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Results for “Rate Setting and Review”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 19 recordsLinked to original sources
PubMed1992

Antitrust issues for the nurse anesthetist: areas of concern.

This article is the second of a two-part article on antitrust issues as applicable to certified registered nurse anesthetist (CRNAs). The first part, presented in the March 1992 issue, provided an overview of antitrust law and discussed issues related to establishing jurisdiction under federal law. The second part, presented in this issue, focuses on specific antitrust areas of concern to the CRNA, including staff privileges, peer review, price fixing, and insurance. Specific practical recommendations for dealing with antitrust situations are offered.

Antitrust Laws↗
PubMedDate not supplied

Setting rates for Medicaid managed behavioral health care: lessons learned.

This paper reviews Tennessee's experience setting, monitoring, and updating capitation rates for Medicaid managed behavioral health care, and draws lessons from those experiences for other states. Our review of assumptions about four components of Tennessee's rate-setting process--data, benefit design, savings expectations, and processes for monitoring and updating rates--suggests that the initial rate established by Tennessee was inadequate, and its inadequacy resulted primarily from the way available information was used to set the rate, rather than from the method of rate setting selected. Tennessee's experiences illustrate how difficult rate setting is and illuminate several key lessons about the rate-setting process.

Behavioral Medicine↗
PubMed2006

An examination of sources of peer-review bias.

Peer-review ratings of 1,983 posters submitted for three annual conferences of a professional society were examined for evidence of bias. Hypotheses derived from the literature on the better-than-average effect were tested by analyzing 7,383 sets of ratings. Reviewers who authored posters gave lower average ratings than reviewers who did not author posters. Posters having authorship that included at least one reviewer received higher ratings than those having only nonreviewing authors. Reviewers' experience and professional role were also explored as biasing factors. The ratings were converted into z scores, and differences in reliability and acceptance decisions were examined. Implications for current peer-review practices are discussed.

Attitude↗
PubMed1991

RBRVS: still good news for physicians.

Lately, many physicians have been saying they've become disillusioned with the RBRVS. They don't believe the physician payment reform will bring gains for their undervalued evaluation and management services. They don't trust the federal government to live up to its end of the bargain. However, no one should write off the RBRVS. As can be seen from the text below, RBRVS will protect undervalued evaluation and management services in an era of medicare budget-cutting; it will introduce fairness and rationality into the Medicare payment system; it will provide a basis for arguing against unfair cuts in reimbursement (such as the recent ban on payment for most EKG interpretations) and it will bring the profession together to fight against any further cuts in the Medicare program.

Humans↗