Journal of Health Care Finance最新文献

Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization. 初级保健实践转型的成本：加入责任医疗组织。

Journal of Health Care Finance Pub Date : 2018-01-01

Richard Hofler, Judith Ortiz, Brian Coté

{"title":"Cost of Practice Transformation in Primary Care: Joining an Accountable Care Organization.","authors":"Richard Hofler, Judith Ortiz, Brian Coté","doi":"","DOIUrl":"","url":null,"abstract":"The purpose of this study is to examine the costs related to practice transformation from the perspective of primary care organizations transitioning to become participants in Accountable Care Organizations (ACOs). We pose two research questions: 1) Will a Rural Health Clinic that participates in an Accountable Care Organization see higher or lower cost per visit, and 2) If the cost per visit is higher or lower, how large will that difference be? We analyze administrative data from a panel of over 800 Rural Health Clinics for the period 2007 - 2013 using a treatment effects approach, where a clinic's participation in an ACO is viewed as a \"treatment.\" Since the first year that an RHC could join an ACO was 2012 and our most recent year of complete data is 2013, we restricted our analysis of the impact of participation in an ACO to include only 2012 and 2013 data. The estimates of the average treatment effect on the treated (ATET) pertain to only those RHCs that joined ACOs. The results show that those 20 sample ACO RHCs experienced an average from $15.00 to $18.61 higher cost per visit than the matching non-ACO RHCs. At this very early stage of ACO development, our results must be considered very preliminary at best. Whatever conclusions we draw from these results are intended to merely suggest what might be found once many more RHCs join ACOs. The conclusions we draw from this early analysis can lay a foundation for more analysis after data are available when more RHCs join ACOs.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"44 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407893/pdf/nihms-983776.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37041133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Equity Issuance of Health Care Firms after the 2007 Market Crash and the 2010 Affordable Care Act 2007年市场崩溃和2010年《平价医疗法案》后医疗保健公司的股权发行

Journal of Health Care Finance Pub Date : 2017-07-17 DOI: 10.5465/AMBPP.2017.14327abstract

James C. Brau, J. Carpenter

引用次数: 3

Value of Physician Performance in Diabetes System of Care Among the Elderly Medicare Patients: Implications for Pay-for-Performance 老年医疗保险患者糖尿病护理系统中医师绩效的价值:绩效报酬的含义

Journal of Health Care Finance Pub Date : 2017-04-24 DOI: 10.17294/2330-0698.1483

D. Maeng, G. Rohrer, Msph James M. Pitcavage, Do John B. Bulger

{"title":"Value of Physician Performance in Diabetes System of Care Among the Elderly Medicare Patients: Implications for Pay-for-Performance","authors":"D. Maeng, G. Rohrer, Msph James M. Pitcavage, Do John B. Bulger","doi":"10.17294/2330-0698.1483","DOIUrl":"https://doi.org/10.17294/2330-0698.1483","url":null,"abstract":"While pay-for-performance (P4P) is an appealing method of influencing physician behavior, the direct impact of P4P on quality performance and return on investment remains unknown. This study seeks to quantify in dollar terms the value of incremental improvements in Geisinger’s Diabetes System of Care (DSC) – i.e., an all-or-none “bundle” of nine diabetes-related performance measures – among Medicare Advantage members attributable to individual primary care physicians (PCPs). The results indicate that a one-percentage point improvement in the percent of a PCP’s patients with diabetes that met all the DSC elements in a given year – i.e., DSC bundle score – was associated with approximately $4 per-member-per-month (in 2006 dollars) reduction in total medical cost incurred in the same year. This was driven mainly by reductions in inpatient cost. Moreover, there is variation in how much each DSC element contributes to the cost reduction. Among the nine elements, urine protein testing and blood pressure measurements were most consistently associated with lower total medical costs. These findings suggest the DSC may be useful in establishing a feasible P4P scheme that incentivizes PCPs to improve diabetes care quality.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45111065","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

Assessing the cost burden of United States FDA-mandated post-approval studies for medical devices. 评估美国fda规定的医疗器械批准后研究的成本负担。

Journal of Health Care Finance Pub Date : 2016-01-01

Neil J Wimmer, Susan Robbins, Henry Ssemaganda, Erin Yang, Sharon-Lise Normand, Michael E Matheny, Naomi Herz, Josh Rising, Frederic S Resnic

{"title":"Assessing the cost burden of United States FDA-mandated post-approval studies for medical devices.","authors":"Neil J Wimmer, Susan Robbins, Henry Ssemaganda, Erin Yang, Sharon-Lise Normand, Michael E Matheny, Naomi Herz, Josh Rising, Frederic S Resnic","doi":"","DOIUrl":"","url":null,"abstract":"Approved medical devices frequently undergo FDA mandated post-approval studies (PAS). However, there is uncertainty as to the value of PAS in assessing the safety of medical devices and the cost of these studies to the healthcare system is unknown. Since PAS costs are funded through device manufacturers who do not share the costs with regulators, we sought to estimate the total PAS costs through interviews with a panel of experts in medical device clinical trial design in order to design a general cost model for PAS which was then applied to the FDA PAS. A total of 277 PAS were initiated between 3/1/05 through 6/30/13 and demonstrated a median cost of $2.16 million per study and an overall cost of $1.22 billion over the 8.25 years of study. While these costs are funded through manufacturers, the ultimate cost is borne by the healthcare system through the medical device costs. Given concerns regarding the informational value of PAS, the resources used to support mandated PAS may be better allocated to other approaches to assure safety.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"2016 Spec Features","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340422/pdf/nihms-793039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34800513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Growing Importance of Cost Accounting for Hospitals. 医院成本核算的重要性与日俱增。

Journal of Health Care Finance Pub Date : 2016-01-01

Nathan Carroll, Justin C Lord

{"title":"The Growing Importance of Cost Accounting for Hospitals.","authors":"Nathan Carroll, Justin C Lord","doi":"","DOIUrl":"","url":null,"abstract":"Management scholars have identified several cost accounting methods that provide organizations with accurate estimates of the costs they incur in producing output. However, little is known about which of these methods are most commonly used by hospitals. This article examines the literature on the relative costs and benefits of different accounting methods and the scant literature describing which of these methods are most commonly used by hospitals. It goes on to suggest that hospitals have not adopted sophisticated cost accounting systems because characteristics of the hospital industry make the costs of doing so high and the benefits of service-level cost information relatively low. However, changes in insurance benefit design are creating incentives for patients to compare hospital prices. If these changes continue, hospitals' patient volumes and revenues may increasingly be dictated by the decisions of individual patients shopping for low-cost services and as a result, providers could see increasing pressure to set prices at levels that reflect the costs of providing care. If these changes materialize, cost accounting information will become a much more important part of hospital management than it has been in the past.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"43 2","pages":"172-185"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910125/pdf/nihms-1032116.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37459179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Privatization on Efficiency and Productivity: The Case of American Public Hospitals 私有化对效率和生产力的影响:以美国公立医院为例

Journal of Health Care Finance Pub Date : 2015-01-01 DOI: 10.5465/ambpp.2015.16073abstract

Zo Ramamonjiarivelo, Luceta McRoy, J. Epane, Larry R. Hearld, R. Weech-Maldonado

{"title":"The Impact of Privatization on Efficiency and Productivity: The Case of American Public Hospitals","authors":"Zo Ramamonjiarivelo, Luceta McRoy, J. Epane, Larry R. Hearld, R. Weech-Maldonado","doi":"10.5465/ambpp.2015.16073abstract","DOIUrl":"https://doi.org/10.5465/ambpp.2015.16073abstract","url":null,"abstract":"Public hospitals typically operate in more challenging environments than private hospitals. Research suggests that privatization is one of the strategies that struggling public hospitals adopt to stay competitive. The purpose of this study was to examine whether privatization of public hospitals enhances efficiency and productivity. We used a national sample of non-federal acute care public hospitals in 1997 that was tracked through 2013, resulting in a cohort of 436 hospitals (7,386 hospital-year observations). Privatization was defined as conversion from public to either private not-for-profit or private for-profit status. Efficiency was measured by current assets turnover (CATO), fixed assets turnover (FATO), occupancy rate, full-time equivalent (FTE) employees per occupied bed, and work hours per adjusted patient day. Productivity was measured by case mix adjusted admissions per FTE. We controlled for organizational and market factors. Linear regressions with hospital and year fixed-effects models were used to test the hypotheses. Privatization from public to private status was associated with increased efficiency in terms of its positive associations with CATO (β =0.63) and FATO (β =0.23) and its negative association with FTE employees per occupied bed (β =-0.93) all at (p ≤ 0.001). Privatization was associated with increased productivity (β= 0.83; p ≤ 0.001).","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"2015 1","pages":"16073"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70696990","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: 2

Determinants of differentials in pneumonia mortality in the UK and France. 英国和法国肺炎死亡率差异的决定因素。

Journal of Health Care Finance Pub Date : 2014-01-01

Rizwan ul Haq, Patrick Rivers, Muhammad Umar

引用次数: 0

Health insurance reform and the development of health insurance plans: the case of the Emirate of Abu Dhabi, UAE. 健康保险改革和健康保险计划的发展:以阿联酋阿布扎比酋长国为例。

Journal of Health Care Finance Pub Date : 2014-01-01

Samer Hamidi, Sami Shaban, Ashraf A Mahate, Mustafa Z Younis

{"title":"Health insurance reform and the development of health insurance plans: the case of the Emirate of Abu Dhabi, UAE.","authors":"Samer Hamidi, Sami Shaban, Ashraf A Mahate, Mustafa Z Younis","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: The Emirate of Abu Dhabi has taken concrete steps to reform health insurance by improving the access to health providers as well as freedom of choice. The growing cost of health care and the impact of the global financial crisis have meant that countries are no longer able to solely bear the cost. As a result many countries have sought to overhaul their health care system so as to share the burden of provision with the private sector whether it is health care plan providers or employers.Objectives: This article explores and discusses how the policy issues inherent in private health care schemes have been dealt with by the Emirate of Abu Dhabi.Methods: Data was collected in early 2013 on health care plans in Abu Dhabi from government sources.Results: The Abu Dhabi model has private sector involvement but the government sets prices and benefits. The Abu Dhabi model adequately deals with the problem of adverse selection through making insurance coverage a mandatory requirement. There are issues with moral hazards, which are a combination of individual and medical practitioner behavior that might affect the efficiency of the system. Over time there is a general increase in the usage of medical services, which may be reflective of greater awareness of the policy and its benefits as well as lifestyle change.Conclusion: Although the current health care system level of usage is adequate for the current population, as the level of usage increases, the government may face a financial burden. Therefore, the government needs to place safeguards in order to limit its exposure. The market for medical treatment needs to be made more competitive to reduce monopolistic behavior. The government needs to make individuals aware of a healthier lifestyle and encourage precautionary actions.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 3","pages":"47-66"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32668518","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

Public hospitals in peril: factors associated with financial distress. 处于危险中的公立医院:与财政困难有关的因素。

Journal of Health Care Finance Pub Date : 2014-01-01

Zo Ramamonjiarivelo, Robert Weech-Maldonado, Larry Hearld, Rohit Pradhan

引用次数: 0

Hospital diversification strategy. 医院多元化战略。

Journal of Health Care Finance Pub Date : 2014-01-01

Steven R Eastaugh

{"title":"Hospital diversification strategy.","authors":"Steven R Eastaugh","doi":"","DOIUrl":"","url":null,"abstract":"To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 3","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32668515","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