Research agenda brief最新文献

{"title":"Chronic care improvement in Medicare FFS: cosmetic or transforming?","authors":"Sandra M Foote","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As part of the Medicare Modernization Act of 2003, Congress mandated development of \"Voluntary Chronic Care Improvement Programs under Traditional Fee-For-Service.\" These programs represent an ambitious new federal attempt to reduce quality failings under the Medicare fee-for-service (FFS) plan cost-effectively and on a large scale. CCI programs cannot be expected to rescue Medicare from current cost pressures or from the perverse incentives inherent in FFS provider reimbursement, but they may reduce health risks, yield savings, and foster progress toward system integration on behalf of some major subgroups of chronically ill beneficiaries who need added support to manage their health effectively.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 13","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2004-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24591352","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}

{"title":"Federal health web sites: current & future roles.","authors":"Carol Cronin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An examination of the current and possible future roles of federal health Web sites, this paper provides an overview of site categories, functions, target audiences, marketing approaches, knowledge management, and evaluation strategies. It concludes with a look at future opportunities and challenges for the federal government in providing health information online.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 12","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22561018","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}

{"title":"Quality incentives for Medicare+Choice plans.","authors":"Lynn Etheredge,&nbsp;Robert Berenson,&nbsp;Jack Ebeler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Medicare program should be a leader in national efforts to improve quality of care. This paper proposes a new system of quality bonuses for Medicare+Choice plans and lays out a framework of key issues and options to promote discussion about such an initiative.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 11","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22561017","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}

{"title":"Strategies to improve consumer health information services.","authors":"Sandra Foote,&nbsp;Lynn Etheredge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Consumer health information is important in two respects. It helps individuals improve their own health and creates pressure on the healthcare system to produce higher quality care. Initiatives to strengthen consumer health information services are underway in many public and private-sector organizations nationwide. This paper describes some trends in the field and opportunities to spur further progress nationally and at the community level over the next few years.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 10","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22561016","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}

{"title":"Health insurance tax credits for workers: an efficient and effective administrative system.","authors":"L Etheredge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper proposes an administrative system for health insurance tax credits for workers that would be efficient and effective. It features payroll deductions and automatic enrollment, which are proven methods to yield high enrollments at low cost.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 9","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22479912","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}

{"title":"Affordable health benefits for workers without employer coverage.","authors":"L Etheredge,&nbsp;S B Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With 42 million individuals lacking health insurance in 1996, an increase of 1.1 million uninsured from the previous year, new initiatives to deal with health insurance problems merit a high priority among domestic policy initiatives. This paper examines the opportunities for assisting full-time workers (and their families) who do not receive employer-paid health insurance-a group that now includes 49 million individuals-by using three policy tools that Congress and President Clinton have already agreed to use in recent healthcare legislation: (a) equitable tax assistance; (b) market reforms; and (c) competition among health plans that offer economical benefits. Estimates for a model plan illustrate that such strategies could make decent private health insurance more affordable and more accessible for workers and their families who want to purchase it; family insurance protection, with guaranteed issue of insurance and large-group-rated premiums, could be offered at potential savings of 42% (or more). Premiums for worker's coverage, after tax assistance, would be below $1,200 per year, i.e., less than 60 cents per hour. These market-oriented reforms can be accomplished with a limited government role, and, after start-up costs, ongoing federal expenses would be modest, predictable, and controllable. When combined with the new $24 billion child health initiative to assist low-income families, the proposed plan would provide considerable progress toward universal access to affordable insurance coverage.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 8","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22479910","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}

{"title":"Consumers, gag rules, and health plans: strategies for a patient-focused market.","authors":"L Etheredge,&nbsp;S B Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The \"gag rule\" controversy has become a symbol of new tensions and changing relationships among patients, physicians, and health plans. This paper offers a consumer-focused analysis of these fundamental issues from the point of view of a patient with a chronic illness. It starts with a case study of a specific individual and then considers the systemic incentives and other factors that lead to conflicts among patients, physicians, and health plans. This consumer focus invites the reader to consider managed care with the following question in mind: \"What would you want for yourself it you were the patient?\" The paper suggests that many private-sector initiatives, as well as government actions, could contribute to a better health care market. Among the reform strategies discussed are (a) professional responsibility and private-sector standards, (b) consumer assistance, and (c) government regulation. All of us, including persons with chronic illness, need a consumer-focused health system. So, too, do physicians and health plans that want to provide excellent care for all of their patients.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 7","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22479908","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}

{"title":"Paradigm shifts in Medicare reform.","authors":"S B Jones,&nbsp;L Etheredge","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reforms passed by Congress and vetoed by the president during the past year would have accelerated initiatives already transforming Medicare. Operating in a rapidly changing insurance marketplace, Medicare is shifting from a social insurance model toward a private individual insurance model-expanding the number and type of alternative health plans it offers-and growing numbers of beneficiaries are enrolling in these plans. Such reforms, especially if bolstered by legislative reforms that are likely to resurface after the November elections, will rewrite the social contract enacted more than 30 years ago. They require fundamental shifts in ways of thinking about the federal government's responsibilities; the Medicare program's management; relations between the Medicare program and doctors, hospitals, and other health care providers; and the role of beneficiaries in the Medicare program. The likely deferral of further legislative attempts to reform Medicare affords an opportunity to step back and consider these ongoing changes. It is not easy to describe paradigm shifts accurately, but there are advantages to trying. First, conceptual comparisons can allow public discussion to go beyond budget scorekeeping and media soundbites to consider how different the Medicare program will be if it evolves in the new ways being proposed. Second, a conceptual framework can assist health policy analysts to target what to watch for in tracking changes, to assess the tradeoffs involved, and to advise about the needs for refining legislation. This paper includes examples of what to watch for in tracking the implemented changes. The paradigm shifts are summarized below, then described individually in terms of directions of change along a number of continuums. Note that complete paradigm shifts, from one end of a continuum to the other, are seldom completely realized nor even far advanced. But Medicare's ongoing reforms, accelerated by legislative proposals, seem likely predecessors of future changes. For developing this framework, the authors have drawn on the Medicare provisions of the Conference Agreement on the Balanced Budget Act of 1995, the president's proposals as presented in December 1995, and current and proposed Health Care Financing Administration practices.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 6","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22479907","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}

{"title":"Medicare reform: a model for national healthcare reform?","authors":"L Etheredge","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 5","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"1996-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22479906","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}

{"title":"Why not the best for the chronically ill?","authors":"S B Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Premium adjustors to neutralize risk selection among health plans are the weakest component in the technology for assuring competitive markets. It will be many years before we have adjustors adequate to free health plans to invest in and market improved managed care to predictably high-cost chronically ill persons. For want of a fair premium, health plans are driven by risk selection to underinvest in and otherwise \"demarket\" care to these very employees and beneficiaries whose costs and care most need to be managed. To achieve best value for the chronically ill, large employer coalitions, Medicare, and Medicaid should consider radical new approaches, such as establishing separate prices for care to people with specific chronic conditions and purchasing such care both from health plans and directly from provider systems.</p>","PeriodicalId":86195,"journal":{"name":"Research agenda brief","volume":" 3","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22479903","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}