Commentary--Achieving a high-performance health system: High reliability organizations within a broader agenda.
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Biomedical subjects
Publications and source records attributed to Anne K Gauthier.
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Although the fields of public health and health services research have much in common, public health practitioners--in their daily encounters with practical, frontline challenges--may not be aware of the quantity and the quality of information generated by health services research that is directly related to public health activities. We describe a number of health services research resources that public health practitioners may find useful, including an overview of these resources and several in-depth examples.
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We examine cost shifting within the context of Medicare payment policy. We briefly review economic theory and available data and discuss the importance of cost shifting for policy. Then we present four central findings on cost shifting based on the views of former high-level policymakers. First, Medicare's early (pre-prospective) payment policy was a boon to hospitals. Second, Medicare payment policy is a "top-down" affair, driven by budgetary and special-interest politics. Third, federal policymakers may not consciously consider cost shifting, but state policymakers do. Fourth, Medicare payment policy requires constant adjustment, but we are "getting it right" most of the time.