Retiree Health Benefits After Medicare Part D: A Snapshot of Prescription Drug Coverage

Based on employer surveys, assesses how the introduction of the Medicare Part D prescription drug benefit affected employer-based retiree, drug, and other health coverage

How Does Payer Mix and Technical Inefficiency Affect Hospital Net Revenue?

As changes in the US health care system continue to evolve and change, maintaining the financial viability of hospitals is crucial to the system’s operation. Two lines of inquiry have been pursued in describing factors affecting financial viability. The first line of inquiry relates to the external payer mix of patients focusing on patients who are unable to compensate hospitals for the care received. The second line of inquiry focuses on internal management and because hospitals do not typically answer to shareholders, managers become lax and X-inefficiency may arise. In this paper, we assess both these lines of research in order to determine if payment source by patients and/or managerial efficiency contributes to higher total net revenue. By using a weighted DEA we measured the inefficiency of inputs to the production process on our sample of 144 hospitals operating in Florida during 2005. We used the derived inefficient use of inputs along with the number of days by payer group (Medicare, Medicaid, private insurance, other public insurance, and uncompensated care) in order to explain their effects on total net revenue. To preview our results, we found that the inefficient use of beds and the provision of care to patients who are considered as uncompensated care reduce significantly total net revenue while private pay patients and patients covered by other public insurance add to total net revenue. These findings add to the literature by showing that it is patient payer mix and managerial inefficiency together affect hospital financial viability. We also demonstrate how our findings contribute to current policy debates both on the federal US and the state of Florida level.Hospital, Net Revenue, Efficiency, Payer, Uncompensated Care

Disability Status as an Unobservable: Estimates From a Structural Model

We propose an index of "true disability" by treating disability status as an unobservable phenomenon which is both causally related to a number of exogenous characteristics of an individual and correlated with a number of observed indicators of health, impairment and qualifications for employment. First, we define true disability and distinguish it from related concepts. We then discuss the importance of an objective and reliable measure of disability for research on the determinants of behavior. Next, we present the specification of our structural model for estimating true disability as a latent variable. Finally, we report the results of our estimation in a simple model of Labor force participation, and compare the effect of using the constructed index and a self-reported disability measure on understanding the determinants of behavior and choice.

Transforming the Orientation of a Health Organization through Community Involvement

Health organizations have been oriented to meeting needs and fulfilling demands which are perceived and defined by physician providers (Freidson, 1970 Stevens, 1971). Organizational goals, services, structures, and processes of operation were formulated in accordance with the interests, values, and concerns of provider-members. Latent to this provider orientation was the assumption that professional members were the ones most qualified to determine what was best for the organization and for its consumers (Freidson 1971). In recent times, however, numerous social changes have occurred on a societal level and within the institution of medicine (Hepner, 1972; Somers, 1971; Rosengren and Lefton, 1969). These changes have encouraged consumers to challenge the provider orientation of health organizations and to ask whether providers or consumers should determine the actions of the organization (Berki and Heston, 1972; Zola and McKinlay, 1974; Corey et al, 1972). It is within this context that the Penn Urban Health Services Center at the Graduate Hospital of the University of Pennsylvania sought to develop a consumer orientation through the mechanism of community involvement. To move toward attaining this goal, Penn-Urb established a Community Involvement Committee (CIC) which had two charges: to develop a mechanism by which information could be exchanged between the health organizations and the community. to develop a mechanism for effectively involving the community in the process of planning and developing Penn-Urb. It was hoped that through the fulfillment of these two charges, Penn-Urb and its community could increase their awareness and understanding of each other and become more responsive to respective needs and demands

Customization Or Conformity? An Institutional And Network Perspective On The Content And Consequences Of TQM Adoption

This study develops a theoretical framework that integrates institutional and network perspectives on the form and consequences of administrative innovations. Hypotheses are tested with survey and archival data on the implementation of total quality management (TQM) programs and the consequences for organizational efficiency and legitimacy in a sample of over 2,700 U.S. hospitals. The results show that early adopters customize TOM practices for efficiency gains, while later adopters gain legitimacy from adopting the normative form of TQM programs. The findings suggest that institutional factors moderate the role of network membership in affecting the form of administrative innovations adopted and provide strong evidence for the importance of institutional factors in determining how innovations are defined and implemented. We discuss implications for theory and research on institutional processes and network effects and for the literatures on innovation adoption and total quality management.(.)Business Administratio

Centerscope

Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.

Healthcare quality management in Great Britain and Czech Republic

Healthcare quality can be defined as the summary of the results achieved in prevention, diagnosis and treatment, based on findings of medical science and practice, or as the degree of excellence of the provided care in relation to a contemporary level of knowledge and technological development and in compliance with economic possibilities. Research and monitoring of the effectiveness of quality systems can be implemented in different ways: (1) measuring the quality system through the entire institution rating (self-assessment or accreditation), based on the assumption that appropriate care is the result of well-organized processes and systematic quality assurance and improvement; (2) measuring critical points in the process of care compliance of specialists with recommended practices or professional standards; (3) measuring outcomes in relation to the benefit of patients, such as clinical outcomes, client satisfaction and perceived quality of life in connection with the results of the provided care. The paper deals with monitoring the effectiveness of quality in health facilities based on customer satisfaction and compares patient satisfaction rating methodologies applied in the United Kingdom and in Czech Republic

Governing Boards and Profound Organizational Change in Hospitals

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69047/2/10.1177_107755878904600204.pd