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Academic Journals
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From:Healthcare Financial Management (Vol. 67, Issue 12) Peer-ReviewedHospitals will have three months more to prepare for post-payment reviews of the "two-midnight" rule after Medicare delayed any such action until April 1. The new rule specified that inpatient hospital admissions are...
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From:CytoJournal (Vol. 7, Issue 1) Peer-ReviewedByline: Inderpreet. Dhillon, Martha. Pitman, Richard. DeMay, Pamela. Archuletta, Vinod. Shidham The confusion centered around appropriate use of the CPT billing code 88172 is addressed in the commentary from the...
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From:Expert Review of Pharmacoeconomics & Outcomes Research (Vol. 10, Issue 3) Peer-ReviewedAuthor(s): Michael Barry [[dagger]â ] 2 , Cara Usher 1 , Lesley Tilson 1 Keywords : Ireland; medicines; patient co-payment; pharmacoeconomic assessment; pricing; reimbursement In Ireland, healthcare policy...
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From:Contemporary Long Term Care (Vol. 23, Issue 3)Updated data should impact reimbursement GROUPS REPRESENTING HOME HEALTH AGENCIES (HHAs) are urging the Health Care Financing Administration (HCFA) to modify the proposed prospective payment system for HHAs to ensure...
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From:Health Care Financing Review (Vol. 11, Issue 3) Peer-ReviewedAlternative geographic configurations for Medicare payments to health maintenance organizations Introduction Provisions of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) authorized that full...
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From:Health Care Financing Review (Vol. 14, Issue 2) Peer-ReviewedDeclining operating margins under Medicare's prospective payment system (PPS) have focused attention on the adequacy of payment rates. The question of whether annual updates to the rates have been too low or cost...
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From:Medical World News (Vol. 34, Issue 8)Medicare is not adequately reimbursing family practice physicians, and is reimbursing specialists too much. The Health Care Financing Administration calculates practice expenses based on standards set in 1984, and has...
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From:Health Care Financing Review (Vol. 14) Peer-ReviewedIntroduction The Medicare program was enacted into law in 1965 as title XVIII of the Social Security Act. The new Federal health insurance program, effective July 1, 1966, provided basic health insurance coverage for...
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From:Journal of the American Dietetic Association (Vol. 89, Issue 10) Peer-ReviewedAbstract The implications of malnutrition on the Medicare Prospective Payment System of diagnosis-related groups DRGs) were examined in 185 Medicare patients, aged 65 to 69 years, admitted to an acute-care tertiary...
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From:Health Care Financing Review (Vol. 16, Issue 2) Peer-ReviewedThis article provides an overview of the Medicare Transaction System (MTS), a Health Care Financing Administration (HCFA)-wide initiative to be implemented starting in 1997 which will develop a national, standard,...
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From:Health Care Financing Review (Vol. 16, Issue 4) Peer-ReviewedDuring 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals, trends for inputs and...
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From:AORN Journal (Vol. 65, Issue 3) Peer-ReviewedThe Association of Operating Room nurses is supporting federal legislation that would modify Medicare and state statutes for reimbursement. Registered nurse first assistants (RNFAs) are vitally important to surgical...
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From:Healthcare Financial Management (Vol. 50, Issue 11) Peer-ReviewedThe refusal of insurers to reimburse healthcare providers for certain days of care or entire admissions can lead to losses amounting to millions. However, providers can avoid insurer-denied days of care by assigning a...
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From:The Hedgehog Review (Vol. 20, Issue 3) Peer-Reviewed"The White Coats Are Coming," he announced with a wry smile. A fitting title for his book, I thought, but then found myself looking down at my own white coat, wishing I hadn't worn it to my clinic today. Noticing my...
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From:Healthcare Financial Management (Vol. 73, Issue 9) Peer-ReviewedThe Centers for Medicare & Medicaid Services (CMS) issued an FY20 final rale for Medicare's inpatient prospective payment system (IPPS) and the long-term care hospital (LTCH) PPS, affecting about 3,300 acute-care...
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From:Healthcare Financial Management (Vol. 73, Issue 12) Peer-ReviewedMedicare kept two major hospital payment cuts in a 2020 final payment rule, released Nov. 1, but removed a proposal to require hospitals to release privately negotiated health plan payment rates. The controversial...
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From:Healthcare Financial Management (Vol. 74, Issue 1) Peer-ReviewedThe Maryland Total Cost of Care (TCOC) program, one of the nation's most innovative advanced alternative payment (APM) models, has entered year two. Finance leaders across the nation can benefit from a closer look at how...
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From:Healthcare Financial Management (Vol. 74, Issue 1) Peer-ReviewedThe Trump administration requires hospitals to post online the rates they negotiate with health plans, as well as rates for 300 "shoppable services," by 2021. The Nov. 15 final rule from the Centers for Medicare &...
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From:Canadian Public Administration (Vol. 51, Issue 3) Peer-ReviewedWhat is the best way to pay providers to deliver health services? The research evidence strongly suggests that there is no single answer; rather, one must consider the incentives and disincentives inherent in...
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From:Review of Optometry (Vol. 146, Issue 8) Peer-ReviewedThe use of scanning computerized ophthalmic diagnostic imaging has become much more prevalent in the evaluation and management of anterior segment and posterior segment disease. Proper documentation in the patient...