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| Author | : Jack Langenbrunner |
| Publisher | : World Bank Publications |
| Total Pages | : 348 |
| Release | : 2009-01-01 |
| Genre | : Medical |
| ISBN | : 0821378244 |
Download Designing and Implementing Health Care Provider Payment Systems Book in PDF, ePub and Kindle
Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.
| Author | : National Academies of Sciences Engineering and Medicine |
| Publisher | : |
| Total Pages | : |
| Release | : 2021-09-30 |
| Genre | : |
| ISBN | : 9780309685061 |
Download The Future of Nursing 2020-2030 Book in PDF, ePub and Kindle
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
| Author | : Duane C. Abbey |
| Publisher | : CRC Press |
| Total Pages | : 168 |
| Release | : 2009-05-20 |
| Genre | : Business & Economics |
| ISBN | : 1420092782 |
Download Healthcare Payment Systems Book in PDF, ePub and Kindle
Healthcare Payment Systems: An Introduction provides a complete introduction to healthcare payment systems. Written by Duane Abbey, one of the nation‘s leading experts and most sought out consultants on payment systems, this volume makes the monumental task of medical reimbursement approachable and manageable. Covering the fundamentals and terminology needed to understand this discipline, and the strategies needed to master it, Dr. Abbey will help you begin to develop the solid core of skills and knowledge needed to confidently approach payment systems as tools to use rather than hazards to avoid -- tools that will lead to improved revenue cycles and higher levels of profitability.
| Author | : Duane C. Abbey |
| Publisher | : CRC Press |
| Total Pages | : 113 |
| Release | : 2009-05-20 |
| Genre | : Business & Economics |
| ISBN | : 1040083153 |
Download Healthcare Payment Systems Book in PDF, ePub and Kindle
Healthcare Payment Systems: An Introduction provides a complete introduction to healthcare payment systems. Written by Duane Abbey, one of the nation‘s leading experts and most sought out consultants on payment systems, this volume makes the monumental task of medical reimbursement approachable and manageable. Covering the fundamentals and terminology needed to understand this discipline, and the strategies needed to master it, Dr. Abbey will help you begin to develop the solid core of skills and knowledge needed to confidently approach payment systems as tools to use rather than hazards to avoid -- tools that will lead to improved revenue cycles and higher levels of profitability.
| Author | : National Academies of Sciences, Engineering, and Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 195 |
| Release | : 2019-12-30 |
| Genre | : Medical |
| ISBN | : 0309493463 |
Download Integrating Social Care into the Delivery of Health Care Book in PDF, ePub and Kindle
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
| Author | : Institute of Medicine |
| Publisher | : National Academies Press |
| Total Pages | : 360 |
| Release | : 2001-08-19 |
| Genre | : Medical |
| ISBN | : 0309072808 |
Download Crossing the Quality Chasm Book in PDF, ePub and Kindle
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
| Author | : Caryn Bredenkamp |
| Publisher | : World Bank Publications |
| Total Pages | : 69 |
| Release | : 2019-12-19 |
| Genre | : Medical |
| ISBN | : 1464815216 |
Download Transition to Diagnosis-Related Group (DRG) Payments for Health Book in PDF, ePub and Kindle
This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
| Author | : Prof Dr Syed Mohamed Aljunid |
| Publisher | : Partridge Publishing Singapore |
| Total Pages | : 147 |
| Release | : 2022-11-20 |
| Genre | : Business & Economics |
| ISBN | : 154377198X |
Download Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance: a Case Study of Acheh Provincial Health Insurance Book in PDF, ePub and Kindle
The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.
| Author | : Zuzana Feachem |
| Publisher | : World Bank Publications |
| Total Pages | : 172 |
| Release | : 1999 |
| Genre | : Medical |
| ISBN | : 9780821343371 |
Download Implementing Health Sector Reform in Central Asia Book in PDF, ePub and Kindle
It is easy for reformers and their overseas advisers to develop conceptually strong plans for health sector reform that appeal to governments, donors, and academics. Transforming these plans into successful action has proved to be extremely difficult. Toward the goal of improving assistance to this sector, the Economic Development Institute (EDI) of the World Bank held a seminar in Ashgabat, Turkmenistan in June 1996. This publication provides a summary of the proceedings and papers presented at that seminar. It was attended by delegations from five countries in Central Asia and from Azerbaijan and Mongolia. The content of this volume emphasizes topics central to the restructuring of health sector financing and health care delivery systems at a time of transition to market economies and to democracy. Maintaining and improving the health status of the population while preventing rapid escalation of health care expenditure were the recurrent themes throughout the seminar.
| Author | : The World Bank |
| Publisher | : World Bank Publications |
| Total Pages | : 67 |
| Release | : 2013 |
| Genre | : Electronic book |
| ISBN | : |
Download Fairness and Accountability Book in PDF, ePub and Kindle
The new MENA health strategy for 2013-2018 is focused on the creation of “fair” and “accountable” health systems in the region. Conceived through a yearlong process, it captures the World Bank’s commitment to overarching principles in a sustainable manner. It first analyzes the status of health systems in the region; then describes how health care can be made more fair and accountable; next provides examples of World Bank global expertise and products to do so; and concludes with details of how the strategy will be implemented. Through this strategy, the World Bank is committed to supporting governments to implement their priorities in the health sector in order to create more fair and accountable systems for the people.
