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The authors studied the ratio of costs to charges (RCC) used to estimate the cost of Medicare hospital cases in the formula which sets cost outlier payments. The authors estimate that, under current payment policy, the cost of the average cost outlier case is overestimated by 23 percent. The causes of this overestimate are a secular decline in RCC of between 2 and 3 percent a year and the fact that cost outlier cases typically receive a higher percentage of ancillary charges that have a very low actual RCC. The inaccurate estimate of the cost of cost outlier cases contravenes current policy intent in two important ways. First, it changes the fraction of the excess costs that are insured from the intended 75 percent to 92 percent. Secondly, cases face different cost outlier thresholds, and therefore receive different payment amounts, depending on the mix of ancillary and accommodation services required by the patient. It would be possible to improve the measurement of the cost of cost outlier cases by using separate RCCs for ancillary and accommodation charges. The outcomes of alternative policies are estimated in the report.

Medicare. --- Hospitals --- Outliers, DRG --- Prospective Payment System --- Prospective payment --- economics --- economics

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In the Balanced Budget Act of 1997, Congress mandated that Health CareFinancing Administration (HCFA) implement a Prospective Payment System (PPS)for inpatient rehabilitation. The Centers for Medicare and Medicaid Services(CMS, the successor agency to HCFA) issued the final rule governing such aPPS on August 7, 2001.

Hospitals. --- Hospitals --- Inpatients --- Rehabilitation Centers --- Prospective Payment System --- Patients --- Health Facilities --- Reimbursement Mechanisms --- Persons --- Health Care Facilities, Manpower, and Services --- Insurance, Health, Reimbursement --- Health Care --- Financing, Organized --- Names. --- Economics --- Health Care Economics and Organizations --- Prospective payment --- Rehabilitation services

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This report details the analyses that RAND performed to support the Health Care Financing Administration's efforts to design, develop and implement the Prospective Payment System for inpatient rehabilitation.

Hospitals. --- Hospitals - Rehabilitation services - Prospective payment - United States. --- Hospitals --- Inpatients --- Prospective Payment System --- Rehabilitation Centers --- Reimbursement Mechanisms --- Health Facilities --- Patients --- Persons --- Health Care Facilities, Manpower, and Services --- Insurance, Health, Reimbursement --- Health Care --- Financing, Organized --- Named Groups --- Economics --- Health Care Economics and Organizations --- Hospitals & Medical Centers --- Public Health --- Health & Biological Sciences --- Rehabilitation services --- Prospective payment --- Healthcare Economics and Organizations --- Capital --- Conditions, Economic --- Consumption --- Cost of Living --- Easterlin Hypothesis --- Economic Conditions --- Economic Factors --- Economic Policies --- Economic Policy --- Economics, Home --- Factors, Economic --- Home Economics --- Household Consumption --- Macroeconomic Factors --- Microeconomic Factors --- Policies, Economic --- Policy, Economic --- Production --- Remittances --- Utility Theory --- Consumer Price Index --- Condition, Economic --- Consumer Price Indices --- Consumption, Household --- Economic Condition --- Economic Factor --- Factor, Economic --- Factor, Macroeconomic --- Factor, Microeconomic --- Factors, Macroeconomic --- Factors, Microeconomic --- Household Consumptions --- Hypothesis, Easterlin --- Index, Consumer Price --- Indices, Consumer Price --- Living Cost --- Living Costs --- Remittance --- Theories, Utility --- Theory, Utility --- Utility Theories --- Community Financing --- Grants --- Organized Financing --- Financing, Community --- Grant --- Community-Based Distribution --- Contraceptive Distribution --- Delivery of Healthcare --- Dental Care Delivery --- Distribution, Non-Clinical --- Distribution, Nonclinical --- Distributional Activities --- Healthcare --- Healthcare Delivery --- Healthcare Systems --- Non-Clinical Distribution --- Nonclinical Distribution --- Delivery of Dental Care --- Health Care Delivery --- Health Care Systems --- Activities, Distributional --- Activity, Distributional --- Care, Health --- Community Based Distribution --- Community-Based Distributions --- Contraceptive Distributions --- Deliveries, Healthcare --- Delivery, Dental Care --- Delivery, Health Care --- Delivery, Healthcare --- Distribution, Community-Based --- Distribution, Contraceptive --- Distribution, Non Clinical --- Distributional Activity --- Distributions, Community-Based --- Distributions, Contraceptive --- Distributions, Non-Clinical --- Distributions, Nonclinical --- Health Care System --- Healthcare Deliveries --- Healthcare System --- Non Clinical Distribution --- Non-Clinical Distributions --- Nonclinical Distributions --- System, Health Care --- System, Healthcare --- Systems, Health Care --- Systems, Healthcare --- Third-Party Payers --- Health Insurance Reimbursement --- Reimbursement, Health Insurance --- Third-Party Payments --- Health Insurance Reimbursements --- Insurance Reimbursement, Health --- Insurance Reimbursements, Health --- Payer, Third-Party --- Payers, Third-Party --- Payment, Third-Party --- Payments, Third-Party --- Reimbursements, Health Insurance --- Third Party Payers --- Third Party Payments --- Third-Party Payer --- Third-Party Payment --- Healthcare Facilities, Manpower, and Services --- Person --- Clients --- Client --- Patient --- Facilities, Health --- Facility, Health --- Health Facility --- Mechanism, Reimbursement --- Mechanisms, Reimbursement --- Reimbursement Mechanism --- Centers, Rehabilitation --- Center, Rehabilitation --- Rehabilitation Center --- Adjustment, Discretionary --- Discretionary Adjustment Factor --- Prospective Pricing --- Prospective Reimbursement --- Reimbursement, Prospective --- Adjustment Factor, Discretionary --- Adjustment Factors, Discretionary --- Adjustments, Discretionary --- Discretionary Adjustment --- Discretionary Adjustment Factors --- Discretionary Adjustments --- Factor, Discretionary Adjustment --- Factors, Discretionary Adjustment --- Payment System, Prospective --- Payment Systems, Prospective --- Pricing, Prospective --- Prospective Payment Systems --- Prospective Reimbursements --- Reimbursements, Prospective --- System, Prospective Payment --- Systems, Prospective Payment --- Inpatient --- Benevolent institutions --- Infirmaries --- Health facilities --- Prospective Payment System. --- Inpatients. --- economics. --- United States.

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This revised edition of Basics of PET Imaging presents an unparalleled text on the basics of PET imaging technology. Distinguished author, Dr. Gopal B. Saha, has updated his previous bestselling work with concise chapters on PET fundamentals, including: Basic physics Instrumentation and data acquisition Production of PET radionuclides Performance characteristics of PET scanners Regulatory and reimbursement issues To maximize understanding, and to help technologists and residents prepare for board exams, chapters include pertinent basic science and equations along with sample problems and practice questions. The remarkable combination of Dr. Saha’s brevity and clarity of content once again makes this edition an ideal reference book for nuclear medicine professionals interested in the basics of PET imaging.

Medicine. --- Nuclear medicine. --- Radiology, Medical. --- Tomography, Emission --- Medical physics --- Allied Health Occupations --- Image Enhancement --- Radionuclide Imaging --- Reimbursement Mechanisms --- Tomography --- Indicators and Reagents --- Image Interpretation, Computer-Assisted --- Investigative Techniques --- Technology --- Tomography, Emission-Computed --- Radiopharmaceuticals --- Technology, Radiologic --- Prospective Payment System --- Diagnostic Techniques, Radioisotope --- Diagnostic Imaging --- Laboratory Chemicals --- Technology, Industry, and Agriculture --- Analytical, Diagnostic and Therapeutic Techniques and Equipment --- Insurance, Health, Reimbursement --- Photography --- Health Occupations --- Diagnostic Techniques and Procedures --- Disciplines and Occupations --- Technology, Industry, Agriculture --- Financing, Organized --- Specialty Uses of Chemicals --- Diagnosis --- Economics --- Chemical Actions and Uses --- Health Care Economics and Organizations --- Chemicals and Drugs --- Health Care --- Medicine --- Radiology, MRI, Ultrasonography & Medical Physics --- Health & Biological Sciences --- Tomography, Emission. --- Medical physics. --- Health physics --- Health radiation physics --- Medical radiation physics --- Radiotherapy physics --- Radiation therapy physics --- Computerized emission tomography --- Emission tomography --- PET (Tomography) --- PET-CT (Tomography) --- Positron emission tomography --- Positron emission transaxial tomography --- Radionuclide tomography --- Scintigraphy, Tomographic --- Tomography, Radionuclide --- Radiology. --- Medicine & Public Health. --- Nuclear Medicine. --- Imaging / Radiology. --- Biophysics --- Physics --- Diagnostic imaging --- Positrons --- Radioisotope scanning --- Data processing --- Emission --- Clinical radiology --- Radiology, Medical --- Radiology (Medicine) --- Atomic medicine --- Radioisotopes in medicine --- Medical radiology --- Radioactive tracers --- Radioactivity --- Physiological effect --- Radiological physics --- Radiation