THE UNITED STATES IS A NATION IN WHICH 47 MILlion citizens have no health insurance, more than 16% of the country’s gross domestic product is spent on rapidly increasing health costs, and stark disparities exist in health care access, exemplified by 20% of the population currently residing in federally designated health professional shortage areas. These formidable challenges have led to renewe...

This paper focuses on a broad movement toward a fundamentally different way of paying healthcare providers. The approach reaches beyond the old dichotomies about whether healthcare providers are reimbursed on a fee-for-service or a "capitated" or per-person payment. Instead, these reforms seek to create direct linkages between payments to healthcare providers and measures of the quality and eff...

Globally, healthcare service delivery faces many challenges that transcend regional and national boundaries. Population growth, increased life expectancy, increasingly stringent regulatory and compliance requirements, and demand for more and better access to quality care are driving up healthcare costs and creating a chronic shortage of skilled professionals. Continuing to deliver healthcare se...

Controlling healthcare costs is a multifaceted problem for governments all over the world, as they have the difficult task of ensuring that patients receive high quality care, and that this is delivered as efficiently as possible. Through the use of quantitative analysis, an attempt is made to determine the areas of activity of 32 Greek Public Obstetrical and Gynaecological Units which present ...

We study the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high-, middle-, and low-income region. In each region, a policy maker chooses health care quality to maximise the utility of its residents when health care costs are financed by general income taxation. In equilibrium, regions with hi...

Section 1886(e)(4) of the Social Security Act requires the Secretary of the Department of Health and Human Services to update the rates of individual diagnosis-related groups under the prospective payment system beginning in fiscal year 1986, taking into account the recommendations of the Prospective Payment Assessment Commission (1985a and b). Section 1886(e)(4) of the Act reads as follows: "(...

An increasing focus on hospital productivity has rendered a need for more thorough knowledge of cost drivers in hospitals, including a need for quantification of the impact of age, case-mix and other characteristics of patients, as well as establishment of the cost-quality relationship.The aim of this study is to identify cost drivers for vascular surgery in Danish hospitals with a specific vie...

As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-valu...

In the debate over health care costs, the tired statement that ‘everyone does not need a Cadillac when a Chevy will do’ is all too frequently cited. One implication of this statement is that high quality equals high cost. In fact, health care should turn to another automotive slogan, ‘Quality is Job 1’. In health care, high quality care often results in lower costs and improved outcomes. Consid...