Evidence-Based Imaging Guidelines and Medicare Payment Policy

Evidence-based imaging guidelines and Medicare payment policy.

OBJECTIVE This study examines the relationship between evidence-based appropriateness criteria for neurologic imaging procedures and Medicare payment determinations. The primary research question is whether Medicare is more likely to pay for imaging procedures as the level of appropriateness increases. DATA SOURCES The American College of Radiology Appropriateness Criteria (ACRAC) for neurolo...

Medicare payment policy: does cost shifting matter?

We examine cost shifting within the context of Medicare payment policy. We briefly review economic theory and available data and discuss the importance of cost shifting for policy. Then we present four central findings on cost shifting based on the views of former high-level policymakers. First, Medicare's early (pre-prospective) payment policy was a boon to hospitals. Second, Medicare payment ...

Medicare payment policy and the controversy over hospital cost shifting.

This article examines (i) the background and debate over cost shifting; (ii) hospitals as business institutions that often shift the financial responsibility for their costs in the form of differential pricing; and (iii) how the cost-shifting debate affects and is affected by Medicare. The aim is to gain a better understanding of how changes in reimbursement by large government health insurance...

Medicare payment and hospital capital: future policy options.

Medicare payment and hospital capital: the evolution of policy.