scholarly journals Limited Consequences of a Transition From Activity-Based Financing to Budgeting: Four Reasons Why According to Swedish Hospital Managers

2019 ◽  
Vol 56 ◽  
pp. 004695801983836
Author(s):  
Lina Maria Ellegård ◽  
Anna Häger Glenngård
Keyword(s):  
Health Care Systems ◽  
County Council ◽  
External Control ◽  
Midlevel Managers ◽  
Managed Health Care ◽  
Global Budgets ◽  
Actual Design ◽  
Care Systems ◽  
Global Budgeting ◽  
Textbook Design

Activity-based financing (ABF) and global budgeting are two common reimbursement models in hospital care that embody different incentives for cost containment and quality. The purpose of this study was to explore and describe perceptions from the provider perspective about how and why replacing variable ABF by global budgets affects daily operations and provided services. The study setting is a large Swedish county council that went from traditional budgeting to an ABF system and then back again in the period 2005-2012. Based on semistructured interviews with midlevel managers and analysis of administrative data, we conclude that the transition back from ABF to budgeting has had limited consequences and suggest 4 reasons why: (1) Midlevel managers dampen effects of changes in the external control; (2) the actual design of the different reimbursement models differed from the textbook design; (3) the purchasing body’s use of other management controls did not change; (4) incentives bypassing the purchasing body’s controls dampened the consequences. The study highlights the challenges associated with improvement strategies that rely exclusively on budget system changes within traditional tax-funded and politically managed health care systems.

The Logics and Politics of Post-WWII Migration to Western Europe

2008 ◽  
Vol 41 (1) ◽  
pp. 251-252
Author(s):  
Waldemar A. Skrobacki
Keyword(s):  
New York ◽  
Western Europe ◽  
Health Care Systems ◽  
Pension Plans ◽  
Cambridge University ◽  
Managed Health Care ◽  
The People ◽  
Care Systems ◽  
State Of Affairs ◽  
Sensitive Issues

The Logics and Politics of Post-WWII Migration to Western Europe, Anthony M. Messina, New York: Cambridge University Press, 2007, pp. xv, 290.One of the most contentious and politically sensitive issues in Europe is immigration. The demographic trends indicate that the Old Continent is indeed getting older. To maintain their living standards, Europeans have to either increase birth rates or open the gates to immigrants in an orderly and welcoming way. Yet despite the practicality and, sooner rather than later, the necessity for an open, comprehensive and pro-active immigration policy, European countries are far from having one. At best, they have procedures concerning how to handle foreigners. The main “culprits” for this state of affairs are the people rather than governments. The Europeans, however rational the arguments for increasing immigration may be, are unwilling to embrace it. Paradoxically, those who are most opposed (and vote accordingly) are older people, even though they depend most on a large taxpayer base without which cheques from government-run pension plans would stop flowing eventually and publicly managed health care systems would run out of money.

Institutional Pharmacoeconomics: Who Benefits?

2002 ◽  
Vol 37 (6) ◽  
pp. 668-671
Author(s):  
F. Randy Vogenberg
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
High Quality ◽  
Quality Health Care ◽  
Managed Health Care ◽  
Quality Health ◽  
Care Systems ◽  
High Quality Health Care ◽  
The Many ◽  
The Impact

Managed health care has changed the way health services are provided and paid for. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care, with a special emphasis on how these changes are affecting pharmacists working in health systems. Managed health care systems are still evolving, and the expertise of pharmacists will be needed for these systems to attain their primary goal: the delivery of affordable, comprehensive, high-quality health care.

Reforming the Health Care System: The Universal Dilemma

1993 ◽  
Vol 19 (1-2) ◽  
pp. 21-36
Author(s):  
Uwe E. Reinhardt
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Universal Access ◽  
Health Care Systems ◽  
Care Providers ◽  
Access To Health ◽  
Global Budgets ◽  
Industrialized Nations ◽  
Care Systems

This Article surveys alternative approaches by which the advanced industrialized nations seek to cope with the twin problems that health care poses everywhere: the provision of universal access to health care and the control of national spending on health care. Although approaches to these twin problems vary considerably among nations at this time, there may well be a convergence toward a common approach in the next century. Under that approach, all health care systems will be subject to top-down global budgets and will put their health care providers into “statistical fishbowls” that reveal just how effectively these providers allocate the global budgets at their disposal.

Ambulatory Payment Classes: Obstacle or Opportunity for Health Care Systems?

2000 ◽  
Vol 35 (2) ◽  
pp. 114-119
Author(s):  
C. Nick Wilson
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Services ◽  
Health Care Systems ◽  
Quality Health Care ◽  
Managed Health Care ◽  
Quality Health ◽  
Care Systems ◽  
The Many ◽  
The Impact

Managed health care has changed the way health services are provided and paid for. It is still evolving. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care with special emphasis placed on how these changes may affect pharmacists working in health systems. The expertise provided by pharmacists will be needed to fulfill the potential of affordable, comprehensive, and quality health care as promised by managed care. Pharmacists must understand what is happening, why it is happening, and what is likely to happen in the future. To be an active and effective player, you must understand what is happening on the field.

MORE MANAGED HEALTH-CARE SYSTEMS USE INCENTIVE PAY TO REWARD "BEST" DOCTORS

PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. A30-A30
Author(s):  
J. F. L.
Keyword(s):  
Health Care Systems ◽  
Incentive Pay ◽  
Test Results ◽  
Good Doctor ◽  
Managed Health Care ◽  
Family Practitioners ◽  
High Quality Medical Care ◽  
Care Systems ◽  
Doctor's Office

What It Takes to Be Rated a Good Doctor Here are some of the more than 20 quality standards used by U.S. Healthcare Inc. to determine what level of incentive payments family practitioners, pediatricians and internists will receive for delivering high quality medical care. • How easy is it to make appointments for checkups? • How long is the waiting time in a doctor's office? • How much personal concern does a doctor show for patients? • How readily can patients obtain follow-up test results? • Would patients recommend their doctor to others? • Do doctors provide regular immunizations for children? Breast-cancer checks for women? Colon-cancer checks for men? • What percent of a doctor's patients transfer to another physician's care each year?

160: Cost-Effectiveness of Medical Management Strategies of Nephrolithiasis in Different Health Care Systems

2004 ◽  
Vol 171 (4S) ◽  
pp. 42-43 ◽  
Author(s):  
Yair Latan ◽  
David M. Wilhelm ◽  
David A. Duchene ◽  
Margaret S. Pearle
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Medical Management ◽  
Health Care Systems ◽  
Management Strategies ◽  
Care Systems
Sign in / Sign up

Export Citation Format

Share Document