Social and Behavioral Sciences Commons^™

The Centers For Medicare And Medicaid Services’ Approach To Value-Based Purchasing, Bettina Berman

Value-Based Purchasing Newsletter

Although evidence suggests that both the quality and the affordability of health care can be improved¹, it is likely that such improvements will come at great cost. Healthcare expenditures in the United States (U.S.) are expected to rise precipitously - from $1.5 trillion in 2005 to over $4 trillion in 2016.² Medicare, the nation’s single largest health care purchaser, spent an estimated $425 billion on health services in 2007. With the projected growth in Medicare beneficiaries, the amount may surpass $800 billion by 2017, placing the government under significant pressure to control health care costs.³

This …

Uncle Sam's Debut On The Value-Based Purchasing Stage, Neil I. Goldfarb

Value-Based Purchasing Newsletter

No abstract provided.

Political Economy, Moral Economy And The Medicare Modernization Act Of 2003, Judie Svihula

The Journal of Sociology & Social Welfare

Through the lens of political and moral economy, I examined the dominant values and actors in the legislative process of the Medicare Modernization Act of 2003. In my content analysis of federal hearings, I found that witnesses from government agencies, Congress and think tanks had almost equal presence at the hearings. Witnesses who were invited by Congress to testify at the hearings expressed twice as much support for private interests than for the general Medicare population or low-income beneficiaries. Few expressed concern for the uninsured population. Witnesses offered almost four times as many expressions of support for market rationalism than …

Tracing The History Of Medicare Home Health Care: The Impact Of Policy On Benefit Use, Joan K. Davitt, Sunha Choi

The Journal of Sociology & Social Welfare

We trace key policy changes that affected use of the Medicare home health benefit from the 1980s through the prospective payment system implemented in 2000, analyzing the impact on three measures of home care use: expenditures, users and visits. We demonstrate the impact of policies generated in the legislative, the judicial, and the executive branches of government and the gaming behavior of home health agencies in response to policy changes. Our analysis suggests that the policy itself and the implementation process are critical to understanding benefit use. The incentives in the policies and agency reactions had the potential to generate …