scholarly journals The Influence of BPJS Health Payment and Service Method for Satisfaction of BPJS Health Members in South Tangerang

2020 ◽  
Author(s):  
Nining Suryani ◽  
Muhammad Sopiyana
Keyword(s):  
Health Payment

scholarly journals A 15-Year Trend of Catastrophic Health Payment and its Inequality in China: Evidence from Longitudinal Data

2021 ◽  
Author(s):  
Yongjian Xu ◽  
Yiting Zhou ◽  
Andi Pramono
Keyword(s):  
Health Care ◽  
Decomposition Analysis ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Chinese Government ◽  
Nutrition Survey ◽  
Basic Medical Insurance ◽  
Poor Households ◽  
Health Payment ◽  
Basic Medical

Abstract Background：The Chinese health care system has gone through two major cycles of reform since the 1980s. This study aims to comprehensively track the trends in the occurrence of catastrophic health payment and its inequality in the past 15 years, which may help better understand the influence of health system reforms on catastrophic health payment and its inequality. Methods：The study employed the subset of data from China Health and Nutrition Survey conducted from 1991 to 2015. Concentration index and decomposition analysis were used to measure the magnitude of income-related inequality in catastrophic health payment and decompose it into determinants respectively. Results: The incidence of catastrophic health expenditure in China increased from 3.10% in 1993 to 8.90% in 2004, and still maintained at a high level in the following years. The incidence gap of catastrophic health payment between the richest and poorest became increasingly wider over year. Moreover, the adjusted concentration indexes were all negative in each year, decreasing from -0.202 in 1991 to -0.613 in 2015. The basic medical insurance didn’t decrease the incidence of catastrophic health payment and showed the second largest contribution on the inequality in catastrophic health payment before 2004. However, this contribution began to decline after 2006. Conclusions: After the New Health Care Reform, although the Chinese government has taken many measures to protect poor households from catastrophic health payment, the incidence gap between the rich and poor has widened. China has nearly achieved universal coverage in recent years, however, the basic medical insurance in China was not enough to protect households from catastrophic health payment. Our study suggests that improving the generosity of existing basic medical insurance, and reforming the medical insurance payment system would be helpful to reduce the incidence of catastrophic health payment. The use of big data tools and techniques to effectively screen the poor households, and strengthening the social medical aid system would be helpful to decrease the pro-rich inequality in catastrophic health payment.

scholarly journals UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Wei Yang
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Systems ◽  
Significant Proportion ◽  
Medical Costs ◽  
Urban China ◽  
Substantial Part ◽  
Rural And Urban ◽  
Care Systems ◽  
Health Payment

Abstract Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.

scholarly journals Understanding the Non-medical Costs of Healthcare: Evidence from Inpatient Care for Older People in China

2019 ◽  
Vol 242 ◽  
pp. 487-507
Author(s):  
Wei Yang
Keyword(s):  
Older People ◽  
Medical Costs ◽  
Longitudinal Survey ◽  
Rural Populations ◽  
Substantial Part ◽  
Medical Visits ◽  
Using Data ◽  
New Policies ◽  
Health Payment ◽  
Care For Older People

AbstractNon-medical costs, including costs associated with carers, travel, food and accommodation for family members who care for older people during their medical visits, can constitute a substantial part of total healthcare costs, especially for older people. Using data from the 2015 China Health and Retirement Longitudinal Survey, this study examines the effects of such non-medical costs on catastrophic health payments and health payment-induced poverty among older people in China. Results indicate that non-medical costs account for approximately 18 per cent of total inpatient costs. The percentage is highest for those in the lowest economic brackets. Rural populations are more likely than urban populations to incur catastrophic health payments and suffer from health payment-induced poverty. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. These findings suggest that policymakers should look to develop new policies that facilitate reimbursement of non-medical costs, particularly for the rural population.

The Influence of Medicare Home Health Payment Incentives: Does Payer Source Matter?

2006 ◽  
Vol 43 (2) ◽  
pp. 135-149 ◽  
Author(s):  
David C. Grabowski ◽  
David G. Stevenson ◽  
Haiden A. Huskamp ◽  
Nancy L. Keating
Keyword(s):  
Home Health ◽  
Payment Incentives ◽  
Payer Source ◽  
Health Payment

scholarly journals Impoverishing effect of household healthcare expenditure in semi-rural communities in Yenagoa, Nigeria

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Adedotun Daniel Adesina ◽  
Daprim Samuel Ogaji
Keyword(s):  
Rural Communities ◽  
Social Insurance ◽  
Healthcare Expenditure ◽  
Health Financing ◽  
Simple Random Sampling ◽  
Healthcare Spending ◽  
Poverty Line ◽  
The Rich ◽  
Health Payment ◽  
Payment Mechanisms

Inequity in the payment mechanism for healthcare systematically affects poorer households more than the rich. This article examines the impoverishing effect of healthcare expenditure on households in Yenagoa. Data was obtained from a crosssectional survey of households in 2 communities in Yenagoa selected by simple random sampling. A pretested, structured, interviewer-administered questionnaire was used to obtain information on household (HH) income, general expenditures and financing for healthcare. Two international poverty lines designed by World Bank were employed to classify households as poor, extremely poor and to determine the impoverishing effects of households’ healthcare expenditures. Responses were received from 525 HHs with 9.2% of HHs falling below poverty line, another 9% pushed deeper into poverty after healthcare spending. A 12.3% and 16% increase in the poverty and extreme poverty gaps respectively were attributable to health payment. A significant percentage of households who were non-poor were pushed into poverty after healthcare spending. There is need for increased public spending and implementation of innovative pre-payment mechanisms and social insurance that assures financialrisk protection and equity in health financing in Yenagoa.

Mental Health Payment-by-Results Clusters and the Model of Human Occupation Screening Tool

2012 ◽  
Vol 33 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Sun W. Lee ◽  
Kirsty Forsyth ◽  
Mary Morley ◽  
Mike Garnham ◽  
David Heasman ◽  
...  
Keyword(s):  
Mental Health ◽  
Screening Tool ◽  
Human Occupation ◽  
Model Of Human Occupation ◽  
Health Payment

Using Predicted Therapy Visits in the Medicare Home Health Prospective Payment System

2016 ◽  
Vol 29 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Betty Fout ◽  
Michael Plotzke ◽  
Thomas Christian
Keyword(s):  
Current System ◽  
Prospective Payment System ◽  
Home Health ◽  
Payment System ◽  
Health Claims ◽  
Fee For Service ◽  
Prospective Payment ◽  
Home Health Agencies ◽  
Therapy Services ◽  
Health Payment

A criticism of Medicare’s home health prospective payment system is its partial reliance on cost-based reimbursement of therapy services provided by home health agencies (HHAs) to Medicare fee-for-service (FFS) beneficiaries, potentially overincentivizing the provision of therapy services. Using Medicare FFS home health claims and assessment data, we estimated a model to predict therapy use as a proxy for clinical need and replace actual therapy use with the prediction in the home health payment system. We estimated a $1.178 billion (95% confidence interval, $1.171-$1.184) decrease in home health payments relative to levels under the current system. The majority of the decrease was due to the model predicting fewer high therapy episodes than actually occurred. It may therefore be more appropriate to predict both therapy and nontherapy use, requiring an overhaul of the current system.

scholarly journals Are specialist psychiatric services losing the PbR race?: commentary on… clustering in mental health payment by results

2014 ◽  
Vol 20 (4) ◽  
pp. 235-236
Author(s):  
Vishwa Radhakrishnan
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Services ◽  
Psychiatric Services ◽  
Short Term ◽  
Specialist Services ◽  
Health Payment

SummaryPayment by results (PbR) is a payment platform for healthcare services. Introduced to acute physical healthcare services in England in 2003–2004, the system has continued to expand and is currently being implemented in acute mental health services. Owing to the variations and complexities of the patients who access specialist psychiatric services, existing clusters do not always accurately capture their needs. The development of PbR tools specific to psychiatric subspecialties is ongoing, but might not be available in the short term. The funding of acute mental health services through PbR might have funding implications for specialist services such as psychiatry of intellectual disability.

scholarly journals The Impact of Cognitive Impairment on Resource Utilization During Medicare Home Health Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Julia Burgdorf ◽  
Jennifer Wolff
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Resource Utilization ◽  
Home Health Care ◽  
Cognitive Status ◽  
Home Health ◽  
Payment System ◽  
Health Payment ◽  
The Relationship

Abstract Older adults with cognitive impairment have unique care needs that often lead to greater levels of health care utilization. Prior work suggests that older adults with cognitive impairment access home health care at higher rates; yet, recent Medicare home health payment system revisions exclude patient cognitive status when determining risk adjustment. This research examines the relationship between patient cognitive status and resource utilization during Medicare home health care. We examine 1,217 (weighted n=2,134,620) community-dwelling older adults who received Medicare-funded home health between 2011-2016, using linked nationally representative survey data from the National Health and Aging Trends Study (NHATS), home health patient assessment data, Medicare claims data, and Medicare Provider of Services files. We use weighted, multivariable negative binomial regressions to model the relationship between patient dementia status and the expected number of total visits and number of each visit type (nursing, therapy, and aide) during home health. Models adjusted for patient sociodemographic characteristics and health and functional status during home health, as well as home health provider characteristics. Among Medicare home health patients, the presence of cognitive impairment during home health is associated with 2.87 additional total visits (p<0.001), 1.27 additional nursing visits (p<0.01), and 1.23 additional therapy visits (p=0.04) during the home health episode. Findings suggest that recent revisions to the Medicare home health payment system may disincentivize home health care for older adults with dementia and/or financially penalize home health providers whose patient populations have a greater dementia burden.

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