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1. The Devil of Health Reform Is in the Details.

Author

Healy, Bernadine

Subjects
HEALTH care reform, MEDICAL care, PHYSICIANS, MEDICAL records, HEALTH insurance
Abstract

The article discusses the white papers on policy options released by U.S. Senate Finance Committee headed by Senator Max Baucus for the health care reform being pursued by U.S. President Barack Obama and other Democrats. This legislation is believed to give Americans affordable, high-quality healthcare and the freedom to choose the doctor or health plan they want. Issues on the creation of an electronic medical record, investing in expanded comparative effectiveness studies, and the new public health insurance options are analyzed.

Published
2009

2. Treatment compliance under physician–industry relationship: a framework of health-care coordination in the USA.

Author

Chen, Jie and Vargas-Bustamante, Arturo

Subjects
PATIENT compliance, PHYSICIANS, MEDICAL care, HOSPITAL patients, MEDICAL records, HEALTH insurance, HEALTH insurance agents
Abstract

Objective Factors associated with treatment compliance have been well studied. However, no study has examined treatment compliance under the context of physician–industry relationship. This study developed a conceptual framework of physician–industry relationship and treatment compliance, and empirically tested patients' treatment compliance and affordability under the physician–industry relationship in the USA. Design We first proposed a conceptual framework to analyze different scenarios, where the physician–industry relationship could impact patients' treatment compliance and affordability, taking into consideration the role of health insurers. We then employed a nationally representative data set to investigate these relationships. Multivariable logistic regressions were employed to examine the physician–industry relationship and the physicians' perception of patients' treatment compliance. Setting and Participants 2008 Health Tracking Physician Survey. Results Our results showed that physicians with closer industry relationships were more likely to report rejection of care by insurers [odds ratios (ORs): 1.24–1.85, P < 0.001], patients' non-compliance with treatment (OR: 1.34, P < 0.01) and patients' inability to pay (OR: 1.42, P < 0.01) as the major problems affecting their ability to provide high quality care, when compared with physicians without industry relationships. Conclusions Our results shed light on the lack of articulation among industry, physicians and health insurers in the USA. It is important to make sure that different agents in the health-care marketplace, such as physicians, industry, and health insurers, coordinate more efficiently to provide quality and consistent care to patients. [ABSTRACT FROM PUBLISHER]

Published
2013
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3. Long-Run Effects of Temporary Incentives on Medical Care Productivity

Author

Celhay, Pablo, Gertler, Paul, Giovagnoli, Paula, and Vermeersch, Christel

Subjects
SYMPTOMS, CHILDREN, HEALTH INSURANCE, CHILD HEALTH, DISEASE, MEASUREMENT, PHYSICIANS, WEIGHT LOSS, PRIMARY CARE, FINANCING, ADOLESCENTS, LOW BIRTH WEIGHT, IMPLEMENTATION, QUALITY OF HEALTH, PHYSICIAN, PREMATURE BIRTH, HEALTH CONDITIONS, POPULATION, HEALTH PROGRAMS, PERSONALITY, INCOME, MEDICAL OFFICER, WORKERS, INCENTIVES, PUBLIC HOSPITALS, PILL, HEALTH OUTCOMES, MEDICAID, HEALTH, SMOKING, MEDICAL RECORDS, INTERVENTION, HEALTH ORGANIZATION, CLINICAL TRIALS, REHABILITATION, CLINICAL PRACTICE, HOSPITAL PERSONNEL, HEALTH ECONOMICS, EXERCISE, PATIENT, EVALUATION, PATIENTS, COUNSELING, HEALTH FACILITIES, GENERAL PRACTITIONERS, RANDOMIZED CONTROLLED TRIALS, COMMUNITY HEALTH, BIRTH CONTROL, HYPERTENSION, MEDICINE, MORTALITY, MEDICAL EDUCATION, HEALTH PROFESSIONALS, HEALTH CLINICS, PREVENTION, SCREENING, RISKS, CLINICS, INTERVIEW, HOSPITALS, PHARMACISTS, HEALTH SECTOR, WORKPLACE, COSTS, MARKETING, PREGNANT WOMEN, PNEUMONIA, HIV TESTING, FEES, DEMAND, QUALITY OF HEALTH CARE, VACCINE, ANTENATAL CARE, PREVENTIVE MEDICINE, OLDER CHILDREN, EPIDEMIOLOGY, DIABETES, GENERAL PRACTICE, PHARMACY, MEDICAL PERSONNEL, HEALTH POLICY, PAIN, TREATMENT, CHOICE, CANCER, MEDICAL SCIENCE, HEALTH WORKERS, PROBABILITY, PUBLIC HEALTH CARE, ADDICTION, PREGNANCY, HEALTH CARE, INFECTIONS, OBESITY, EFFECTS, INSURANCE, PRENATAL CARE, NUTRITION, PUBLIC HEALTH, EQUITY, HYGIENE, MEDICAL SCHOOLS, SMOKERS, BIRTH, MEDICAL CARE, DOCTORS, HOSPITAL RECORDS, ILLNESS, FIXED COSTS, PSYCHOLOGY, NEWBORN HEALTH, MORBIDITY, SMOKING CESSATION, PEDIATRICS, KNOWLEDGE, CHILD HEALTH SERVICES, ANEMIA, PRIMARY HEALTH CARE, HEALTH RESULTS, SEROLOGY, WELLNESS, HIV, MEDICAL TREATMENT, CARE, SLEEP, DIARRHEA, MATERNAL AND CHILD HEALTH, LIFE, PREGNANT WOMAN, BIRTH WEIGHT, HEALTH SERVICES, OBSERVATION, HEALTH CARE FACILITIES, NURSES, WEIGHT, HEALTH TARGETS, ALL, TETANUS
Abstract

The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of prenatal care was 34 percent higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 15 months and likely 24 months or more after the incentives ended. These results are consistent with a model where the incentives enable providers to address the fixed costs of overcoming organizational inertia in innovation, and suggest that temporary incentives may be effective at motivating improvements in long-run provider performance at a substantially lower cost than permanent incentives.

Published
2015