Note: Supplemental materials are not guaranteed with Rental or Used book purchases.
Purchase Benefits
Looking to rent a book? Rent Designing and Implementing Health Care Provider Payment Systems How-To Manuals [ISBN: 9780821378151] for the semester, quarter, and short term or search our site for other textbooks by Langenbrunner, John C.; Cashin, Cheryl; O'Dougherty, Sheila. Renting a textbook can save you up to 90% from the cost of buying.
Preface | p. xi |
Acknowledgments | p. xiii |
List of Contributors | p. xv |
Abbreviations | p. xviii |
Glossary | p. xix |
Overview: What, How, and Who: An Introduction to Provider Payment Systems | p. 1 |
Aims and Readership of This Volume | p. 1 |
Provider Payment Systems and Methods: An Overview | p. 3 |
Main Characteristics of Provider Payment Methods | p. 12 |
The Way Forward | p. 19 |
Organization of This Volume | p. 20 |
Notes | p. 24 |
References | p. 24 |
Primary Health Care Per Capita Payment Systems | p. 27 |
Overview of PHC Provider Payment Systems | p. 27 |
Defining the Health Policy Context | p. 27 |
Methodology for Developing a Per Capita PHC Payment System | p. 33 |
Defining a PHC Package of Services | p. 35 |
Setting the PHC Pool and Calculating the Base Per Capita Rate | p. 37 |
Calculating Risk Adjustment Coefficients | p. 40 |
Developing an Enrollment Database | p. 52 |
Calculating Each Provider's Per Capita Budget | p. 61 |
Designing a Finance and Management System | p. 62 |
Designing a Monitoring and Quality Assurance System | p. 75 |
Expanding the Base Per Capita Rate and Package of Services | p. 87 |
Implementation Issues | p. 89 |
The Link between PHC Per Capita Payment and the Health System Axes: Experience from Four Central Asian Republics | p. 97 |
Note | p. 120 |
References | p. 120 |
Case-Based Hospital Payment Systems | p. 125 |
Overview of Case-Based Hospital Payment Systems | p. 125 |
Defining Case Grouping Criteria | p. 134 |
Completing Cost-Accounting Analysis | p. 148 |
Calculating Case Group Weights | p. 159 |
Calculating the Base Rate | p. 161 |
Designing an Information and Billing System | p. 170 |
Refining Case Grouping | p. 190 |
Implementation Issues | p. 192 |
Case Studies from Kazakhstan and the Kyrgyz Republic | p. 196 |
Notes | p. 211 |
References | p. 212 |
Hospital Global Budgeting | p. 215 |
Overview | p. 215 |
Setting the Hospital Global Budget | p. 218 |
Performance Incentives | p. 229 |
Nonbudget Funding | p. 232 |
An Overview of Costing | p. 241 |
Managing the New Global Budget | p. 248 |
Annual Adjustments | p. 248 |
References | p. 253 |
A Primer on Contracting | p. 255 |
Introduction | p. 255 |
Which Contract? | p. 256 |
Volumes | p. 257 |
Which Contract When? | p. 259 |
Consortia | p. 261 |
Duration of Contract | p. 262 |
Note | p. 262 |
Health Management Information Systems: Linking Purchasers and Providers | p. 263 |
Background | p. 263 |
Implementing Appropriate Provider Systems | p. 268 |
Implementing Appropriate Purchaser Systems | p. 283 |
Implementing an Appropriate Link between Purchaser and Provider Systems | p. 291 |
Concluding Remarks | p. 297 |
Annex 5.1: A Primer on Health Management Information Systems | p. 300 |
Notes | p. 304 |
References | p. 304 |
Index | p. 307 |
Boxes | |
Incentives | p. 2 |
Balance of Decision Rights in Costa Rica | p. 33 |
Top-Down Estimation of the PHC Pool as a Health Policy Tool | p. 39 |
Open Enrollment in Zhezkazgan, Kazakhstan | p. 56 |
Budget Overruns and the Unadjusted Base Per Capita Rate | p. 63 |
Budget Neutrality and a Per Capita Rate Adjusted Using Age/Sex Adjustors | p. 64 |
Budget Neutrality and a Per Capita Rate Adjusted Using Both Geographic and Age/Sex Adjustors | p. 65 |
Introductory Training for Finance Managers in Uzbekistan | p. 68 |
Basic Health Management for General Practitioners in Uzbekistan | p. 70 |
Issues and Solutions in a Fully Automated System in the Kyrgyz Republic | p. 74 |
Benchmarking, Not Targets, in Karaganda, Kazakhstan | p. 84 |
PHC Monitoring System in Karaganda, Kazakhstan | p. 86 |
Provider Satisfaction | p. 93 |
Results of Increased Provider Autonomy in Karaganda, Kazakhstan | p. 96 |
Karaganda Achievements | p. 110 |
Possible Adjustment Coefficients to the Payment Per Case Formula | p. 132 |
Initial Case Groups and Weights in the Kyrgyz Republic | p. 135 |
Major Diagnostic Categories in the Australian Refined Diagnosis-Related Groups Classification | p. 141 |
Serial Example: Calculating Average Cost per Case | p. 144 |
Table of Contents provided by Ingram. All Rights Reserved. |
The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.
The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.