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  • 1
    Online Resource
    Online Resource
    Special Issues with Single-Payer Health Insurance Systems (2013)
    Washington, DC : World Bank
    Details
    UID:
    gbv_79759213X
    Format: Online-Ressource
    Series Statement: Health, Nutrition and Population (HNP) discussion paper
    Content: Health insurance systems have been broadly classified into two groups based on the number of insurance pools: single-payer and multiple-payer systems. In single-payer systems, one organization-typically the government-collects and pools revenues and purchases health services for the entire population, while in multiple-payer systems several organizations carry out these roles for specific segments of the population. This paper examines the organization and operation of single-payer health insurance systems. We classify single-payer systems into four generic models: regional/private, regional/public, central/private, and central/public. The differences between these models are the level of centralization of financing and administration of health care (regional or central) and the ownership of health care providers (mainly public or mainly private). These four models are compared in four topic areas: revenue collection, risk pooling, purchasing, and social solidarity. The single-payer models are then contrasted with systems that use multiple-payer models. The comparisons are made in the same four topics: revenue collection, risk pooling, purchasing, and social solidarity. The paper concludes with a discussion of specific issues for low- and middle-income countries considering a choice between single- and multiple-payer systems.
    Language: English
    URL: Volltext  (kostenfrei)
    Library Location Call Number Volume/Issue/Year Availability
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    Stabi Berlin
  • 2
    Online Resource
    Online Resource
    Pricing Health Services for Purchasers : A Review of Methods and Experiences (2013)
    Washington, DC : World Bank
    Details
    UID:
    gbv_797592032
    Format: Online-Ressource
    Series Statement: Health, Nutrition and Population (HNP) discussion paper
    Content: This paper reviews methodologies and international experience related to costing and pricing health services. Several factors affect the determination of the prices purchasers pay for health services. These include: the method of provider payment; the availability of information on costs, volumes, outcomes, and patient and provider characteristics; methods used to calculate providers' costs; and characteristics of purchasers and providers-including the regulatory environment, provider autonomy, negotiating power, and the degree of competition. The paper focuses on methods for setting levels of payment under different provider payment mechanisms. Line item and global budgets remain the most common reimbursement methods in developing countries. However, many of these countries are implementing mixed payment systems that have greater information demands. The principal payment types used in high-income countries-capitation, payments per case or diagnosis, and fee-for-service-are reviewed here, and implications for low- and middle-income countries discussed. To minimize incentives for under- or over-utilization, prices that purchasers pay for health care services should be related to the unit costs of services. However, establishing the true unit cost of health services is complicated, and detailed data needed to correctly allocate indirect costs to the units of services are not generally available in developing countries. The organizational characteristics of health care providers and their relationships with purchasers strongly influence the way prices for health services are determined. Pertinent characteristics include provider autonomy, provider negotiating power, and the degree of competition. The principal constraint on the development of provider payments systems in developing countries is the limited availability of information on costs, volumes, and patient characteristics. However, international experiences reveal a variety of options for setting prices for health care purchasers in developing countries that are reforming their payment systems.
    Language: English
    URL: Volltext  (kostenfrei)
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    Stabi Berlin
  • 3
    Online Resource
    Online Resource
    The RAND Health Care Payment and Delivery Simulation Model (PADSIM) : Concepts, Methods, and Examples (2016)
    [Erscheinungsort nicht ermittelbar] : RAND Corporation
    Details
    UID:
    gbv_1877800732
    Format: 1 Online-Ressource
    ISBN: 9780833095268
    Content: This report describes RAND’s Health Care Payment and Delivery Simulation Model (PADSIM), developed to more effectively analyze the impacts of current and future reforms to provider payment policy, such as changes in how much providers are paid for their services and the degree to which payments are determined by the volume of services. PADSIM offers a systematic framework for quantifying such reforms and providers’ responses to them
    Note: English
    Language: Undetermined
    URL: kostenfrei
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  • 4
    Online Resource
    Online Resource
    Medicare Imaging Demonstration Final Evaluation : Report to Congress (2014)
    [Erscheinungsort nicht ermittelbar] : RAND Corporation
    Details
    UID:
    gbv_1877802360
    Format: 1 Online-Ressource
    ISBN: 9780833089656
    Content: In 2011, the Medicare Imaging Demonstration from the Centers for Medicare & Medicaid Services began testing whether exposing ordering clinicians to appropriateness guidelines for advanced imaging would reduce ordering inappropriate images. Small changes in ordering patterns were noted, but decision support systems were unable to assign appropriateness ratings to many orders, limiting the potential effectiveness of decision support
    Note: English
    Language: Undetermined
    URL: kostenfrei
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  • 5
    Online Resource
    Online Resource
    Paths to sustainability for innovative delivery system programs (2015)
    [Santa Monica, Calif.] : Rand Corporation
    Details
    UID:
    gbv_1008664499
    Format: 1 Online-Ressource
    ISBN: 9780833091277 , 0833091271
    Note: "RR-1090-BCMASS"--Colophon , Caption title , Includes bibliographical references
    Language: English
    Keywords: Electronic books
    URL: Volltext  (kostenfrei)
    URL: kostenfrei
    URL: kostenfrei
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  • 6
    Online Resource
    Online Resource
    Resources and capabilities of the Department of Veterans Affairs to provide timely and accessible care to veterans (2015)
    Santa Monica, CA : RAND Corporation
    Details
    UID:
    gbv_1008665320
    Format: 1 Online-Ressource (xxxii, 377 pages)
    ISBN: 9780833092151 , 0833092154
    Content: The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA's) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth
    Content: The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA's) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans' demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth
    Note: "Sponsored by the U.S. Department of Veterans Affairs , DOI: 10.7249/RR1165.2 , Includes bibliographical references (pages 347-377)
    Language: English
    Keywords: Electronic books
    URL: Volltext  (kostenfrei)
    URL: kostenfrei
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    Fulltext
    Stabi Berlin
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