Hospital & Physician Rate-Setting Systems: A Reference Manual for Developing and Implementing Rate Structures (Hfma Healthcare Financial Management Series)

The task of controlling healthcare spending has been passed along to state governments, public and private payors and to providers themselves. These professionals are faced with the task of designing and implementing reimbursement rates in an era of managed care. This book aims to provide assistance to healthcare professionals who are responsible for developing and implementing rate setting systems. It features five case studies of states that have successfully implemented different types of rate structures, details methods and admininstration techniques for both hospitals and physicians, discusses the organizational structure of different rate setting systems, and examines how to determine and update hospital payment rates through different techniques.