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Cost and use of capitated medical services : evaluation of the program for prepaid managed health care
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Year: 1992 Publisher: Santa Monica, CA : RAND Corporation,

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Abstract

Throughout the 1970s and into the early 1980s continuing efforts to control inflation in Medicaid expenditures led states to adopt stricter Medicaid eligibility standards, which in combination with a recession in the early 1980s left nearly 40 percent of the nation's poor without medical coverage. To prevent further restrictions in Medicaid access, the Robert Wood Johnson Foundation (RWJ) sponsored a demonstration project, the Program for Prepaid Managed Health Care (PPMHC) in the first half of the 1980s. This RAND Corporation report contains the design and results from the cost and utilization evaluation of the PPMHC.


Book
Final report on assessment instruments for a prospective payment system
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ISBN: 0833059939 0833032216 9780833032218 9780833059932 Year: 2004 Publisher: Santa Monica, CA Rand Health

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Outpatient institutional rehabilitation services, 1987-1990 : who provides them and how do they compare?
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Year: 1993 Publisher: Santa Monica, CA : RAND Corporation,

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The overall growth of Medicare Part B charges for rehabilitation services is high and if unabated, will exacerbate Medicare's cost containment problem. Regression models show that the pattern of therapy used, the use of multiple providers, and patient characteristics and diagnostic categories all have an impact on charges. However, even controlling for all other factors, independent rehabilitation agencies consistently had the highest charges across all models, and hospital outpatient departments the lowest. Thus, if rehabilitation services are included in Medicare's projected new payment reform, Ambulatory Payment Groups, and if the reform covers only hospital outpatient departments, it would encourage a shift to more expensive providers.


Book
Costs, productivity, and the utilization of physician's extenders in Air Force primary medicine clinics
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Year: 1983 Publisher: Santa Monica, CA : RAND Corporation,

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This report addresses the question of whether the extensive use of physician extenders--nonphysicians trained to perform some of the medical and administrative tasks traditionally performed by physicians--in Air Force hospitals is cost-effective. Specifically, it examines the productivity of extenders in outpatient care and the costs of procuring and using extenders. The authors focused on one type of extender, physician assistants (PAs), who are typically Air Force corpsmen with one year of classroom and one year of clinical training. The general conclusions were the following: In typical Air Force primary adult medicine clinics, PAs can substitute for physicians one-to-one for 80-90 percent of the patients whose problems lie within the PA's expertise. Relying on PAs to perform most of the primary medicine workload is currently cost-effective, and will remain so until the earnings of civilian physicians decrease markedly relative to the earnings of PAs.


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The Financial impact of nursing home-based geriatric nurse practitioners : an evaluation of the Mountain States Health Corporation GNP Project
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Year: 1989 Publisher: Santa Monica, CA: Rand,

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Final report on assessment instruments for a prospective payment system
Authors: --- --- --- --- --- et al.
ISBN: 0833032224 0833059947 9780833032225 9780833059949 Year: 2004 Publisher: Santa Monica, CA RAND

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Executive Summary of Analyses for the Initial Implementation of the Inpatient Rehabilitation Facility Prospective Payment System
Authors: --- --- --- --- --- et al.
ISBN: 1598753649 Year: 2002 Publisher: Santa Monica : RAND Corporation,

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Abstract

In the Balanced Budget Act of 1997, Congress mandated that Health CareFinancing Administration (HCFA) implement a Prospective Payment System (PPS)for inpatient rehabilitation. The Centers for Medicare and Medicaid Services(CMS, the successor agency to HCFA) issued the final rule governing such aPPS on August 7, 2001.

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