ABSTRACT
BACKGROUND: The Patient Protection and Affordable Care Act instituted pay-for-performance programs, including Hospital Value-Based Purchasing (HVBP), designed to encourage hospital quality and efficiency. OBJECTIVE AND METHOD: While these programs have been evaluated with respect to their implications for care quality and financial viability, this is the first study to assess the relationship between hospitals' cost inefficiency and their participation in the programs. We estimate a translog specification of a stochastic cost frontier with controls for participation in the HVBP program and clinical and outcome quality for California hospitals for 2012-2015. RESULTS: The program-participation indicators' parameters imply that participants were more cost inefficient than their peers. Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased operating costs. CONCLUSION: The estimated coefficients for the outcome quality variables suggest that future determination of HVBP payment adjustments, which will depend solely on mortality rates as measures of clinical care quality, may not only be aligned with increasing healthcare quality but also reducing healthcare costs.
Subject(s)
Medicare/economics , Purchasing, Hospital/economics , Value-Based Purchasing/economics , California , Cost-Benefit Analysis/economics , Cost-Benefit Analysis/legislation & jurisprudence , Cost-Benefit Analysis/organization & administration , Economics, Hospital , Hospital Costs , Humans , Mandatory Programs/economics , Mandatory Programs/organization & administration , Medicare/organization & administration , Models, Econometric , Purchasing, Hospital/legislation & jurisprudence , Purchasing, Hospital/organization & administration , Stochastic Processes , United States , Value-Based Purchasing/legislation & jurisprudence , Value-Based Purchasing/organization & administrationSubject(s)
Disclosure/legislation & jurisprudence , Drug Industry/legislation & jurisprudence , Equipment and Supplies , Centers for Medicare and Medicaid Services, U.S. , Conflict of Interest/legislation & jurisprudence , Purchasing, Hospital/economics , Purchasing, Hospital/legislation & jurisprudence , United StatesABSTRACT
Purchasing fraud leads to significant losses for healthcare entities and damages the reputation of the industry. Designing and implementing an effective internal control environment helps reduce the risk of fraud. An effective control environment includes a variety of policies, procedures, strategies, and tactics.
Subject(s)
Fraud/prevention & control , Purchasing, Hospital/legislation & jurisprudence , Risk Management/methods , United StatesABSTRACT
With the growing wave of acquisitions of practices by hospitals, antitrust regulators are putting the deals under harsh scrutiny to see if they're just a cover for raising prices rather than coordinating care and improving quality. "If there's an issue, I want to know about it now," says St. Luke's President and CEO Dr. David Pate, whose hospital met such a roadblock. "Let's just see if there are issues. We don't believe that there are."
Subject(s)
Antitrust Laws , Practice Valuation and Purchase/legislation & jurisprudence , Practice Valuation and Purchase/trends , Purchasing, Hospital/legislation & jurisprudence , Hospital-Physician Relations , United StatesSubject(s)
Hospital Costs/organization & administration , Purchasing, Hospital/legislation & jurisprudence , Quality Assurance, Health Care , Cost Control/methods , Hospital Costs/legislation & jurisprudence , Humans , Patient Protection and Affordable Care Act , Patient Satisfaction , United StatesSubject(s)
Equipment and Supplies/supply & distribution , Purchasing, Hospital/legislation & jurisprudence , Contract Services/legislation & jurisprudence , Cost Control , Economic Competition , Humans , Purchasing, Hospital/economics , Purchasing, Hospital/organization & administration , State Medicine , United KingdomABSTRACT
The Advance Planning Document (APD) process governs the procedure by which States obtain approval for Federal financial participation in the cost of acquiring automated data processing equipment and services. This final rule reduces the submission requirements for lower-risk information technology (IT) projects and procurements and increases oversight over higher-risk IT projects and procurements by making technical changes, conforming changes and substantive revisions in the documentation required to be submitted by States, counties, and territories for approval of their Information Technology plans and acquisition documents.
Subject(s)
Electronic Data Processing/organization & administration , Financing, Government/organization & administration , Information Systems/legislation & jurisprudence , Public Assistance/legislation & jurisprudence , United States Dept. of Health and Human Services/legislation & jurisprudence , Child , Federal Government , Humans , Information Systems/standards , Public Assistance/standards , Purchasing, Hospital/legislation & jurisprudence , Purchasing, Hospital/standards , State Government , United StatesSubject(s)
Equipment and Supplies/economics , Patents as Topic/legislation & jurisprudence , Antitrust Laws , Commerce/legislation & jurisprudence , Economic Competition/ethics , Economic Competition/legislation & jurisprudence , Economic Competition/trends , Government Regulation , Guidelines as Topic , Humans , Medicare/economics , Medicare/legislation & jurisprudence , Purchasing, Hospital/economics , Purchasing, Hospital/legislation & jurisprudence , United States , United States Food and Drug AdministrationSubject(s)
Hospitals, Voluntary/legislation & jurisprudence , Practice Valuation and Purchase/legislation & jurisprudence , Purchasing, Hospital/legislation & jurisprudence , Surgicenters/organization & administration , Fraud , Physician Self-Referral/legislation & jurisprudence , Practice Valuation and Purchase/economics , Surgicenters/economics , United States , United States Dept. of Health and Human ServicesABSTRACT
The procurement process in Italy is becoming more complex and expensive. In a complete overhaul of the system, there are new product classifications and new procedures to adopt.