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3.08 MB
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
|
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| Kaiser/HRET |
Source of 'Survey of Employer-Sponsored Health Benefits, 2009'
|
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| USA Inc. |
Mentioned as part of document title/source header
|
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| PROMETHEUS Payment System |
Example of bundled payments
|
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| Medicare |
Subject of the report (Medicare & Medicaid), also 'Medicare Acute Care Episode Demonstration', 'Medicare Demonstratio...
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| Medicaid |
Subject of the report (Medicare & Medicaid)
|
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| Accountable Care Organizations (ACOs) |
Concept discussed in reimbursement reform
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| CMS |
Website www.cms.gov/demoprojects cited for Medicare Demonstration Project Overviews
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| Special Commission on the Healthcare Payment, Commonwealth of Massachusetts |
Source of recommendations
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| Center for Medicare & Medicaid Innovation |
Mentioned in context of testing Accountable Care Organizations
|
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| Health Affairs |
Journal or publication cited
|
Locations (2)
| Location | Context |
|---|---|
|
Location where 'Cutting Healthcare Costs by Putting Doctors on a Budget' was adopted in Jan 2010
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|
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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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