Models of Health Plan Payment and Quality Reporting

Models of Health Plan Payment and Quality Reporting
Author: Jacob Glazer
Publisher: World Scientific Publishing Company
Total Pages: 208
Release: 2016-12-22
Genre: Business & Economics
ISBN: 9813202882

The book pulls together a series of articles by the authors that initiated the research areas of "optimal risk adjustment" and "optimal quality reporting." The papers present the basic theoretical models and link them to empirical application. Design of health insurance premiums to achieve efficient and fair outcomes is also covered. The chapters in the book also cover the intellectual development of approaches to health insurance regulation, beginning with more abstract models to those with explicit empirical and policy applications.

Models of Health Plan Payment and Quality Reporting

Models of Health Plan Payment and Quality Reporting
Author: Jacob Glazer
Publisher: World Scientific Publishing Company
Total Pages: 208
Release: 2016-12-25
Genre: Business & Economics
ISBN: 9789813202870

"The book pulls together a series of articles by the authors that initiated the research areas of "optimal risk adjustment" and "optimal quality reporting." The papers present the basic theoretical models and link them to empirical application. Design of health insurance premiums to achieve efficient and fair outcomes is also covered. The chapters in the book also cover the intellectual development of approaches to health insurance regulation, beginning with more abstract models to those with explicit empirical and policy applications."--Publisher's website.

Crossing the Quality Chasm

Crossing the Quality Chasm
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 359
Release: 2001-07-19
Genre: Medical
ISBN: 0309132967

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.

Rewarding Provider Performance

Rewarding Provider Performance
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 273
Release: 2007-02-17
Genre: Medical
ISBN: 0309102162

The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies

Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies
Author: OECD
Publisher: OECD Publishing
Total Pages: 447
Release: 2019-10-17
Genre:
ISBN: 9264805907

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Crossing the Global Quality Chasm

Crossing the Global Quality Chasm
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 399
Release: 2019-01-27
Genre: Medical
ISBN: 0309477891

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.