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A 1998 report to the Health Care Financing Administration (now known as the Centers for Medicare and Medicaid Services) noted that in the five years of the demonstration project, the seven hospitals would have had expenditures of $438 million for coronary artery bypasses for Medicare beneficiaries, but the change in reimbursement methodology ...
In the health insurance and the health care industries, FFS occurs if doctors and other health care providers receive a fee for each service such as an office visit, test, procedure, or other health care service. [5] Payments are issued only after the services are provided. FFS is potentially inflationary by raising health care costs. [6]
According to Essentials of Managed Health Care, as of 2012 the chargemaster file typically included between 20,000 and 50,000 price definitions. [ 13 ] [ 14 ] The Lewin Group analyzed utilization of the chargemaster and found that a low proportion of hospitals carried out regular reviews of their chargemaster implementation. [ 15 ]
Price bundling plays an increasingly important role in many industries (e.g. banking, insurance, software, automotive) and some companies even build their business strategies on bundling. In bundle pricing, companies sell a package or set of goods or services for a lower price than they would charge if the customer bought all of them separately.
Medco provided pharmacy services to private and public employers, health plans, labor unions, government agencies, and individuals served by Medicare Part D Prescription Drug Plans. Medco was a member of the S&P 500 and ranked number 34 on the 2011 Fortune 500 list, [ 1 ] with 2011 revenues of more than $70 billion. [ 2 ]
In 1997, the health maintenance organization entered into an asset purchase agreement with PHP Healthcare Corporation of Reston, Virginia (PHP), a Delaware for-profit corporation. [3] In 1999, the company went bankrupt when the $120 million they were owed by Pinnacle Health Enterprises was never paid. [2] [4]
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The 340B Drug Pricing Program is a US federal government program created in 1992 that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to "stretch scarce federal resources as far as possible ...