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Biomedical subjects

T S Jost

Publications and source records attributed to T S Jost.

At least 19 recordsLinked to original sources
PubMed2000

Medicare and Medicaid financing of pain management.

Many Americans who endure pain are beneficiaries of the Medicare and Medicaid programs; however, these programs have many gaps and deficiencies and fail to cover some vital pain management services. Moreover, Medicare and Medicaid provider certification requirements and payment provisions fail to attend to pain management issues, creating disincentives for the provision of adequate pain treatment. Finally, Medicare and Medicaid surveillance and enforcement programs might be deterring adequate provision of pain management. This article reviews these problem areas, and suggests reforms that would address them.

Journal Article↗
PubMed1998

Public financing of pain management: leaky umbrellas and ragged safety nets.

Although many people in pain depend on public health care programs for aid, these programs cover pain relief only fragmentarily. He examines the gaps and deficiencies in Medicare and Medicaid funding of pain relief, and explores the effects of Medicare and Medicaid fraud enforcement on pain management.

Drug Costs↗
PubMed1995

Health care contracts in Britain and the United States: a case for technology transfer?

One unexpected point of convergence between the British and North American health care systems is the increased use of negotiated contracts to govern relationships between purchasers and providers. In Britain, the internal market reforms introduced a special regime of National Health Service (NHS) contracts; in the United States there has been a move from disorganization towards integration with the emergence of larger purchasing coalitions and provider organizations. While, in the past, US patients were simply billed for services or assigned claims to the provider, it is now common for payment to be made directly from purchaser to provider and for the terms of these transactions to be set out in contracts. This paper draws on the reading of contracts, interviews with contracting parties, and ongoing research on NHS contracting in Wales to compare contracting practice within the two systems. It examines how the very different environments of the public, hierarchically-regulated NHS and the private health care market of the US influence the detailed content of contract clauses. The analysis passes over similarities, different solutions to common problems, and fundamental differences of approach, before considering the possibilities for transfers of contracting 'technology'.

Contract Services↗
PubMed1995

The British health care reforms, the American health care revolution, and purchaser/provider contracts.

The health care systems of the United States and the United Kingdom are changing rapidly. After the Thatcher government's 1989 white paper, the formerly unified British National Health Service (NHS) was split into purchaser and provider sides, with the NHS District Health Authorities becoming purchasers, and the NHS hospitals, now reconstructed as independent NHS trusts, becoming providers. The U.S. health care system, driven by market forces rather than government fiat, has been moving rapidly toward integration, with increasingly formalized purchaser and provider relationships. Contracts are found at the purchaser/provider interface in both systems. We reviewed American and British purchaser/provider contracts. The contracts address similar issues but often take disparate approaches. These dissimilarities illuminate the profound, continuing differences between the two systems. They also, however, offer possibilities to transfer contracting "technology" between the two contracting cultures.

Competitive Bidding↗
PubMed1994

Medicare and Medicaid false claims: prohibitions and sanctions.

Both state and federal agencies are cracking down on health care professionals who file false Medicare claims, but physicians who make good faith attempts to comply with the law are fairly secure from prosecution, since both criminal and civil penalties must be based on willful or knowing breaches of the law.

Fraud↗
PubMed1993

Selling cost containment.

Health care expenditures in the United States have continued to grow despite efforts to control them. This Article discusses the need for health care reform, outlines the model that reform should follow, and considers why the United States has not progressed toward a workable solution. It introduces a single-payer approach to cost containment and explains how such an approach could be "sold" in the United States. Finally, the Article examines various ways to mobilize support for such health care reform.

Attitude of Health Personnel↗