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Do preset per visit payment rates affect home health agency behavior?

This article reports on preliminary impacts during the first year of a demonstration in which home health agencies (HHAs) were paid a prospectively set rate for each Medicare home health visit rendered, rather than being reimbursed for costs. Forty-seven agencies in five States participated. The evaluation compared the experiences of randomly assigned treatment agencies and their patients with those of control agencies and their patients and found no compelling evidence of any demonstration impact on agency cost per visit, the volume of home health services, agency revenue and profit, patient selection and retention, quality of care, or use and cost of Medicare services.

Costs and Cost Analysis↗

Report of two smoking cessation programs: telephone intervention and group sessions.

Matthew Thornton Health Plan (MTHP) offered two separate smoking cessation programs within the HMO setting. The two programs, telephone intervention with self-help materials and group counseling/education sessions, were evaluated over a 12-month period: both programs allowed members (n = 226) the option of choosing nicotine replacement therapy (NRT). As an incentive, MTHP reimbursed members who were successful quitters at 6 months for the NRT or offered them a $50 savings bond. At 12 months, cessation rates for both groups were at or above 30% except among patients participating in group counseling/education and not receiving NRT where quit rates were about 20%. Though not a controlled research project, results suggest that active HMO intervention in smoking cessation can be successful. In these programs, the combination of behavioral support and a reimbursement plan were associated with high quit rates.

Health Maintenance Organizations↗

Antiemetic therapy in managed care oncology: roundtable discussion.

Few diagnoses are feared more by patients than cancer. In addition to the life-threatening nature of many cancers, the spectre of very difficult the treatment provides patients with little or no level of comfort. However, recent advances in the treatment of the side effects of cancer chemotherapy are helping to change these attitudes. On April 4, 1996, a panel of experts was convened to discuss these issues and how they affect MCOs.

Antiemetics↗

Use of a geriatric formulary in long-term care.

The use of drug formularies in nursing facilities (NFs) is a fairly new idea. A large long-term care pharmacy provider prepared a formulary specific to a geriatric population. This open formulary is contained within a handbook of clinical monographs, complete with dosing information, cost comparisons, and references to NF regulations affecting the use of particular drugs.

Aged↗