Payment systems

Physician payment system (even salaries can be translated into incentives if their level is adjusted according to criteria such as induced expenses, patient satisfaction and quality of care)... 

Cartelier, J. (1996) Payment systems and dynamics in a monetary economy , in... 

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. 

Expertise - in payment systems, planning systems, new technology, or whatever it is that the project concerns. 

Hospital-Based Outpatient Clinics The Outpatient Prospective Payment System (OPPS) is the method for compensation for hospital-based outpatient facilities (DHHS, 2000a). With this system, there is a professional component (e.g., for physician providers) and a technical component (e.g., for nonphysician health care professionals) to billing that describes the various contributions of the health care team during the specific patient encounter. Ambulatory Payment Classification (APC) codes are used within this system to describe the type and complexity of the patient visit to the insurance company. When pharmacists provide services within a hospital-based clinic, the compensation for the service goes to the hospital facility instead of directly to the provider. The revenue generated should be able to be tracked internally as to which department or health care professional was involved in the care of the patient (Snella and Sachdev,... 

Department of Health and Human Services (DHHS), Office of the Inspector General. 2000a. Medicare program, prospective payment system for hospital outpatient services. Fed Reg 65 18433 available at www.gpoaccess. gov/fr/. 

In 1992, the federal government adopted the resource-based relative value scale (RBRVS) method as the Medicare physician payment system. The RBRVS represents a ranking of services according to fhe relative costs of the resources required to provide the services. The system has three components (1) the relative work involved in providing the service, (2) practice expenses, and (3) liability insurance costs. The system also permits the use of modifying factors, such as geographic differences and annual increases. A pharmaceutical care RBRVS system was developed as part of fhe Minnesota Pharmaceutical Care Project. 

Creation of U.S. Medicare and Medicaid Programs Medicare Stimulated the growth of hospital pharmacy positions Medicaid Created demand for millions of prescriptions Created administrative issues Created prepaid third-party prescription payment systems... 

Centers for Medicare Medicaid Services. Hospital outpatient prospective payment system. August 2000. http //cms.hhs.gov/regulations/hopps, accessed March 13, 2003. 

In addition to use of multitiered co-payment systems to control costs, MCOs are frequently using generic incentives and mail-order delivery systems. Typical generic incentives are financially based, either being the lowest tier in a tiered system or having coupons offered to cover the co-payment for a one-month utilization. Audit reports have demonstrated that a mere 1 % increase in generic utilization... 

Last, there has been an expansion of cardiology clinical pharmacy into ambulatory settings. Due in part to prospective and fixed payment systems and the growing sophistication of pharmacists in therapeutic decision mak-... 

BuPf89 Holger Biirk, Andreas Pfitzmann Digital Payment Systems Enabling Security and Unobservability Computers Security 8/5 (1989) 399-416. 

Damg90 Ivan Bjerre Damgard Payment Systems and Credential Mechanisms with Provable Security Against Abuse by Individuals Crypto 88, LNCS 403, Springer-Verlag, Berlin 1990, 328-335. 

PfWa92a Birgit Pfitzmann, Michael Waidner How to Break and Repair a Provably Secure Untraceable Payment System Crypto 91, LNCS 576, Springer-Verlag, Berlin 1992, 338-350. 

Medicare Hospital Outpatient Services Prospective Payment System (2001). Centers for Medicare and Medicaid Services proposed rules. Fed Regist 66 44671... 

Prospective Payment Assessment Commission (ProPAC) a federal commission established under the Social Security Act amendments of 1983 to advise and assist Congress and the Department of Health and Human Services in maintaining and updating the Medicare prospective payment system. 

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