Global Budget Battles

Science ◽  
1995 ◽  
Vol 270 (5244) ◽  
pp. 1905-1905
Keyword(s):  
2021 ◽  
Vol 868 ◽  
pp. 46-64
Author(s):  
Klaus Heeger ◽  
Anne-Sophie Himmel ◽  
Frank Kammer ◽  
Rolf Niedermeier ◽  
Malte Renken ◽  
...  
Keyword(s):  

Author(s):  
Yaping Xiao ◽  
Jennifer A. Logan ◽  
Daniel J. Jacob ◽  
Rynda C. Hudman ◽  
Robert Yantosca ◽  
...  
Keyword(s):  

Author(s):  
Elham Hatef ◽  
Hadi Kharrazi ◽  
Ed VanBaak ◽  
Marc Falcone ◽  
Lindsey Ferris ◽  
...  

Maryland Department of Health (MDH) has been preparing for alignment of its population health initiatives with Maryland’s unique All-Payer hospital global budget program. In order to operationalize population health initiatives, it is required to identify a starter set of measures addressing community level health interventions and to collect interoperable data for those measures. The broad adoption of electronic health records (EHRs) with ongoing data collection on almost all patients in the state, combined with hospital participation in health information exchange (HIE) initiatives, provides an unprecedented opportunity for near real-time assessment of the health of the communities. MDH’s EHR-based monitoring complements, and perhaps replaces, ad-hoc assessments based on limited surveys, billing, and other administrative data. This article explores the potential expansion of health IT capacity as a method to improve population health across Maryland.First, we propose a progression plan for four selected community-wide population health measures: body mass index, blood pressure, smoking status, and falls-related injuries. We then present an assessment of the current and near real-time availability of digital data in Maryland including the geographic granularity on which each measure can be assessed statewide. Finally, we provide general recommendations to improve interoperable data collection for selected measures over time via the Maryland HIE. This paper is intended to serve as a high- level guiding framework for communities across the US that are undergoing healthcare transformation toward integrated models of care using universal interoperable EHRs.


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Atik Nurwahyuni ◽  
Wan Aisyiah Baros

Tidak ada sistem pembayaran pelayanan Kesehatan yang sempurna dalam penerapannya termasuk sistem pembayaran DRG (Diagnosis-Related Groups) yang lebih dikenal dengan nama INA-CBGs (Indonesia Case-Based Groups) di Indonesia. Beberapa negara yang mengadopsi DRG telah menerapkan kebijakan pembayaran mixed method DRG-Global Budget dengan variasi implementasinya demi menjaga kesinambungan sistem jaminan kesehatan nasional di negaranya. BPJS Kesehatan menginisiasi studi operasional penerapan sistem pembayaran rumah sakit mixed-method INA-CBGs dan Global Budget mulai tahun 2018. Terdapat tiga tahapan dalam uji coba sistem pembayaran rumah sakit mixed-method INA-CBGs dan Global Budget ini. Tahap pertama adalah Global Budget Tanpa Resiko yang bertujuan untuk menguji metode penghitungan global budget dan mengidentifkasi tantangan yang dihadapi bila kebijakan mixed method INA-CBGs dan Global Budget ini diberlakukan. Studi dilakukan di 5 (lima) kabupaten/kota di 30 rumah sakit (RS). Hasil studi menunjukkan bahwa metodologi penghitungan global budget yang diterapkan cukup akurat untuk memprediksi realisasi klaim di RS. Penghitungan global budget di tingkat kabupaten/kota lebih akurat hasilnya dibandingkan dengan menghitung global budget di tingkat RS karena mengakomodir shifting pasien dari RS yang satu ke RS yang lainnya akibat perubahan kapasitas RS. Perubahan kapasitas RS di tahun berjalan dan adanya pandemi COVID-19 menyebabkan adanya selisih antara penghitungan global budget dan realisasi klaim.


2011 ◽  
Vol 32 (1) ◽  
pp. 169-187 ◽  
Author(s):  
Wen-Hsiang Wu ◽  
Chin-Tsai Lin ◽  
Kua-Hsin Peng
Keyword(s):  

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Liyang Xie ◽  
Michel Boudreaux ◽  
Luisa Franzini
Keyword(s):  

Orthopedics ◽  
2020 ◽  
Author(s):  
Wayne Wilkie ◽  
Nequesha Mohamed ◽  
Ethan Remily ◽  
Jennifer Etcheson ◽  
Iciar Dávila Castrodad ◽  
...  

2019 ◽  
Vol 21 (1) ◽  
pp. 105-114
Author(s):  
Katalin Gaspar ◽  
France Portrait ◽  
Eric van der Hijden ◽  
Xander Koolman

Abstract Global budget (GB) arrangements have become a popular method worldwide to control the rise in healthcare expenditures. By guaranteeing hospital funding, payers hope to eliminate the drive for increased production, and incentivize providers to deliver more efficient care and lower utilization. We evaluated the introduction of GB contracts by certain large insurers in Dutch hospital care in 2012 and compared health care utilization to those insurers who continued with more traditional production-based contracts, i.e., cost ceiling (CC) contracts. We used the share of GB hospital funding per postal code region to study the effect of contract types. Our findings show that having higher share of GB financing was associated with lower growth in treatment intensity, but it was also associated with higher growth in the probability of having at least one hospital visit. While the former finding is in line with our expectation, the latter is not and suggests that hospital visits may take longer to respond to contract incentives. Our study covers the years of 2010–2013 (2 years before and 2 years following the introduction of the new contracts). Therefore, our results capture only short-term effects.


2018 ◽  
Vol 33 (7) ◽  
pp. 2043-2046 ◽  
Author(s):  
Ronald E. Delanois ◽  
Chukwuweike U. Gwam ◽  
Jeffrey J. Cherian ◽  
Jennifer I. Etcheson ◽  
Nicole E. George ◽  
...  

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