Health Care Financ R
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Health Care Financ R · Jan 1999
Comparative StudyHealth expenditure trends in OECD countries, 1970-1997.
This article provides an overview of current trends in health expenditures in 29 OECD countries and recent revisions of OECD health accounts. U. S. health expenditures are compared with those of other OECD countries. The interactions of cost-containment measures with changes in the public-private mix of financing and in the composition of health care spending are discussed.
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The shift in the site of service delivery from inpatient and institutional to ambulatory and community settings has been prompted by concerns over cost and the prospect for improving the quality of life. In response to these concerns, Medicare has implemented several demonstrations that emphasize ambulatory and community-based services. ⋯ One examines home health care in relation to the other Medicare post-acute benefits, and the other focuses on the use of home health care in the treatment of end stage renal disease (ESRD). Finally, two articles report on Section 1915c Medicaid home and community-based waiver programs.
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Health Care Financ R · Jan 1999
Strategies for containing drug costs: implications for a Medicare benefit.
As policymakers consider adding a prescription drug benefit to Medicare, cost containment will be an important issue. This article discusses strategies to hold down the prices paid for prescription drugs. ⋯ Since Medicare beneficiaries constitute a large share of the prescription drug market, getting access to FSS prices may not be feasible. A flat rebate is one alternative.
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Health Care Financ R · Jan 1997
Expenditures for mental health services in the Utah Prepaid Mental Health Plan.
This article examines the effect of a mental health carve-out, the Utah Prepaid Mental Health Plan (UPMHP), on expenditures for mental health treatment and utilization of mental health services for Medicaid beneficiaries from July 1991 through December 1994. Three Community Mental Health Centers (CMHCs) provided mental health services to Medicaid beneficiaries in their catchment areas in return for capitated payments. The analysis uses data from Medicaid claims as well as "shadow claims" for UPMHP contracting sites. ⋯ The results indicate that the UPMHP reduced acute inpatient mental health expenditures and admissions for Medicaid beneficiaries during the first 2 1/2 years of the UPMHP. In contrast, the UPMHP had no statistically significant effect on outpatient mental health expenditures or visits. There was no significant effect of the UPMHP on overall mental health expenditures.