Reducing Inappropriate Medicare Spending

Author : United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care
Publisher :
ISBN 13 :
Total Pages : 120 pages
Book Rating : 4.00/5 ( download)

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Download or read book Reducing Inappropriate Medicare Spending written by United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care and published by . This book was released on 1992 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.53/5 ( download)

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Download or read book Reducing Inappropriate Medicare Spending written by United States. Congress. Senate. Committee on Finance. Subcommittee on Medicare and Long-Term Care and published by . This book was released on 1992 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : William Scanlon
Publisher :
ISBN 13 :
Total Pages : 16 pages
Book Rating : 4.92/5 ( download)

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Download or read book Medicare written by William Scanlon and published by . This book was released on 1995 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Author : James C. Cosgrove
Publisher : DIANE Publishing
ISBN 13 : 1437916139
Total Pages : 53 pages
Book Rating : 4.33/5 ( download)

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Download or read book Medicare written by James C. Cosgrove and published by DIANE Publishing. This book was released on 2009-09 with total page 53 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare spending on home health totaled $12.9 billion in 2006, up 44% from 2002. Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare home health spending and utilization. This report examines the growth in Medicare home health spending and utilization and the benefit's vulnerability to improper payments. The report focused on states with the highest growth in Medicare home health spending or utilization; fraudulent and abusive practices contributing to recent spending and utilization; and administrative issues that make it vulnerable to improper payments. Includes recommendations. Charts and tables.

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309144337
Total Pages : 852 pages
Book Rating : 4.39/5 ( download)

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Download or read book The Healthcare Imperative written by Institute of Medicine and published by National Academies Press. This book was released on 2011-01-17 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

Author : Bradford Rodgers
Publisher : Nova Snova
ISBN 13 : 9781536148114
Total Pages : 0 pages
Book Rating : 4.13/5 ( download)

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Download or read book Medicare written by Bradford Rodgers and published by Nova Snova. This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare is the nations health insurance program for persons aged 65 and older and certain disabled persons. Medicare consists of four distinct parts: Part A (Hospital Insurance, or HI); Part B (Supplementary Medical Insurance, or SMI); Part C (Medicare Advantage, or MA); and Part D (the outpatient prescription drug benefit). Medicare covered over 58 million people in 2017 and has wide-ranging impact on the health-care sector and the overall U.S. economy. The Part A program is financed primarily through payroll taxes levied on current workers and their employers; these taxes are credited to the HI Trust Fund. From its inception, the HI Trust Fund has faced a projected shortfall. The 2018 Medicare Trustees Report projects that, under intermediate assumptions, the HI Trust Fund will become insolvent in 2026, three years earlier than estimated in the prior years report as discussed in chapter 1. As reported in the next 2 chapters, spending under the program (except for a portion of administrative costs) is considered mandatory spending and is not subject to the appropriations process. Thus, there generally are no limits on annual Medicare spending. Medicare is most acutely impacted by the sequestration of mandatory funds, since Medicare benefit payments are considered mandatory spending. Special sequestration rules limit the extent to which Medicare can be reduced in a given fiscal year. Chapter 4 focuses on reducing expenditures, unnecessary utilization, and improper payments through prior authorization. The Centers for Medicare & Medicaid Services (CMS) has begun using prior authorization in Medicare through a series of fixed-length demonstrations designed to measure their effectiveness, and one permanent program. The billions of dollars in Medicare outlays as well as program complexity make it susceptible to improper payments, including fraud. Although there are no reliable estimates of fraud in Medicare, in fiscal year 2017 improper payments for Medicare were estimated at about $52 billion. The last 2 chapters address ways to prevent and manage Medicare fraud.

Author : Aspen Health Law Center
Publisher :
ISBN 13 :
Total Pages : 156 pages
Book Rating : 4.73/5 ( download)

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Download or read book Health Care Fraud and Abuse written by Aspen Health Law Center and published by . This book was released on 1998 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.10/5 ( download)

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Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Author : OECD
Publisher : OECD Publishing
ISBN 13 : 9264266410
Total Pages : 304 pages
Book Rating : 4.14/5 ( download)

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Download or read book Tackling Wasteful Spending on Health written by OECD and published by OECD Publishing. This book was released on 2017-01-10 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: Countries could potentially spend significantly less on health care with no impact on health system performance, or on health outcomes. This report reviews strategies put in place by countries to limit ineffective spending and waste.

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 0309477891
Total Pages : 399 pages
Book Rating : 4.95/5 ( download)

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Download or read book Crossing the Global Quality Chasm written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-27 with total page 399 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.