRGs) and the Medicare Program written by and published by . This book was released on 1983 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book DRGs written by Robert B. Fetter and published by . This book was released on 1991 with total page 384 pages. Available in PDF, EPUB and Kindle. Book excerpt: The DRG Patient classification system. Use of DRGs for managing hospital resources. The product-line management model. Cost accounting and budgeting. Nursing resources. Use of DRGs for financing patient care. Structure of a DRG-based prospective payment system. Using DRGs for international comparisons. DRG analogues for ambulatory care and long-term care
Author :The World Bank;World Health Organization Publisher :World Bank Publications ISBN 13 :146481323X Total Pages :410 pages Book Rating :4.4/5 (648 download)
Book Synopsis Healthy China: Deepening Health Reform in China by : The World Bank;World Health Organization
Download or read book Healthy China: Deepening Health Reform in China written by The World Bank;World Health Organization and published by World Bank Publications. This book was released on 2019-04-04 with total page 410 pages. Available in PDF, EPUB and Kindle. Book excerpt: The report recommends that China maintain the goal and direction of its healthcare reform, and continue the shift from its current hospital-centric model that rewards volume and sales, to one that is centered on primary care, focused on improving the quality of basic health services, and delivers high-quality, cost-effective health services. With 20 commissioned background studies, more than 30 case studies, visits to 21 provinces in China, the report proposes practical, concrete steps toward a value-based integrated service model of healthcare financing and delivery, including: 1) Creating a new model of people-centered quality integrated health care that strengthens primary care as the core of the health system. This new care model is organized around the health needs of individuals and families and is integrated with higher level care and social services. 2) Continuously improve health care quality, establish an effective coordination mechanism, and actively engage all stakeholders and professional bodies to oversee improvements in quality and performance. 3) Empowering patients with knowledge and understanding of health services, so that there is more trust in the system and patients are actively engaged in their healthcare decisions. 4) Reforming public hospitals, so that they focus on complicated cases and delegate routine care to primary-care providers. 5) Changing incentives for providers, so they are rewarded for good patient health outcomes instead of the number of medical procedures used or drugs sold. 6) Boosting the status of the health workforce, especially primary-care providers, so they are better paid and supported to ensure a competent health workforce aligned with the new delivery system. 7) Allowing qualified private health providers to deliver cost-effective services and compete on a level playing field with the public sector, with the right regulatory oversight, and 8) Prioritizing public investments according to the burden of disease, where people live, and the kind of care people need on a daily basis.
Book Synopsis Diagnosis Related Groups (DRGs) and the medicare program : implications for medical technology. by :
Download or read book Diagnosis Related Groups (DRGs) and the medicare program : implications for medical technology. written by and published by DIANE Publishing. This book was released on 1983 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Healthcare Imperative by : Institute of Medicine
Download or read book The Healthcare Imperative written by Institute of Medicine and published by National Academies Press. This book was released on 2011-01-17 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
Book Synopsis Case-based Payment Systems for Hospital Funding in Asia An Investigation of Current Status and Future Directions by : OECD
Download or read book Case-based Payment Systems for Hospital Funding in Asia An Investigation of Current Status and Future Directions written by OECD and published by OECD Publishing. This book was released on 2015-11-02 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: The report focuses on a review of the implementation experience of case-based and DRG mechanisms in the Asia and Pacific region, drawing particularly on research in Australia, Japan, New Zealand, the Republic of Korea, Singapore and Thailand.
Book Synopsis Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). by :
Download or read book Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). written by and published by . This book was released on 1986 with total page 450 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Price Setting and Price Regulation in Health Care by : OECD
Download or read book Price Setting and Price Regulation in Health Care written by OECD and published by OECD Publishing. This book was released on 2019-06-26 with total page 298 pages. Available in PDF, EPUB and Kindle. Book excerpt: The objectives of this study are to describe experiences in price setting and how pricing has been used to attain better coverage, quality, financial protection, and health outcomes. It builds on newly commissioned case studies and lessons learned in calculating prices, negotiating with providers, and monitoring changes. Recognising that no single model is applicable to all settings, the study aimed to generate best practices and identify areas for future research, particularly in low- and middle-income settings. The report and the case studies were jointly developed by the OECD and the WHO Centre for Health Development in Kobe (Japan).
Book Synopsis Crossing the Quality Chasm by : Institute of Medicine
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-08-19 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Book Synopsis The Health Workforce in Ethiopia by : Berhanu Feysia
Download or read book The Health Workforce in Ethiopia written by Berhanu Feysia and published by World Bank Publications. This book was released on 2012-01-12 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although Ethiopia has made steady progress in health outcomes over the past 10 years, some health challenges remain, particularly those related to maternal health. In part this may be linked to the insufficient number of health professionals providing maternal care services, particularly in the rural parts of the country.
Book Synopsis Changing Health Care Systems and Rheumatic Disease by : Institute of Medicine
Download or read book Changing Health Care Systems and Rheumatic Disease written by Institute of Medicine and published by National Academies Press. This book was released on 1997-02-09 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt: Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions: Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions? If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes? If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships? If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?
Book Synopsis New Inpatient Hospital Payment Methodology by :
Download or read book New Inpatient Hospital Payment Methodology written by and published by . This book was released on 2013 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Pay for Performance in Health Care by : Jerry Cromwell
Download or read book Pay for Performance in Health Care written by Jerry Cromwell and published by RTI Press. This book was released on 2011-02-28 with total page 388 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.
Book Synopsis Report and Recommendations to the Secretary, U.S. Department of Health and Human Services by : United States. Prospective Payment Assessment Commission
Download or read book Report and Recommendations to the Secretary, U.S. Department of Health and Human Services written by United States. Prospective Payment Assessment Commission and published by . This book was released on 1984 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients by : Rand Corporation
Download or read book The Effects of the DRG-based Prospective Payment System on Quality of Care for Hospitalized Medicare Patients written by Rand Corporation and published by . This book was released on 1991 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: To control rising health care costs, the federal government, in 1983, established a prospective payment system (PPS) to reimburse hospitals for inhospital care of Medicare patients. PPS changed the way Medicare reimbursed hospitals from a cost or charge basis to a prospectively determined fixed-price system in which hospitals are paid according to the diagnosis-related group (DRG) into which a patient is classified. This report constitutes the executive summary of an evaluation of the impact of the DRG-based PPS system. Six conditions were selected for the evaluation: congestive heart failure, acute myocardial infarction, hip fracture, pneumonia, cerebrovascular accident, and depression. The authors used both explicit and implicit measures to assess quality of care. Two key policy conclusions emerge from the findings: (1) at least through the middle of 1986, PPS did not interrupt a long-term trend toward better hospital care; and (2) PPS has had a detrimental effect on patients' stability at discharge. The authors recommend that physicians, hospitals, and professional review organizations undertake a more systematic assessment of a patient's readiness to leave the hospital, and that clinically detailed data on sickness at admission, processes, discharge status, and outcomes continue to be collected regularly as long as PPS is in place.
