Fee-For-Service (FFS) contracts, first introduced in 2004, dramatically changed the way the pharmaceutical distribution supply chains are designed, managed, and operated. Investment buying (IB), forward buying in anticipation of drug price increases, used to be the way the distributors made most of their profits! FFS contracts limit the amount of inventory distributors can carry at any time (by...

This study explores the impact of program structure on children's use of care by comparing care use in State Children's Health Insurance Program (SCHIP) and Medicaid covered populations in a State where children share the same provider network and are both in a primary care case management system with the same Medicaid fee structure. We then compare care use in this system to care use in an SCH...

To study the effects of managed care on dialysis patients, we compared the quality of life and patient satisfaction of patients in a managed care demonstration with three comparison samples: fee-for-service (FFS) patients, managed care patients outside the demonstration, and patients in a separate national study. Managed care patients were less satisfied than FFS patients about access to health...

BACKGROUND It is widely believed that the method of payment of physicians may affect their clinical behaviour. Although payment systems may be used to achieve policy objectives (e.g. cost containment or improved quality of care), little is known about the effects of different payment systems in achieving these objectives. OBJECTIVES To evaluate the impact of different methods of payment (capi...

INTRODUCTION Researchers and consultants have promoted expansion of Medi-Cal managed-care (MCMC) to additional Medi-Cal beneficiaries currently covered under the Medi-Cal Fee-forService (FFS) program to achieve greater cost efficiency and quality of care. Proponents have also promoted MCMC as a cost-effective way to expand state-subsidized health insurance for many of the State’s 6.5 million un...

BACKGROUND: This study presents preliminary findings for the first nine months of the State of Colorado USA Medicaid capitation Pilot Project. Two different models of capitation (model I and model II) are compared with fee for service (FFS) in providing services to severely and persistently mentally ill adults. In model I the state's mental health authority contracts with community mental healt...

The paper provides theoretical analysis for hospitals’heterogeneity in the response to the change from the the fee-for-service (FFS) system to a per diem prospective payment system with a length-of-stay dependent step-down rate (SDR): hospitals with shorter (longer) average length of stay under FFS have longer (shorter) average length of stay under SDR. We also show that for FFS hospitals with ...

BACKGROUND National Health and Nutrition Examination Survey (NHANES) records have been linked to health care use and expenditure information from Medicare records. Claims data are generally available only for traditional fee-for-service (FFS) enrollees and not for Medicare Advantage enrollees. Differences in health characteristics between Medicare Advantage and traditional FFS enrollees could a...

Although Medicare Managed Care (MMC) was introduced as a way to reduce costs, the effect of the program on total Medicare spending is unknown. Current literature has focused on three conflicting sets of findings including spillover effects from managed care which reduce total Medicare spending and positive selection into managed care and overpayments to managed care plans relative to Fee-for-Se...

Objective. To assess the impact of switching from a fee-for-service (FFS) delivery system to managed care on access to, use of, and satisfaction with health care for children. Data Sources/Study Setting. A 1998 survey of Medicaid recipients in rural Minnesota. Study Design. Using a quasi-experimental framework, we compare the experiences of children on Medicaid living in counties that had switc...