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.

SourceResearch connectionFrom yearThrough year

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

At least 451 records · Page 25Linked to original sources

PubMed1994

Effect of increased Medicaid fees on physician participation and enrollee service utilization in Tennessee, 1985-1988.

Integration of low-income persons, now covered largely through Medicaid, into mainstream provider networks requires sufficient numbers of physicians willing to serve them. This paper examines a 1986 change in fees in Tennessee that was aimed explicitly at increasing physician participation in Medicaid. County/monthly panel data from 1985-1988 were used to examine visits per enrollee, physician participation, and caseloads. Higher fees were found to lead to increased participation in both urban and rural countries, but were less effective in increasing the number of visits per enrollee in urban areas and physician caseloads in both urban and rural areas. A measure of the residential segregation of Medicaid enrollees within each county was found to have a negative influence on the number of visits per enrollee, on participation, and on caseloads when measured across all participating physicians.

Fees, Medical↗

PubMed1993

Fee structure for investigational drug studies.

The development and implementation of a fee structure for a pharmacy-coordinated investigational drug service is described. A pilot task and time study established specific time and cost elements for investigational drug services provided by the pharmacy department. To fully assess the costs in dispensing investigational drugs, each research study that used the investigational drug service was broken down into five phases of service. Each phase was further categorized by specific tasks or activities, and a time element to perform each activity or task was determined. Since some studies could require more elaborate randomization of patients, more extensive review of protocols, or more individualized dispensing procedures than others, a range of charges was derived: $2800 for standard protocols to $5700 for more complicated studies. An institutional drug therapy newsletter describing the services and costs was distributed to all medical staff members and principal investigators. The development of a fee structure for an investigational drug service coordinated by the pharmacy department has ensured that pharmacy services are adequately reimbursed and has allowed the department to allocate appropriate personnel to provide the services.

Drug Evaluation↗

PubMed1993

Family practice and internal medicine office fees: an analysis of charge differences.

BACKGROUND: This study applies the concept of economic efficiency to primary health care physicians. Comparisons of charges made by family physicians and general internists would provide evidence of "optimal" health care delivery of primary care services. METHODS: A list of all active licensed primary care physicians was obtained from the office of the Oregon State Board of Medical Examiners. Two thousand eight hundred forty-three questionnaires were sent to Oregon primary care physicians. Of the 1365 responses, 484 were family physicians and 341 were general internists. RESULTS: The study found that family physicians had significantly lower mean office visit fees than general internists, while both groups had essentially similar patient mixes. This difference in fees could not be explained by patient case mix. CONCLUSIONS: The findings of this study and the body of literature available support the concept that family practice physicians provide economically efficient primary health care. If two similarly trained physicians provide a comparable level of medical care, with the same or similar outcome (or output), the physician who provides the care for the lowest cost should be used.

Diagnosis-Related Groups↗

PubMed1993

User fees: fair cost containment or a tax on the sick?

The federal government's reduction in transfer payments for health and education, in combination with a severe recession, has put provincial and territorial health ministries, health professionals and hospital administrators under immense financial pressure. In response, user fees are being discussed as one way to maintain medicare. Yet, charging levies for health services presents numerous ethical problems. User fees would end the universality of and accessibility to health care for many Canadians. Hence, they would constitute an unfair tax on the sick and the poor. The hardest hit would be the elderly, children, women, aboriginal people, the disabled and the chronically ill.

Cost Control↗

PubMed1993

A comparison of physician-patient interaction at fee-for-service and HMO sites.

Research has begun to identify elements in the practice environment that influence practice styles and health outcomes. One key element known to influence physician-patient interaction is the type of treatment environment: fee-for-service or health maintenance organization. Observers using the Davis Observation Code coded 82 physician-patient encounters in private practice settings and 72 encounters in a health maintenance organization. Populations were similar on all demographic measures except age, with health maintenance organization patients being older. Fee-for-service visits were shorter but included more coded behaviors per observation interval, resulting in equivalent total numbers of coded behaviors in each type of visit. Health maintenance organization visits included significantly more patient questions, preventive services, disease prevention, treatment planning, and discussion of substance use. Results may have reflected physician gender differences across sites or patient self-selection to sites rather than site differences. These results have implications for developing further research to explore treatment environment, process, and outcome.

Adult↗

PubMed1996

Health plan satisfaction and risk of disenrollment among social/HMO and fee-for-service recipients.

Health plan satisfaction among the elderly is affected by multiple individual and locational factors. We used a general behavioral framework of predisposing, enabling, and service use factors to produce adjusted satisfaction scores. These then were included in a logistic analysis to determine the effect of satisfaction on continued membership in social health maintenance organizations (S/HMOs) or continued participation in fee-for-service care. S/HMO members, after one year in the plan, generally reported satisfaction scores comparable to Medicare beneficiaries in fee-for-service care. Satisfaction with perceived physician quality and interpersonal relationships with the providers reduced the risk of disenrollment. Functional impairment reduced the likelihood of disenrollment, but this effect varied by community. Being impaired was protective in communities with established HMOs. In markets where HMOs were emerging or where intensive HMO competition was beginning, disability increased the likelihood of changing current coverage. S/HMO membership, after adjusting for the market area's general disenrollment propensities, had varying effects. Being a newly formed plan was not a consistent predictor of higher disenrollment rates.

Aged↗

PubMedDate not supplied

The influence of physicians' attitudes on abortion performance, patient management and professional fees.

Although religion is the most powerful predictor of whether a doctor will perform any abortions, satisfaction with his or her patients and emotional reaction to the abortion procedure powerfully affect the physician's practice. Doctors who are most satisfied with their patients are less likely to ask unmarried teens for parental consent and to charge lower fees. Physicians who are severely disturbed over abortion perform terminations less frequently and more often ask spousal or parental consent--but charge lower fees and are more likely to accept Medicaid patients.

Abortion, Induced↗

PubMed1996

[The medical certificate--contents, form, deficiencies, fees].

The medical certificate ist a written health certificate based on the results of a medical diagnosis or examination. It does not contain scientifically base conclusions. The various forms of the certificate can be, for example, certificates of unfitness for work, certificates for insurance companies, certificates for exemption from school sports, diet certificates for tax returns, confirmation of a stable diabetes condition for driving licence authorities, certificates as proof of unfitness to plead in the process of criminal law. It is an offence (section 278 German Penal Code) to issue false health certificates for use with a public authority or insurance company contrary to one's knowledge. The form of some certificates is free, in some cases forms are used. "Standard form certificates" for insurance company are extended certificates. Certificates, especially free-form certificates, often have deficiencies: the purpose or addressee is not quoted; the date of the examination has not been entered; it is not apparent whether the statement is based on objective results; "catchword" like diagnostic terms are used: the necessary form ist not adhered to. The "Law concerning Compensation for Witnesses and Experts" (ZSEG) and the Scale of Medical Fees (GOA) set the standards for assessing the fee for a certificate.

Confidentiality↗

PubMed1997

Fee-for-service dentistry or managed care: one dentist's opinion.

Contrasts are drawn between dental care based on fee-for-service and managed care financial arrangements. The advantages of fee-for-service include (for the profession) slow acceptance of managed care in dentistry compared to medicine; (for society and the patient) more community service, higher technical quality of work, and stimulation of innovations; and (for the individual dentist) the strong dentist-patient bond as well as professionalism.

Attitude of Health Personnel↗

PubMed1997

An economic analysis of managed fee-for-service and direct reimbursement.

This economic analysis compares the direct reimbursement approach with the managed fee-for-service approach to the delivery and payment for dental care. Asymmetrical distribution of information between patients and dentists characterizes the market and gives rise to a principal-agent problem. To solve this problem, third-party payers have devised various methods for managing delivery and payment for dental care by monitoring and encouraging providers to assure a certain level of quality at defined costs. Direct reimbursement has been promoted by dental care providers as an alternative to the traditional third-party payer model and has at its core the elimination of many of the currently used managed care control mechanisms. The authors conclude that managed fee-for-service plan concepts deal with current economic issues more realistically than do direct reimbursement arrangements. Furthermore, the authors predict that direct reimbursement prevalence would lead to higher average prices for dental care and a change in the mix of services skewed toward high cost, marginally beneficial treatments.

Communication↗

PubMed1998

[Appendectomy with respect to flat fee and special rate charges. Cost analysis of open and laparoscopic operation].

The introduction of flat charges per case and special fees, first put into effect on Jan. 1, 1996, has lead medical and administrative personnel to rethink how fixed daily hospital rates, costs individually determined by each hospital, and prime costs for hospital and nursing charges will be reimbursed. The amount paid for flat charge cases and special fees (in German Marks) are currently the same nationwide. This applicable system of billing consists of a combination of diagnosis (ICD 9) and the type of therapy administered after each specific operation (ICPM). Between Jan. 1, 1996 and Dec. 31, 1996 we had 78 cases, where detailed personnel and relevant costs were recorded with the aid of three sheets of medical records and two reports for each patient. When comparing expenditures and compensation, there were deficits in 75 cases and surpluses in 3. This existing pressure to cut costs should not be allowed to lead to uncritical medical judgement. The major costs of an operation are for disposable materials, especially for the use of the endo-cutter. Laparoscopic appendectomies, on selected patients in our clinic, has created a deficit when covering costs for open appendectomies. The knowledge we have gained from this now enables us to balance out the deficit.

Aged↗

PubMed1981

Reputation, training, fee, and androgyny: their comparative effects on impressions of therapist credibility.

Two hundred and forty-eight college students viewed a vignette from a therapy-analogue session. Before Ss viewed the vignette they all read a summary that described the vignette plus an additional description that stressed different aspects of the therapist. One-fifth of the Ss were told of the therapist's excellent reputation, one-fifth were told of the therapist's excellent training and credentials, one-fifth were told of the therapist's high fee, and one-fifth were told of the therapists' androgenous personality. The remaining one-fifth of the Ss, who served as controls, were told nothing further; they only received the standard description of the vignette. After the vignette, Ss completed measures designed to assess their perception of therapist credibility and attractiveness. The results indicate that the androgenous therapist was rated as most credible and attractive (whereas the high-fee-charging therapist was least credible and attractive.) Explanation for these results and implications are discussed.

Attitude↗

PubMed1984

Obstetric care in a health maintenance organization and a private fee-for-service practice: a comparative analysis.

This study compares the quality of obstetric care provided for patients in two distinct groups: a federally-qualified health maintenance organization and a private fee-for-service practice. Patients of both groups were delivered in the same hospital with resident coverage equally accessible to both groups. From January, 1979, through December, 1981, the period of the study, the physician group delivered 2385 patients, 57% of them from the health maintenance organization and 43% from the fee-for-service practice. Not only were comparisons of maternal and fetal outcomes available for the two patient groups, but the yearly trends and individual performances of the physicians were available as well. This paper addresses the question, all other things being equal, is the level of care and ultimate outcome the same for both groups of patients? The results in some instances showed surprising differences.

Adult↗

PubMed2003

Effect of filmless imaging on utilization of radiologic services with a two-stage, hospital-wide implementation of a picture archiving and communication system: initial experience of a fee-for-service model.

A medium-sized general hospital using a fee-for-service model implemented a hospital-wide picture archiving and communication system (PACS) in two stages. This study evaluated the reporting time with filmless operation and the effect of filmless imaging on referring physicians' use of the radiologic service before and after completion of the second stage of PACS implementation. The relationship between the total number of hospital patients and the number of radiologic department patients was also evaluated. All sample images were retrieved from the PACS. All corresponding reports except for one for a computerized tomography study were available. The median reporting time for different studies performed during working hours was less than 2 hours. There was a significantly positive and linear relationship (p < 0.01) between the total number of hospital patients and the number of radiologic department patients after hospital-wide implementation of PACS. We conclude that the fee-for-service model had no negative impact on referring physicians' use of radiologic services in a filmless hospital.

Data Interpretation, Statistical↗

PubMed1999

Pricing strategy for aesthetic surgery: economic analysis of a resident clinic's change in fees.

The laws of microeconomics explain how prices affect consumer purchasing decisions and thus overall revenues and profits. These principles can easily be applied to the behavior aesthetic plastic surgery patients. The UCLA Division of Plastic Surgery resident aesthetics clinic recently offered a radical price change for its services. The effects of this change on demand for services and revenue were tracked. Economic analysis was applied to see if this price change resulted in the maximization of total revenues, or if additional price changes could further optimize them. Economic analysis of pricing involves several steps. The first step is to assess demand. The number of procedures performed by a given practice at different price levels can be plotted to create a demand curve. From this curve, price sensitivities of consumers can be calculated (price elasticity of demand). This information can then be used to determine the pricing level that creates demand for the exact number of procedures that yield optimal revenues. In economic parlance, revenues are maximized by pricing services such that elasticity is equal to 1 (the point of unit elasticity). At the UCLA resident clinic, average total fees per procedure were reduced by 40 percent. This resulted in a 250-percent increase in procedures performed for representative 4-month periods before and after the price change. Net revenues increased by 52 percent. Economic analysis showed that the price elasticity of demand before the price change was 6.2. After the price change it was 1. We conclude that the magnitude of the price change resulted in a fee schedule that yielded the highest possible revenues from the resident clinic. These results show that changes in price do affect total revenue and that the nature of these effects can be understood, predicted, and maximized using the tools of microeconomics.

Costs and Cost Analysis↗

PubMed2006

Fees or refuges: which is better for the sustainable management of insect resistance to transgenic Bt corn?

The evolution of resistance in insect pests will imperil the efficiency of transgenic insect-resistant crops. The currently advised strategy to delay resistance evolution is to plant non-toxic crops (refuges) in close proximity to plants engineered to express the toxic protein of the bacterium Bacillus thuringiensis (Bt). We seek answers to the question of how to induce growers to plant non-toxic crops. A first strategy, applied in the United States, is to require Bt growers to plant non-Bt refuges and control their compliance with requirements. We suggest that an alternative strategy is to make Bt seed more expensive by instituting a user fee, and we compare both strategies by integrating economic processes into a spatially explicit, population genetics model. Our results indicate that although both strategies may allow the sustainable management of the common pool of Bt-susceptibility alleles in pest populations, for the European corn borer (Ostrinia nubilalis) one of the most serious pests in the US corn belt, the fee strategy is less efficient than refuge requirements.

Animals↗

PubMed2001

Role of slotting fees and trade promotions in shaping how tobacco is marketed in retail stores.

OBJECTIVE: To examine how the retail environment in which tobacco is sold has changed because of the slotting fees and trade promotions paid by the tobacco companies. Public policy options for dealing with this environment are also evaluated. DATA SOURCES: A literature review, telephone interviews, and observation. RESULTS: The tobacco companies have been dramatically increasing the volume of slotting fees and trade promotions they pay to retailers, creating a more tobacco friendly retail environment containing self service displays and ample point-of-sale advertising. Critics express concern that these payments have kept prices lower and more varied than they might be otherwise, created more opportunities for pilferage and underage selling, and provided more youth exposure to tobacco promotions. Public policy makers could either ban these payments, institute policies designed to mitigate their harmful effects, or leave the situation as it is, relying on enforcement of existing statutes as well as market forces to reduce harm. Actions that might mitigate harmful effects would include putting minimum retail prices on tobacco products, banning self service displays, requiring retailers to be licensed, and adding more warning signs at the point of sale. CONCLUSION: Additional research is needed before determining the most appropriate public policy stance.

Advertising↗

PubMed2003

[Analysis of direct nursing activity and patient outcomes related to graded fee of nursing management for inpatient].

PURPOSE: The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient. METHOD: The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, chi(2)-Test and regression. RESULT: Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order. CONCLUSION: The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

English Abstract↗