Return on investment point of service Computerized Provider Charge Entry.
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Provider charge entry systems offer many benefits to users and organizations. At Vanderbilt University Medical Center, a web-based provider charge entry system promises to deliver benefits in reducing days in accounts receivable, reducing labor required for claims and edit processing, and implementing business rules that deliver both strategic and financial benefits. (+info)
Medicare program; physicians' referrals to health care entities with which they have financial relationships (Phase II). Interim final rule with comment period.
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This interim final rule with comment period (Phase II of this rulemaking) incorporates into regulations the provisions concerning ownership and investment exceptions in paragraphs (c) and (d) and the compensation exceptions in paragraph (e) of section 1877 of the Social Security Act (the Act). Phase II also addresses comments concerning the reporting requirements in section 1877(f) of the Act. Phase I (as defined below) addressed the majority of issues in implementing section 1877 of the Act. Phase II both addresses the remaining issues not addressed in Phase I and responds to public comments. In general, in response to public comments, the Department has attempted to reduce regulatory burden by broadening exceptions using the Secretary's discretionary authority under the statute to create exceptions that pose no risk of fraud or abuse. For the convenience of affected parties, we have set out the entire rule as previously promulgated, including the changes made by this rulemaking. (+info)
Tobacco and transition: an overview of industry investments, impact and influence in the former Soviet Union.
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OBJECTIVES: To quantify the contribution the tobacco industry has made to foreign direct investment (FDI) in the former Soviet Union (FSU) as an indicator of its political and economic leverage; to explore the impact this has had on production capacity and tobacco control in the region. DESIGN: Data on industry investment and its impact on cigarette production capacity were collated from industry journals, reports, and websites. Data on total FDI were obtained from the European Bank of Reconstruction and Development. RESULTS: By the end of 2000, transnational tobacco companies (TTCs) had invested over 2.7 billion US dollars in 10 countries of the FSU. Tobacco money as a proportion of FDI varies from 1% to over 30% in Uzbekistan. Cigarette production capacity in the factories receiving investments tripled from 146 to 416 billion cigarettes per annum and the TTCs' market share has increased from nothing to between 50-100% in the markets in which they invested. Findings suggest that the effectiveness of national tobacco control measures corresponds broadly to the nature of the political and economic transition in each country and the size of industry investment, which is determined in part by the political context. Thus more effective measures tend to be seen in democratic states with smaller or no industry investments while the least effective measures are seen in highly centralised, one party states with high levels of industry investment or those with limited governmental capacity. CONCLUSIONS: The entry of the TTCs at a time of major political and economic change left the FSU particularly vulnerable to industry influence. This influence was enhanced by the industry's significant contribution to FDI, their ability to take over existing state monopolies in all but the largest countries, and the lack of democratic opposition. (+info)
Asthma disease management: regression to the mean or better?
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OBJECTIVES: To assess the effectiveness of disease management as an adjunct to treatment for chronic illnesses, such as asthma, and to evaluate whether the statistical phenomenon of regression to the mean is responsible for many of the benefits commonly attributed to disease management. STUDY DESIGN: This study evaluated an asthma disease management intervention in a Colorado population covered by Medicaid. The outcomes are presented with the intervention group serving as its own control (baseline and postintervention measurements) and are compared with a matched control group during the same periods. METHODS: In the intervention group, 388 asthmatics entered and 258 completed the 6-month program; 446 subjects participated in the control group. Facilities charges were compared for both groups during the baseline and program periods. Both groups were well matched demographically and for costs at baseline. RESULTS: Using the intervention group as its own control revealed a 49.1% savings. The control group savings were 30.7%. Therefore, the net savings were 18.4% (P < .001) for the intervention group vs controls. Although the demonstrated savings were less using a control group to correct for regression to the mean, they were statistically significant and clinically relevant. CONCLUSION: When using a control group to control for the statistical effects of regression to the mean, a disease management intervention for asthma in a population covered by Medicaid is effective in reducing healthcare costs. (+info)
Estimating the economic value to societies of the impact of health research: a critical review.
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Estimating the economic value to societies of health research is a complex but essential step in establishing and justifying appropriate levels of investment in research. The practical difficulties encountered include: identifying and valuing the relevant research inputs (when many pieces of research may contribute to a clinical advance); accurately ascribing the impact of the research; and appropriately valuing the attributed economic impact. In this review, relevant studies identified from the literature were grouped into four categories on the basis of the methods used to value the benefits of research. The first category consists of studies that value the direct cost savings that could arise from research leading either to new, less-costly treatments or to developments such as vaccines that reduce the number of patients needing treatment. The second category comprises studies that consider the value to the economy of a healthy workforce. According to this "human capital" approach, indirect cost savings arise when better health leads to the avoidance of lost production. The third category includes studies that examine gains to the economy in terms of product development, consequent employment and sales. The studies placed in the fourth category measure the intrinsic value to society of the health gain, by placing a monetary value on a life. The review did not identify any consistency of methodology, but the fourth approach has most promise as a measure of social value. Many of the studies reviewed come from industrialized nations and a proposal is made by the present reviewers for an international initiative, covering developed and developing countries, to undertake further methodological analysis and testing. (+info)
Health in the developing world: achieving the Millennium Development Goals.
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The Millennium Development Goals depend critically on scaling up public health investments in developing countries. As a matter of urgency, developing-country governments must present detailed investment plans that are sufficiently ambitious to meet the goals, and the plans must be inserted into existing donor processes. Donor countries must keep the promises they have often reiterated of increased assistance, which they can easily afford, to help improve health in the developing countries and ensure stability for the whole world. (+info)
Exploring the impact of foreign direct investment on tobacco consumption in the former Soviet Union.
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BACKGROUND: Tobacco is the single largest cause of morbidity and mortality in the developed world; in the former socialist bloc tobacco kills twice as many men as in the west. Although evidence shows that liberalisation of the cigarette trade through the elimination of import barriers leads to significant increases in consumption, far less is known about the impact of foreign direct investment on cigarette consumption. This paper seeks to explore the impact that the substantial transnational tobacco company investments have had on patterns of tobacco trade and consumption in the former Soviet Union. DESIGN: Routine data were used to explore trends in cigarette trade and consumption in the 15 countries of the former Soviet Union from the 1960s to the present day. Comparisons were made between trends in countries that have received substantial investment from the tobacco transnationals and countries that have not. RESULTS: Between 1991 and 2000 cigarette production increased by 96% in countries receiving industry investment and by 11% in countries that did not. Over the same period cigarette consumption increased by 40%; the increase was concentrated in countries receiving investments. Despite these investments, cigarette imports still outweigh exports and no trade surplus has yet to result. CONCLUSIONS: The findings suggest that liberalisation of inward investment has a significant and positive impact on cigarette consumption and that without appropriate safeguards, market liberalisation may have long term negative impacts on health. Specific trade rules are needed to govern trade and investment in this uniquely harmful product. Implementation of effective tobacco control policies should precede tobacco industry privatisation. International financial organisations pressing for privatisation should ensure this occurs. (+info)
Payback arising from research funding: evaluation of the Arthritis Research Campaign.
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OBJECTIVES: Using a structured evaluation framework to systematically review and document the outputs and outcomes of research funded by the Arthritis Research Campaign in the early 1990s. To illustrate the strengths and weaknesses of different modes of research funding. METHODS: The payback framework was applied to 16 case studies of research grants funded in the early 1990s. Case study methodology included bibliometric analysis, literature and archival document review and key informant interviews. RESULTS: A range of research paybacks was identified from the 16 research grants. The payback included 302 peer-reviewed papers, postgraduate training and career development, including 28 PhD/MDs, research informing recommendations in clinical guidelines, improved quality of life for people with RA and the reduction of the likelihood of recurrent miscarriage for women with antiphospholipid syndrome. The payback arising from project grants appeared to be similar to that arising from other modes of funding that were better resourced. CONCLUSIONS: There is a wide diversity of research payback. Short focused project grants seem to provide value for money. (+info)