Search results
Results From The WOW.Com Content Network
Consistent with our trends all year, payer mix remained strong in the fourth quarter of 2024, with same-facility managed care admissions up 9.2% compared to the prior-year quarter.
This distribution is relatively stable; in 2008, 31% went to hospital care, 21% to physician/clinical services, 10% to pharmaceuticals, 4% to dental, 6% to nursing homes, 3% to home health care, 3% for other retail products, 3% for government public health activities, 7% to administrative costs, 7% to investment, and 6% to other professional ...
All-payer rate setting is a price setting mechanism in which all third parties pay the same price for services at a given hospital. [1] It can be used to increase the market power of payers (such as private and/or public insurance companies) versus providers, such as hospital systems , in order to control costs.
National Inpatient Sample (NIS) (formerly the Nationwide Inpatient Sample): A 20 percent stratified sample of all-payer, inpatient discharges from U.S. community hospitals (excluding rehabilitation and long-term acute-care hospitals). The NIS is available from 1988 forward, and a new database is released annually, approximately 18 months after ...
In 2011, Medicare was the primary payer for an estimated 15.3 million inpatient stays, representing 47.2 percent ($182.7 billion) of total aggregate inpatient hospital costs in the United States. [13] The Affordable Care Act took some steps to reduce Medicare spending, and various other proposals are circulating to reduce it further.
Physicians and other health care providers lack the necessary actuarial, underwriting, accounting and finance skills for insurance risk management, but their most severe problem is the greater variation in their estimates of the average patient cost, which leaves them at a financial disadvantage as compared to insurers whose estimates are far ...
In the mid-1980s, it was believed that Medicare's hospital prospective payment system with diagnosis-related groups may have led to hospitals' discharging patients to post-hospital care (such as skilled nursing facilities) more quickly than was appropriate, to save money. [10]
A mere 2.5 percent of all primary care doctors have gone through the certification process. “I cannot say it enough,” said then-Sen. Carl Levin (D-Mich.) at the meeting. “Unless primary care physicians can identify the disease of addiction and know how to intervene, we will make slower progress than we should,” Levin said.