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Results for “Insurance, Health, Reimbursement”

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At least 55 records · Page 3Linked to original sources
PubMed1979

Cost containment through risk-sharing by primary-care physicians.

A new type of independent practice association has been organized to encourage primary-care physicians in private practice to become coordinators and financial managers for all medical care. Each patient chooses one internist, family or general physician or pediatrician and must be referred by that physician for all specialized care. The primary-care physician authorizes payment from his own account for all care provided to his patients. He shares any dificit or surplus remaining at the end of the year. After four years of operation, United Healthcare has 610 primary-care physicians treating 23,000 patients. Total hospital use during 1978 and 293 bed-days per 1000 patients, as compared with 479 for Blue Cross. The hospital-admission rate per 1000 was 88, as compared with 101 for Blue Cross. Average lengths of stay were 3.3 and 4.7 dyas, respectively. This plan represents another means to control costs in the private medical marketplace.

Consumer Behavior↗
PubMed1988

Financing outpatient mental health care: how much does insurance actually help?

Providers of mental health services in both public and private sectors are becoming increasingly dependent on third-party health insurance to cover the costs of outpatient psychotherapy. The present investigation examines reimbursement rates for the cost of the average course of psychotherapy for a sample of industries in one city. Results suggest that insurance coverage should not be viewed as a panacea by mental health providers.

Community Mental Health Services↗
PubMed1981

Medicare and Medicaid programs; schedules of guidelines for physical therapy and respiratory therapy services: Health Care Financing Administration. Proposed notice.

This notice sets forth proposed schedules of salary equivalency guidelines for Medicare program reimbursement for the reasonable cost of physical therapy and respiratory therapy services furnished under an arrangement with a hospital or other provider. The schedules would be used by the program's fiscal intermediaries to determine the maximum allowable cost of such services. These schedules would revise the schedules published February 25, 1981, which were effective for services furnished on or after October 1, 1980. The revised schedules would apply to services furnished on or after October 1, 1981. For cost reporting periods beginning on or after November 1, 1981, the revised guideline amounts would be increased by an adjustment factor. (As explained in Supplementary Information below, some guideline amounts in these proposed revisions are lower than those contained in the schedules that were effective October 1, 1980. We are proposing, therefore, to have a transition period during which the higher of the revised guidelines or the October 1, 1980 guidelines would apply.) In addition, these guidelines would apply to reimbursement under the Medicaid program where they have been incorporated in the State plans or where States follow the Medicare principles of reimbursement.

Insurance, Health↗
PubMed1985

Payment for psychiatric services under Canada's insurance system.

The authors review the impact of Canada's universal health insurance system on the delivery of psychiatric services. They believe that, on balance, Canadian psychiatrists and their patients have benefited from the system. However, certain categories of patients still do not have access to private care, and public facilities in some provinces have long waiting lists for services because of manpower shortages. A substantial number of psychiatrists have opted out of the system because of dissatisfaction with the intrusion of third-party payment on practice. The Canadian system presently discourages copayment by patients, and thus has reinforced the public's belief in free medical care as a right. The authors discuss the benefits to some patients of direct payment for services and emphasize the need for direct payment to remain an option under national health insurance.

Canada↗
PubMedDate not supplied

Changes in mental health financing since 1971: implications for policymakers and patients.

The aggregate share that total mental health spending claims of national income has been stable over the past thirty-five years. This stability is a consequence of immense change--new organizational technologies, new treatment technologies, and a growing supply of providers. Aggregate spending stability has been accompanied by major shifts in the composition of financing, which have tended to spread the costs of mental illness more broadly but also have led to fragmentation in public responsibility for people with mental illnesses. Recent developments suggest that financing could be further constrained in the future, even as fragmentation continues to increase.

Financing, Government↗