Medicare Prospective Payment and the Shaping of U.S. Health Care

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Medicare Prospective Payment and the Shaping of U.S. Health Care
Publisher: The Johns Hopkins University Press | ISBN: 0801888557 | edition 2008 | PDF | 264 pages | 1,33 mb

This is the definitive work on Medicare’s prospective payment system (PPS), which had its origins in the 1972 Social Security Amendments, was first applied to hospitals in 1983, and came to fruition with the Balanced Budget Act of 1997. Here, Rick Mayes and Robert A. Berenson, M.D., explain how Medicare’s innovative payment system triggered shifts in power away from the providers (hospitals and doctors) to the payers (government insurers and employers) and how providers have responded to encroachments on their professional and financial autonomy. They conclude with a discussion of the problems with the Medicare Modernization Act of 2003 and offer prescriptions for how policy makers can use Medicare payment policy to drive improvements in the U.S. health care system

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