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Biomedical subjects

R J Kaden

Publications and source records attributed to R J Kaden.

2 recordsLinked to original sources

Ensuring adequate payment for the use of new technology.

To ensure that proper reimbursement is obtained for utilization of a new technology, providers should demonstrate to payers the long-term cost-effectiveness of the new technology. Providers need to determine the incremental costs incurred in using the technology and various payers' payment rates for such use. If preliminary analysis shows that reimbursement for the technology may be insufficient, providers then should conduct a detailed analysis of the new technology. This analysis should assemble comparative data of internal and external performance benchmarks from various sources, including state, regional, and national databases. In addition, providers should assess the long-term savings achieved by using the new technology, such as reductions in hospital readmissions and repeated procedures. Managed care payers are likely to find such data persuasive in determining whether to increase payment rates for a new device or therapy.

Angioplasty, Balloon, Coronary↗

Integrating new technology with managed care contracting.

The authors of this case study assisted eight teaching hospitals affiliated with the medical school of New Jersey in a financial analysis of the economic impact associated with utilization of the coronary artery stent implant. Consisting of a former health system CEO, a financial consultant/hospital trustee and an experienced hospital executive, this team shared their findings with medical and administrative staff to develop best practice models. The results of a new extended patient follow-up study contrasting outcomes and cost for stent vs. PTCA procedures will be reported later this year.

Benchmarking↗