Description: Analysis of possible mathematical relationships between hospital quality and hospital billed or allowed charges or other measures, using quality data as defined by the U.S. Department of Health and Human Services along with the Hospital Quality Alliance for their Hospital Quality Initiative.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: June 2013 issue of the Social Insurance & Public Finance Section newsletter, In The Public Interest.

Description: An excerpt from the 2002 Annual report of the Boards of Trustees for the Federal Hospital Insurance and Federal supplementary Medical Insurance Trust Funds which describes the basic assumptions and methods used in the estimates under the intermediate assumptions. Also, presented are projections of program costs under two alternate sets if assumptions.

Description: This article discuss the historical regulation and changes to the Medicare Physician Fee Schedule - MPFS.

Description: This is an article explaining the options employers have under the Medicare Part D, or the Prescription Drug Improvement and Medicare Modernization Act - MMA - that took effect in January 2006. The article discusses 4 options under the MMA with the advantages and disadvantages of each.

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: Outline of changes to the Adjust Community Rate ACR Proposal process and Beneficary Information Form, Issue No. 38

Description: Congress has been debating a revision to Medicare Advantage payments including limiting payments to the Medicare Fee-For-Service FFS cost. A county-specific impact study to the benchmark payment rates for each county nationally based on the FFS limitation criteria was performed. This article includes results for Florida, California, Pennsylvania and New York.

Description: Article explores why many integrated delivery systems are struggling and what actions they need to take to succeed.