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Understanding Washington: a nephrologist's perspective from inside the Beltway.
Am J Kidney Dis
December 2013
Division of Nephrology and Hypertension, Georgetown University, Washington, DC. Electronic address:
The major principles that drive U.S. federal health policy-making are: (1) fixed or reduced costs, (2) ensured outcomes (or no evidence of undertreatment), (3) streamlined administration, and (4) political viability.
View Article and Find Full Text PDFState health care financing strategies for children with intellectual and developmental disabilities.
Intellect Dev Disabil
June 2012
School of Social Work, Boston University, Boston, MA 02215, USA.
We provide the first descriptive summary of selected programs developed to help expand the scope of coverage, mitigate family financial hardship, and provide health and support services that children with intellectual and developmental disabilities need to maximize their functional status and quality of life. State financing initiatives were identified through interviews with family advocacy, Title V, and Medicaid organizational representatives. Results showed that states use myriad strategies to pay for care and maximize supports, including benefits counseling, consumer- and family-directed care, flexible funding, mandated benefits, Medicaid buy-in programs, and Tax Equity and Fiscal Responsibility Act of 1982 funding.
View Article and Find Full Text PDFPost-hospital sub-acute care: an example of a managed care model.
J Am Geriatr Soc
January 1997
HealthPartners Geriatrics Program, Minneapolis, MN 55440-1309, USA.
Objective: This article describes Transitional Care Centers (TCC), an innovative sub-acute care program developed by a large managed care organization (HealthPartners in Minnesota) in partnership with five area nursing homes. The purpose of the TCC is to promote continuity of care for frail older members covered under a TEFRA risk contract.
Design: This is a retrospective study of the experiences and outcomes of enrollees who received TCC compared with a like group of enrollees who received customary continuity care through contract services.
Excluded facility financial status and options for payment system modification.
Health Care Financ Rev
August 1994
Department of Health Services and Policy Analysis, University of California, Berkeley.
Psychiatric, rehabilitation, long-term care, and children's facilities have remained under the reimbursement system established under the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 (Public Law 97-248). The number of TEFRA facilities and discharges has been increasing while their average profit rates have been steadily declining. Modifying TEFRA would require either rebasing the target amount or adjusting cost sharing for facilities exceeding their cost target.
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