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At least 1,351 records · Page 75Linked to original sources
PubMed1998

Pharmacotherapy: strategies to control drug costs in managed care.

Pharmacotherapy remains one of the most cost-effective interventions physicians can provide to manage the medical conditions of older patients. Because many older Americans have multiple diseases, the practitioner's goal is to maximize appropriate drug use while avoiding duplicative or interacting medications. Medicare managed care plans seek to provide appropriate medication for the older patient at a reasonable cost through such strategies as formularies, prior authorization, generic and therapeutic substitution, and drug utilization review. Yet, like the medications themselves, these strategies require careful attention to their risks and benefits to the individual patient.

Drug Costs↗
PubMed1998

A comparison of neural network models for the prediction of the cost of care for acute coronary syndrome patients.

Acute coronary syndromes have remained the focus of many clinical economic studies due to the increasing prevalence of the disease and the tightening of cost controls. An accurate descriptive cost model for this population would be a valuable tool for clinical researchers. With such a model, the relative importance of different factors upon the total cost of care could be determined through computer simulation. This study explored the use of different neural network architectures in creating a descriptive cost model. This was a difficult problem in that the costs span 3 orders of magnitude but the output variable of the neural network must be restricted to the range 0-1. Models that used logarithmic transformations and multiple modular networks were created and analyzed. It was found that the model with a single network and logarithmic transformation performed significantly better than other more complicated networks.

Coronary Disease↗
PubMed2002

Prescription drug access: not just a Medicare problem.

While all state Medicaid programs provide outpatient prescription drug coverage, slightly more than one in four Medicaid patients ages 18-64 could not afford to fill at least one prescription in the last year, according to a new study by the Center for Studying Health System Change (HSC). A similar percentage of uninsured adults also had difficulty affording prescription medications. Faced with rapidly rising drug spending, many states have moved to control Medicaid prescription drug spending by imposing copayments, limiting the number of prescriptions and using other cost-containment methods. The study indicates that these state cost-control measures are contributing to Medicaid beneficiaries' prescription drug access problems. State and federal policy makers should keep in mind that the impact of these controls on Medicaid beneficiaries is likely to be greater than on privately insured people, given their higher need and lower incomes.

Adult↗
PubMed1996

Can managed care plans control health care costs?

The health insurance sector has been transformed in the past fifteen years, with managed care replacing indemnity insurance as the norm. This transformation was intended to change the nature of competition in the health care system so that market forces could be used to control costs. Empirical studies have shown that this objective has been met, as areas with high managed care penetration have tended to have much lower rates of increase in their costs. Creating a more efficient health care system will require additional efforts to produce useful measures of quality and to maintain competitive markets.

California↗
PubMed1988

Cost accounting, management control, and planning in health care.

Advantages and pharmacy applications of computerized hospital management-control and planning systems are described. Hospitals must define their product lines; patient cases, not tests or procedures, are the end product. Management involves operational control, management control, and strategic planning. Operational control deals with day-to-day management on the task level. Management control involves ensuring that managers use resources effectively and efficiently to accomplish the organization's objectives. Management control includes both control of unit costs of intermediate products, which are procedures and services used to treat patients and are managed by hospital department heads, and control of intermediate product use per case (managed by the clinician). Information from the operation and management levels feeds into the strategic plan; conversely, the management level controls the plan and the operational level carries it out. In the system developed at New England Medical Center, Boston, Massachusetts, the intermediate product-management system enables managers to identify intermediate products, develop standard costs, simulate changes in departmental costs, and perform variance analysis. The end-product management system creates a patient-level data-base, identifies end products (patient-care groupings), develops standard resource protocols, models alternative assumptions, performs variance analysis, and provides concurrent reporting. Examples are given of pharmacy managers' use of such systems to answer questions in the areas of product costing, product pricing, variance analysis, productivity monitoring, flexible budgeting, modeling and planning, and comparative analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Boston↗
PubMed1989

Who manages the managers? The 1989 Harvey Cushing oration.

New medical knowledge is emerging at a tremendous rate. Diseases such as Alzheimer's disease. Parkinson's disease, cancer, and others (diseases once considered beyond the scope of medicine) are receiving a great deal of attention. Yet it is a paradox that, at a time when we are learning more about the biology of the human being, it is more difficult to creatively develop the new knowledge into diagnostic tests, surgical interventions, and preventive strategies. The pace of biomedical innovation is being slowed by an increase in the intervention of nonmedical "managers of care." The driving force behind managed care is concern over cost. The managers of medical care have sought to control costs by controlling the doctor's decision making. This is the focus of managed care. The physicians of today, therefore, face a remarkable challenge. They must respond to the needs of patients while being held accountable to an increasing number of overseers in the public and private sectors. These managers of care justify their activities on the notion that the patient will be better off and the cost less if the doctor-patient encounter is regulated by protocols, statistical comparison, utilization review, and fee schedules. While doctor's decisions are being managed by others, who is managing the managers? The answer should be the medical community, principally doctors. Unfortunately, the answer at the moment is the payors--governmental reimbursement agencies, intermediaries, employers, hospitals, or new corporations designed to manage medical costs. The challenge to the physician is to retain the responsibility for those things for which he or she is held accountable. The challenge should not be ignored.

Costs and Cost Analysis↗
PubMed2002

Control of prescription costs--is it possible?

The author considers two choices for controlling the cost of prescription drugs: Return the prescription drug program to the TPA, or implement plan design changes. Making changes to the buying habits of the public is key.

Cost Control↗
PubMed1986

Prospective payment in perspective.

Prospective payment promises improvement for a health care system plagued by inefficiency and rising costs, but is likely to disappoint. Serious efforts to control costs threaten the system's access and quality objectives and will be resisted. Moreover, serious cost containment, whether the result of all-payer regulation or competition, requires a stronger civil service than America seems capable of providing. A comparison with the experience in defense demonstrates the important limitations in applying incentive-based models in policy areas with conflicting goals. The search for panaceas will go on, but there are none.

Cost Control↗
PubMed1990

Technology and outpatient review: a preliminary evaluation.

Most health care utilization and cost control programs focus on inpatient care or on high-cost, catastrophic illnesses or injuries. Recently, however, Parkside Health Management Corporation has developed a utilization review program that targets treatments and high-technology procedures performed primarily in an outpatient setting, as well as specific inpatient procedures not included in other review programs. These include chiropractic, podiatric, and physical therapy treatments; cesarean section; and endoscopy, ultrasound in pregnancy, and lithotripsy. The treatments/procedures examined in this program, called Technology and Outpatient Review (TOR), account for approximately 6% of claims expenses. Bigel Institute for Health Policy researchers are evaluating a pilot test to determine TOR's effect on health care costs and utilization, appropriateness, and patient satisfaction.

Ambulatory Care↗
PubMed1999

Cost containment mechanisms in Canada.

AIM: Describe the mechanisms currently being used by federal and provincial/territorial governments, medical associations, and private insurers to control the cost of health care in our country. METHODS: Descriptive method used. Statistics on percentage GDP spent on health, and health status of the population, were compared with other OECD countries. Questions discussed: importance of cost control, why difficult to control, and what is needed to control costs. RESULTS: System-wide mechanisms used to control health care costs include: single payer financing, universal coverage for hospital/physician services, global budgets, preventive health services, evidence-based information systems, and regionalization. Sector specific mechanisms used to control costs of physicians, hospitals, drugs, and technology. Cost control within the health care sector allows spending on other sectors (e.g., employment) that have a proven impact on one's health. Future health care cost containment policies must focus on restraining private sector costs and encouraging movement towards the determinants of health approach. CONCLUSIONS: Canada's relative success in containing costs is the result of public financing of the health insurance system. Our single payer, publicly financed health care system, allows for cost containment and universal access based on need for services rather than ability to pay. The shift of costs from the public to private sector must be curtailed. The determinants of health approach is instrumental in containing and channeling future spending on health.

Canada↗
PubMed1991

Antimicrobial cost and quality control: challenges in the 1990s.

Increasing constraints on health care reimbursement, competition among hospitals, and new high-cost technologies all contribute to escalation of costs in hospitals. The goal in the 1990s is to provide optimum, cost-effective care for patients without compromising quality. Among many proved methods is an effective formulary system with explicit criteria for use of medications, guidelines for use in specialized circumstances, and suggestions for therapeutic alternatives. This last method of cost control received endorsement from several organizations and offers an important function for hospital pharmacists. Hospital pharmacies can play a major role in minimizing antimicrobial costs and promoting optimum patient care.

Anti-Bacterial Agents↗
PubMed1996

Providing cost data to physicians helps contain costs.

Findings of a survey of 1,200 physicians suggest that healthcare organizations that provide physicians with pricing information can reduce resource utilization and control costs more effectively than organizations that do not provide such information. These findings also suggest that healthcare financial managers who are aware of physicians' responses to cost information--and who furnish them with effective cost information--may gain a timely competitive advantage.

Awareness↗