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Extraction Summary

4
People
11
Organizations
2
Locations
2
Events
0
Relationships
8
Quotes

Document Information

Type: Report/presentation slide
File Size: 3.08 MB
Summary

This document outlines possible solutions for restructuring Medicare & Medicaid, focusing on economic factors. Part 1 discusses cost-sharing mechanisms like co-pays and co-insurance, analyzing their impact on consumer behavior and incentives. Part 2 details reimbursement reform options such as bundled payments, global payment systems, pay-for-performance, and Accountable Care Organizations (ACOs), emphasizing a shift from quantity to quality of care.

People (4)

Name Role Context
Geoffrey Baker Author/Contributor
Cited for 'Pay for Performance Incentive Programs in Healthcare'
Stephen Shortell Author/Contributor
Cited for 'How the Center for Medicare & Medicaid Innovation Should Test Accountable Care Organizations'
Lawrence P. Casalino Author/Contributor
Cited for 'How the Center for Medicare & Medicaid Innovation Should Test Accountable Care Organizations'
Elliott S. Fisher Author/Contributor
Cited for 'How the Center for Medicare & Medicaid Innovation Should Test Accountable Care Organizations'

Organizations (11)

Name Type Context
KPCB
Logo and website www.kpcb.com
Kaiser/HRET
Source of 'Survey of Employer-Sponsored Health Benefits, 2009'
USA Inc.
Mentioned as part of document title/source header
PROMETHEUS Payment System
Example of bundled payments
Medicare
Subject of the report (Medicare & Medicaid), also 'Medicare Acute Care Episode Demonstration', 'Medicare Demonstratio...
Medicaid
Subject of the report (Medicare & Medicaid)
Accountable Care Organizations (ACOs)
Concept discussed in reimbursement reform
CMS
Website www.cms.gov/demoprojects cited for Medicare Demonstration Project Overviews
Special Commission on the Healthcare Payment, Commonwealth of Massachusetts
Source of recommendations
Center for Medicare & Medicaid Innovation
Mentioned in context of testing Accountable Care Organizations
Health Affairs
Journal or publication cited

Timeline (2 events)

2010-01
Adoption of 'Cutting Healthcare Costs by Putting Doctors on a Budget'
Rockford, IL
Enactment of Patient Protection and Affordable Care Act

Locations (2)

Location Context
Location where 'Cutting Healthcare Costs by Putting Doctors on a Budget' was adopted in Jan 2010
Location of the Special Commission on the Healthcare Payment

Key Quotes (8)

"Cost-sharing can help control demand for a portion of healthcare by creating incentives for consumers to shop for most cost-effective treatments (although those benefits would be somewhat mitigated by the skew in health spending toward high users)."
Source
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Quote #1
"Once again, a Math Problem: Consider a routine physician office visit in which a provider suggests and / or patient requests various tests, procedures, etc."
Source
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Quote #2
"Note that deductibles drive similar dynamic as a co-pay: once the deductible is met, the member has little or no "skin in the game""
Source
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Quote #3
"Reimbursement reform could help shift drivers of payment from quantity of care to quality of care."
Source
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Quote #4
"Bundled Payments: Providers get a fixed budget to treat an episode of care (i.e. a broken hip). Exceeding the budget means providers absorb additional costs; staying under it lets provider benefit from savings."
Source
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Quote #5
"Global payment system³ (i.e., capitation): Providers are paid up-front to provide care that their patient receives over a period, incentivizing them to manage costs and quality. This global payment is adjusted periodically to reward accessible and high-quality care."
Source
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Quote #6
"Pay for performance4: Reimbursement for care providers varies, based on various quality and efficiency measures such as discharge rate and readmission rate."
Source
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Quote #7
"Accountable Care Organizations (ACOs): Provider groups accept responsibility for the cost and quality of care for a specific population of patients5"
Source
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Quote #8

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