Journal of Health Care Finance articles from March 2002

Journal of Health Care Finance archives from March 2002

Introduction.(medicare)
March 22, 2002... Medicare payments surpassed an estimated $224 billion in 2000, more than double the amount spent a decade earlier. Roughly 90 percent of the payments in 2000 purchased inpatient and outpatient care furnished under traditional fee-for-service...

Medicare payment system for hospital inpatients: diagnosis-related groups.
March 22, 2002... Diagnosis-Related Groups (DRGs) are categories of patient conditions that demonstrate similar levels of hospital resources required to treat the conditions. Each inpatient that is discharged from an acute care hospital can be classified into...

Medicare's fee schedule for hospital outpatient care.
March 22, 2002... Medicare's hospital outpatient prospective payment system (OPPS) went live on August 1, 2000, after a decade of developmental work. The new system introduced a free schedule that replaced the cost-related methods that Medicare previously used...

Inpatient rehabilitation facilities are now paid prospective rates.
March 22, 2002... On January 1, 2002, Medicare began to replace its cost-related inpatient reimbursement method for rehabilitation hospitals and rehabilitation units in hospitals with a prospective payment system. Under the new system, Medicare pays a...

Prospective per diem rates for skilled nursing care.
March 22, 2002... On July 1, 1998, Medicare's cost-related reimbursement method for skilled nursing facility care was replaced with a prospective payment system that includes a case-mix adjustment based-on the Resource Utilization Groups in which Medicare...

Prospective rates for episodes of home health care.
March 22, 2002... Starting October 1, 2000, Medicare began paying providers of home health care at fixed, predetermined rates for services and items bundled into 60-day episodes of home health care. The episode payment rates vary with the patient's clinical,...

Medicare fees for physician services are resource-based.
March 22, 2002... Beginning January 1, 1992, Medicare has relied on a resource-based relative value scale (RBVS) to establish physician fees. Medicare pays 80 percent of the lower of the amount a physician bills for the service or the fee schedule amount. The...

Medicare's risk-adjusted capitation method.
March 22, 2002... Since 1997, the method to establish capitation rates for Medicare beneficiaries who are members of risk-bearing managed care plans has undergone several important developments. This includes the factoring of beneficiary health status into the...