Rural policy brief最新文献_第8页

Medicare physician payments: impacts of changes on rural physicians. 医疗保险医师支付:变化对农村医师的影响。

Rural policy brief Pub Date : 2006-09-01

Keith J Mueller, A Clinton MacKinney, Timothy D McBride

{"title":"Medicare physician payments: impacts of changes on rural physicians.","authors":"Keith J Mueller, A Clinton MacKinney, Timothy D McBride","doi":"","DOIUrl":"","url":null,"abstract":"Medicare payment disproportionately impacts rural physicians compared to urban. For example, 51% of rural physicians, compared to 44% of urban physicians, receive at least 38% of their payments from Medicare.1 Thus, the Medicare physician payment system is of significant rural interest. In this policy brief, we present the effects of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 on physician payment rates in rural areas. Specifically, we examine the impact of creating a floor of 1.00 in the geographic practice cost index (GPCI) for work expense. We also show the effects of the Medicare incentive payment (MIP) for providing services in shortage areas and of the bonus for practicing in a physician scarcity area. Our principal findings are the following: (1) Increases to the GPCI for work expense accounted for a substantial percentage of the two-year increases in total payment to physicians in rural payment areas. (2) Increases in the conversion factor (CF) (base payment) accounted for most of the increases in total payment in all but 6 of the 89 Medicare payment localities; in those 6 areas, the dominant factor was GPCI adjustment. (3) Bonus payments are a more direct means of targeting increased payments to physicians in specific areas than is a general increase in one part of the payment formula.","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":"11 2 (PB2006-2)","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26318147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic disease management systems registries in rural health care. 农村卫生保健中的慢性病管理系统登记。

Rural policy brief Pub Date : 2006-05-01

Anne Skinner, Roslyn Fraser-Maginn, Keith J Mueller

{"title":"Chronic disease management systems registries in rural health care.","authors":"Anne Skinner, Roslyn Fraser-Maginn, Keith J Mueller","doi":"","DOIUrl":"","url":null,"abstract":"Unlabelled: Health care quality is being addressed from a variety of policy perspectives. The 2001 Institute of Medicine report, Crossing the Quality Chasm, calls for sweeping action involving a five-part strategy for change in the U.S. health care system. This agenda for change includes use of evidence-based approaches to address common conditions, the majority of which are chronic. A Chronic Disease Management System (CDMS), or registry, is a tool that helps providers efficiently collect and analyze patient information to promote quality care for the rural population. CDMSs can provide a technological entry point for the impending use of Electronic Medical Records. A CDMS is a patient-centered electronic database tool that helps providers diagnose, treat, and manage chronic diseases. The purpose of this brief is to discuss the different types of CDMSs used by a sample of 14 state organizations and 19 local rural clinics in Maine, Nebraska, New Mexico, South Carolina, Washington, and Wisconsin. As part of a larger study examining the challenges and innovations in implementing disease management programs in rural areas, we conducted interviews with national, state, and local contacts. During interviews, respondents helped us understand the usefulness and functionalities of commonly used CDMSs in rural facilities. Our focus was on the use of CDMSs in the management of diabetes, a disease prevalent in rural populations.Key findings: (1) CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology. (2) Use of a standardized system in a collaborative helps provide data comparisons and share costs involved with technical assistance services across the group.","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":"11 1 (PB2006-1)","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2006-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26038591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medicare Part D: early findings on enrollment and choices for rural beneficiaries. 医疗保险D部分:关于农村受益人登记和选择的早期发现。

Rural policy brief Pub Date : 2006-04-01

Timothy D McBride, Tanchica L Terry, Keith J Mueller

{"title":"Medicare Part D: early findings on enrollment and choices for rural beneficiaries.","authors":"Timothy D McBride, Tanchica L Terry, Keith J Mueller","doi":"","DOIUrl":"","url":null,"abstract":"On January 1, 2006, the Medicare program began offering prescription drug coverage (Medicare Part D) to over 42 million Medicare beneficiaries. This policy brief provides a first snapshot of enrollment in rural and urban areas across the United States and outlines the early findings from an analysis of plans available to rural persons under Medicare's Part D program. The data in this brief will be updated as new data are available from the Centers for Medicare and Medicaid Services (CMS). Key Findings As of March 18, 2006 (date of release by CMS), (1) 59% of rural beneficiaries and 67% of urban beneficiaries have creditable drug coverage. (2) 21% of rural beneficiaries were enrolled in stand-alone prescription drug plans (PDPs), compared to 13% of urban beneficiaries. (3) 3% of rural beneficiaries were enrolled in Medicare Advantage prescription drug (MA-PD) plans, compared to 16% of urban beneficiaries. (4) In non-adjacent rural areas, 22% of rural beneficiaries were enrolled in stand-alone PDPs, and 2% were enrolled in MA-PD plans. (5) All beneficiaries, including those in rural areas, can choose a PDP option that covers 91% of the top 100 formulary drugs. (6) Average monthly premiums and other plan characteristics for MA-PD plans vary significantly across states-for example (excluding Maine), 2 premiums vary from $6 in urban New Hampshire to $53 in rural Hawaii.","PeriodicalId":38994,"journal":{"name":"Rural policy brief","volume":"10 8 (PB2006-8)","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2006-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26011329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of welfare reform on health insurance coverage in rural areas. 福利改革对农村地区医疗保险覆盖面的影响。

Rural policy brief Pub Date : 2005-12-01

Timothy D McBride, Courtney Andrews

引用次数: 0

Contracting with Medicare Advantage plans: a brief for critical access hospital administrators. 与医疗保险优势计划签约:关键通道医院管理人员简介。

Rural policy brief Pub Date : 2005-12-01

Michelle Mason, Roslyn Fraser-Maginn, Keith Mueller, Jennifer King, Andrea Radford, Rebecca Slifkin, Jennifer Lenardson, Lauren Silver, Curt Mueller

引用次数: 0

Assessing the financial effect of Medicare payment on rural hospitals: does the source of data change the results? 评估医疗保险支付对农村医院的财务影响:数据来源会改变结果吗?

Rural policy brief Pub Date : 2005-11-01

Li-Wu Chen, Susan Puumala, Keith J Mueller, Liyan Xu, Kathy Minikus, Catherine Makhanu