Package price contracting: a growing managed care alternative

Article Abstract:

Package pricing is being explored by the Health Care Financing Administration as a possible instrument for reducing medical care costs while maintaining, and possibly improving the quality of health care. The system allows hospitals and physicians to receive a pre-set amount for high cost and high volume services such as cardiac surgery, transplants, and cancer therapy. It saves payers money through the use of negotiated discounts and by charging only for services actually contracted. Providers benefit by being given the potential to increase the volume of cases treated and by being encouraged to increase efficiency without sacrificing quality.

Column, Health care reform

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Quality may be center stage, but cost keeps stealing the show

Article Abstract:

Cost control continues to be the main driving force behind the increasing shift to managed care. A recent survey of 1,115 employers revealed that 77% of them base their health care purchasing decisions primarily on the 'cost to the company.' For health care providers, the leading factor shaping the market is the pursuit of quality. In a competitive environment, managed care organizations are trying to differentiate themselves from other health care providers by promoting the quality of their services.

Standards, Services, Managed care plans (Medical care)

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Physician incentive schemes in prepaid health plans

Article Abstract:

The Health Care Financing Administration (HCFA) issued new regulations that govern risk-bearing schemes by doctors in health maintenance organizations and other prepaid health plans. The rules which take effect on April 26, 1996, aim to prevent underuse of medical services and minimize payment incentives by managed care plans that cover Medicare and Medicaid beneficiaries. Under these rules, a health plan must disclose to HCFA or the Medicaid agency, information regarding physician incentive plans.

Health Maintenance Organizations, HMO Medical Centers, Offices & clinics of medical doctors, Physicians & Surgeons, Offices of Physicians (except Mental Health Specialists), Laws, regulations and rules, Physicians, Medical professions, Physician services utilization

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