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...

the purposes of our study were to identify a drug entry process, collect, and prioritize criteria for selecting drugs for the list of basic health insurance commitments to prepare an “evidence based reimbursement eligibility plan” in iran.the 128 noticeable criteria were found when studying the health insurance systems of developed countries. four parts (involving criteria) formed the first que...

Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimburs...

Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimburs...

Anemia is common in patients with advanced chronic kidney disease (CKD). Though erythropoiesis-stimulating agents (ESAs) have been strongly endorsed in guidelines, it is of particular financial interest. Recently, the reimbursement of ESAs in non-dialytic patients was started by the Korean National Health Insurance System. Thus, we investigated the impact of the reimbursement of ESAs on the ane...

As we discussed in Chapter 1, the federal government gives each state flexibility in establishing its own Medicaid reimbursement methods and rates for nursing home services. While the five states examined all use prospective, facility-specific reimbursement methods, the way each state has designed its reimbursement system varies significantly. The combination of historical, facilityspecific cos...