Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Fees”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed2001

Do Medicaid physician fees for prenatal services affect birth outcomes?

This study exploits a natural experiment to examine the relationship between Medicaid physician fees and birth outcomes among a national sample of pregnant women. Applying a cohort difference-in-differences methodology, I find a significant negative association between these fees and the risk of low birth weight. I estimate that a 10% higher than average relative Medicaid fee is independently associated with a 0.074% lower absolute risk of low birth weight (<2.5 kg) and a 0.035% lower risk of very low birth weight (<1.5kg) among Medicaid-insured women. For low-income women, this association grows significantly. Lastly, I find a moderate association between these fees and use of first trimester prenatal services.

Cost-Benefit Analysis↗
PubMed1999

Physician fees and procedure intensity: the case of cesarean delivery.

While there is a large literature investigating the response of treatment intensity to Medicare reimbursement differentials, there is much less work on this question for the Medicaid program. The answers for Medicare may not apply in the Medicaid context, since a smaller share of a physician's patients will be Medicaid insured, so that income effects from fee changes may be dominated by substitution effects. We investigate the effect of Medicaid fee differentials on the use of cesarean delivery over the period 1988-1992. We find, in contrast to the backward-bending supply curve implied by the Medicare literature, that larger fee differentials between cesarean and normal childbirth for the Medicaid program leads to higher cesarean delivery rates. In particular, we find that the lower fee differentials between cesarean and normal childbirth under the Medicaid program than under private insurance can explain between one half and three-quarters of the difference between Medicaid and private cesarean delivery rates. Our results suggest that Medicaid reimbursement reductions can cause real reductions in the intensity with which Medicaid patients are treated.

Cesarean Section↗
PubMed1985

A comparison of the treatment of rheumatoid arthritis in health maintenance organizations and fee-for-service practices.

This study compares the use of health care services (hospital and ambulatory) by patients with rheumatoid arthritis who were under the care of rheumatologists in prepaid and fee-for-service arrangements. Participating physicians from a random sample of half the rheumatologists in northern California maintained a log of all their patients with well-established diagnoses of rheumatoid arthritis. We interviewed 822 of their patients, using a structured, validated phone survey to obtain information about health care use. Patients in prepaid plans had about the same number and type of hospitalizations and the same rate of surgery as those receiving fee-for-service care. However, fee-for-service patients made more ambulatory visits. We conclude that the use of expensive services (hospital admissions and surgery) for the care of patients with rheumatoid arthritis is not different in fee-for-service and prepaid settings.

Ambulatory Care↗
PubMed2001

Ethical issues regarding fee-for-service-funded research within a complementary medicine context.

Ethical issues are presented concerning the appropriate use of a fee-for-service strategy to fund clinical research assessing preventive complementary medicine approaches, particularly the effectiveness of dietary supplements for disease prevention. Reasons for the need for such an alternative funding approach are identified and historical precedents are noted. Presuming a priori key desiderata of doing no harm, not taking advantage of the ill, and pursuing recognized useful purposes, six key ethical questions from the relevant literature are identified and discussed. Arguments are advanced that there is a sound rational, ethical basis (1) to ask patients to pay for clinical experimentation in the focused area of supplement-directed disease prevention; (2) to accept the reality that those who cannot pay may not participate; (3) to permit moderate profit from the ongoing research; (4) to allow researchers to receive fees for their support of such clinical research; (5) to pursue this alternative funding strategy in addition to conventional sources; and (6) to expect that patients can give informed consent in such settings. It is demonstrated that patient-funded research has been an integral component of clinical research for decades and that there is no inherent reason why explicit patient payment of fees need be less ethical than any other commonly accepted funding models. Accordingly, an ethical case is made for the appropriateness and value of significantly expanded fee-for-service-funded research within a complementary medicine context, particularly the assessment of dietary supplements for disease prevention.

Clinical Trials as Topic↗
PubMed1991

Will endoscopic global fees destroy gastroenterology as a specialty?

The Health Care Financing Administration (HCFA) has recently proposed a plan, effective July 1, 1991, for Medicare to pay for endoscopic procedures according to a global fee arrangement. Under global fees, the charges for any hospital or office visits for 30 days after endoscopy will be considered to be included in the Medicare payment for the endoscopic procedure. Global endoscopy fees depreciate the nonprocedural aspects of the gastroenterologist's care. In concert with other physician income reduction provisions of the 1989 and 1990 Omnibus Budget Reconciliation Acts, global endoscopy fees will dramatically alter the future behavior of gastroenterologists and their attitude toward Medicare patients. The deadline for writing HCFA has passed, but concerned gastroenterologists should protest this plan at once to their Senators and Congressional Representatives.

Endoscopy, Gastrointestinal↗
PubMed1989

Does the dissemination of comparative data on physician fees affect consumer use of services?

The purpose of this study is to empirically examine the effect of disseminating physician-fee information on consumer behavior. Using an experimental design, the effect of access to physician-fee information on rates of doctor-office visits, expenditures for ambulatory care, and costs per visit are examined. The study includes two research samples: a random sample of 658 state government employees and a random sample of 717 Medicare Part B enrollees. Respondents in each sample were randomly assigned to experimental and control groups, with members of the experimental groups receiving a directory listing the fees charged by local physicians for common procedures. Longitudinal archival and survey data are used in the analysis. Findings reveal that the dissemination of fee data does not yield significant reductions in utilization or expenditures. Policy and research implications are discussed.

Adult↗
PubMed2005

Impact on child mortality of removing user fees: simulation model.

OBJECTIVE: To estimate how many child deaths might be prevented if user fees were removed in 20 African countries DESIGN: Simulation model combining evidence on key health interventions' impacts on reducing child mortality with analysis of the effect of fee abolition on access to healthcare services. RESULTS: Elimination of user fees could prevent approximately 233,000 (estimate range 153,000-305,000) deaths annually in children aged under 5 in 20 African countries. CONCLUSION: Given the relatively low cost of abolition, replacing user fees with alternative financing mechanisms should be seen as an effective first step towards improving households' access to health care and achieving the millennium development goals for health.

Africa↗
PubMed1976

Psychotherapy fees and residency training.

Many residents in psychiatry tend to ignore their patients' attitudes and behavior concerning payment of fees for psychotherapy. The authors report on a new fee policy program designed to earn additional revenue for a low-fee outpatient psychotherapy clinic; they stress the therapeutic importance of resident and patient attention to fee-related issues.

Fees, Medical↗
PubMed2005

Considering fees in psychodynamic psychotherapy: opportunities for residents.

OBJECTIVE: The topic of money is ubiquitous to psychodynamic therapy work, yet often neglected in residency training programs. Residency allows a unique opportunity to address issues pertaining to money and their impact on therapy. METHOD: Through the experience of the author, the need for a more explicit and systematic consideration within residency training of financial issues is explored. Perspectives from the relevant literature, therapeutic principles, and their impact on resident training are discussed for several topics. These topics include the difficulties encountered in discussing fees, the negotiation of fees, impact on the stability of the frame, expectations of patients and residents, payment of fees, and handling missed appointments. The applicability of these skills to other venues of practice is highlighted. CONCLUSIONS: By addressing the topic of money and fees in residency training, a richer educational experience can be realized.

Fee-for-Service Plans↗
PubMed1989

The dissemination of physician fee information: impact on consumer knowledge, attitudes, and behaviors.

This study examines the effect of disseminating physician fee information to consumers among two study populations; a Medicare enrolled population and a younger employed population. Using an experimental design, the effect of providing physician fee information on consumer knowledge, attitudes and behaviors is examined. The total sample size is 1,715 and includes 907 State employees and 801 Medicare enrollees. The findings suggest that the distribution of physician fee information may be a minor stimulant to consumerism in health care. The findings also suggest that the strength of the effect of fee information on consumer knowledge, attitudes and behaviors varies by population characteristics and the need for services.

Community Participation↗
PubMed2006

Relationship between pharmaceutical company user fees and drug approvals in Canada and Australia: a hypothesis-generating study.

BACKGROUND: Since the early- to mid-1990s, drug companies have paid fees for a variety of activities carried out by the Therapeutic Products Directorate in Canada and the Therapeutic Goods Administration in Australia. OBJECTIVE: To explore whether changes in approval times for new active substances and in the percentage of new drug submissions receiving positive decisions coincided with the level of user fees. METHODS: Data were collected from a range of Canadian and Australian government publications on the following topics: total funding for and workload of the regulatory agencies, the percentage of income that came from tax revenue and user fees, the percentage of new drug submissions that received a positive decision, and-for Canada only-the percent of submissions that were approved on first review. RESULTS: In both countries, there was a moderate-to-strong positive association between the level of industry funding and the percent of submissions that received a positive decision and a moderate-to-strong (Canada) and moderate (Australia) negative association between the level of industry funding and approval times. CONCLUSIONS: Changes observed in both countries are favorable to the pharmaceutical industry. Other than user fees leading to a pro-industry bias in the regulatory authorities, other possible explanations include a more efficient use of resources, a smaller workload (Canada), an improvement in the quality of drug submissions (Canada), and more resources (Australia). Further research strategies are needed to either confirm or refute the hypothesis that the level of industry funding affects decisions made in drug regulatory systems.

Australia↗
PubMed1994

Stage of cancer at diagnosis for Medicare HMO and fee-for-service enrollees.

OBJECTIVES: Health maintenance organizations (HMOs) with Medicare contracts often provide cancer screening and preventive services not covered under fee-for-service. This study compared cancer patients in HMOs and fee-for-service on stage at diagnosis. METHODS: The study examined stage at diagnosis for aged Medicare enrollees in HMOs and fee-for-service, using information from the Surveillance, Epidemiology, and End Results program, linked with Medicare enrollment files. Twelve cancer sites were investigated, and demographics, area of residence, year of diagnosis (1985 to 1989), and education at the census tract level were controlled. RESULTS: HMO enrollees were diagnosed at earlier stages for cancers of the female breast, cervix, colon, and melanomas and at later stages for stomach cancer. There were no differences for cancers of the prostate, rectum, buccal cavity and pharynx, bladder, uterus, kidney, and ovary. HMO effects were strongest in areas with large, mature HMOs. CONCLUSIONS: Compared with fee-for-service enrollees, HMO enrollees were diagnosed at earlier stages for cancer sites for which effective screening services are available. The earlier detection of certain cancers among HMO enrollees may result from coverage of screening services and, perhaps, promotion by HMOs of such services.

Aged↗
PubMed1994

Salaried and fee-for-service general practitioners: is there a difference in patient turnover?

OBJECTIVE: To compare use of working hours, patient turnover, and patient characteristics in two general practitioner groups which differed in contractual arrangements and income levels (partly fee-for-service vs. salary). DESIGN: Cross-sectional study of all patient contacts during one week. PARTICIPANTS: All general practitioners (GPs) in Oslo (N = 263) with contracts with the municipality. 83% participated. MAIN OUTCOME MEASURE: Time spent in various types of work and patient turnover; the number of patients seen per hour of consultation time. RESULTS: Fee-for-service GPs worked almost exclusively with patients in their own practice, while salaried GPs spent more time out of office (consultation-based patient work constituting 55% of the working hours). The fee-for-service group registered on average 2.68 consultations per hour of patient contact (95% confidence interval: 2.51-2.84). The corresponding numbers for the salaried group were 2.37 (2.24-2.50). Salaried GPs had somewhat more telephone consultations per hour (2.01 vs 1.66 for fee-for-service GPs), leaving a picture of two GP groups with small differences in patient turnover. The two patient populations were remarkably similar and so was the general practitioners' own evaluation of the consultations. CONCLUSIONS: Over a number of years the GPs in Oslo have practised under different contractual arrangements. As a consequence of different expectations and incentives it was expected that consultation activity and patient populations had evolved differently. This proved not to be the case.

Appointments and Schedules↗
PubMed1997

Impact of postal invitations and user fee on influenza vaccination rates among the elderly. A randomized controlled trial in general practice.

OBJECTIVE: To examine the impact of postal invitations and user fee on influenza vaccination rates. DESIGN: A controlled randomized trial in 13 general practices. One third of the participating patients received postal invitations to influenza vaccination free of charge. Another third received postal invitations to influenza vaccination on paying the usual fee (US$ 40-60). The last third served as a control group, being vaccinated at their own request and paying the usual fee. SETTING: General practice in the Counties of Funen and Vejle, Denmark. PATIENTS: Five hundred and eighty-five patients aged 65 years or older, recognized by their general practitioner (GP) as being in the risk group for whom influenza vaccination is recommended. MAIN OUTCOME MEASURES: Influenza vaccination rates. RESULTS: In the control group 25% (19-31%, 95% confidence interval) of the patients were vaccinated, compared with 49% (42-56%) in the group who received a postal reminder and paid the usual fee, and 72% (65-78%) in the group invited to be vaccinated free of charge. CONCLUSION: It is suggested that GPs send postal invitations to their elderly patients in the risk groups urgently recommending influenza vaccination. Attention should also be given to offering free influenza vaccination to elderly patients who have recognized indications for vaccination.

Aged↗
PubMed1990

Medicare program; model fee schedule for physicians' services--HCFA. Notice with comment period.

This notice announces and invites comments on a model fee schedule for physicians' services that is required by section 6102 of the Omnibus Budget Reconciliation Act of 1989. The model fee schedule provides very preliminary estimates for some, but not all, services to illustrate the effects of the Medicare physician payment fee schedule that will begin to take effect in January 1992. In accordance with section 6102(f)(11), we are making the model fee schedule available to the public through publication of this notice. Any comments received from the public will be considered carefully, but not specifically addressed in a subsequent proposed rule.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1992

Medicare program; fee schedule for physicians' services--HCFA. Correction of final rule.

In the November 25, 1991 final rule (56 FR 59624) on the Medicare fee schedule for physician services, we inadvertently set forth regulations on the fee schedule at 42 CFR, part 415. However, our plan for the recodification of HCFA regulations calls for general regulations on payment for Part B medical and other health services to be codified in part 414, with part 415 reserved for regulations on payment to teaching physicians, teaching hospitals, and provider-based physicians. Therefore, in this correction notice, we are redesignating in their entirety the physician fee schedule regulations contained in part 415, subpart A to part 414, subpart A, and reserving part 415 for future use. Also, this document corrects technical errors that appeared in the final rule published in the Federal Register on November 25, 1991 (56 FR 59502) entitled "Medicare Program; Fee Schedule for Physicians' Services".

Fee Schedules↗
PubMed1995

Medical devices; Mammography Quality Standards Act of 1992; inspection fees--FDA. Notice.

The Food and Drug Administration (FDA) is announcing the fees it will assess for inspections of mammography facilities during fiscal year 1995 (FY 95). The Mammography Quality Standards Act of 1992 (MQSA) requires FDA to assess and collect fees from mammography facilities to cover the costs of annual inspections required by the MQSA. This notice explains which facilities are subject to payment of inspection fees, provides information on the costs included in developing inspection fees, and provides information on the inspection, billing, and collection processes.

Ambulatory Care Facilities↗
PubMed1991

Medicare program; fee schedule for physicians' services--HCFA. Final rule.

This final rule sets forth a fee schedule for payment for physicians' services beginning January 1, 1992. Establishment of this fee schedule is required by section 6102(a) of the Omnibus Budget Reconciliation Act of 1989, as amended by the Omnibus Budget Reconciliation Act of 1990. This final rule explains which services will be included in the fee schedule and sets forth the formula for computing payment amounts. Application of transition rules during 1992 through 1995 is also described, as well as other adjustments to fee schedule payment amounts.

Catchment Area, Health↗