The purpose of this study is to compile trends for physician reimbursement, hospital inpatient and outpatient reimbursement the 10 most common orthopaedic sports surgeries based on national payment amounts. Current Procedural Terminology (CPT) codes Medicare Severity–Diagnosis Related Group (MS-DRG) were identified. Utilizing CPT codes, Physician Fee Schedule (MPFS) was utilized obtain amount r...

The United States spends billions of dollars each year preparing for medical emergencies. Noticeably absent from that budget is an effective process to protect the frontline defenders delivering primary care.

The concept of "pay for performance" (P4P) applied to the practice of medicine has become a major foundation in current public and private payer reimbursement strategies for both institutional and individual physician providers. "Pay for performance" programs represent a substantial shift from traditional service-based reimbursement to a system of performance-based provider payment using financ...

The decade since the completion of the sequencing of the human genome has witnessed significant advances in the incorporation of genomic information in diagnostic, treatment, and reimbursement practices. Indeed, as case in point, there are now several dozen commercially available genomic tests routinely applied across a wide range of disease states in predictive or prognostic applications. More...

OBJECTIVE We sought to assess how the inclusion of claims from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients. METHODS Claims data from Washington State were used to create 2 versions of a case-mix index. One version included claims from all provider types; the second version omitted...

The art of predicting the results of any drug treatment has always been a topic of interest among the scientific community across the globe. Many diseases have been attributed to gene defects, giving rise to a whole new field of pharmacogenomics within the domain of clinical pharmacology. Stratified medicine is the science of associating such diseases with genetic defects and predicting the eff...

reimbursement for healthcare has utilized a variety of payment mechanisms with varying degrees of effectiveness. whether these mechanisms are used singly or in combination, it is imperative that the resulting systems remunerate on the basis of the quantity, complexity, and quality of care provided. expanding the role of the electronic medical record (emr) to monitor provider practice, patient r...

BACKGROUND Since the mapping of the human genome in 2003, the development of biomarker targeted therapy and clinical adoption of "personalized medicine" has accelerated. Models for insurance subsidy of biomarker/test/drug packages ("codependent technologies" or technologies that work better together) are not well developed. Our aim was to create a framework to assess the safety, effectiveness, ...