Medicare provider payment from

However, differences between the care provided to patients in the trial and that provided to patients in this group may be due as much to secular trends in the provision of medical care as they are to the adoption of a study protocol. For example, length of stay in the United States has decreased since the early 1980s, due in part to the implementation of the Medicare Prospective Payment System. Thus, historical cohorts from earlier periods may have had longer lengths of stay as inpatients than is currently seen in clinical practice. These data may suggest a protocol-induced decrease in length of stay when one actually does not exist. 

In practice, there are other exclusions from Medicare coverage, particularly for drugs administered as part of a clinical research protocol. Prior to 1983 Medicare paid hospitals for the individual services they provided to patients. Anecdotal evidence suggests that Medicare s payment for clinical research was common in that period (446),... 

Healthcare providers (physicians, hospitals, clinics, etc.) operate and are sustained by the reimbursement or payment for care they provide to patients. In the United States, revenue for healthcare services comes from a variety of sources including the patient, insurance companies (i.e., Blue-Cross/BlueShield, Cigna, Aetna), and the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA). The CMS provides healthcare insurance for Medicare and Medicaid beneficiaries. When interfacing with an insurance company or the CMS, there are three fundamental reimbursement concepts that must be considered to assure appropriate revenue for services provided. These include the concepts of coverage, coding, and payment. 

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