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Paying for Medicare : The Politics of Reform - David G. Smith

Paying for Medicare

The Politics of Reform

By: David G. Smith

Hardcover | 31 December 1991 | Edition Number 1

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** Paying for Medicare received the American Risk and Insurance Association's Elizur Wright Award for itsÿoutstanding contribution to risk management and insurance literature.

The Prospective Payment System and the Medicare Fee Schedule, two of the most effectively sustained and successful efforts at policy innovation in history continue to shape decisions about Medicare and cost containment efforts.

Smith shows how particular policy alternatives were developed; why chosen or rejected; and how provider interests and American political institutions have shaped their design and implementation.

Industry Reviews
-This is two books in one. The first reviews forces that shaped Medicare hospital reimbursement policy during the 1980s. In 1983, Congress adopted the prospective payment system (PPS), a radical departure from the retrospective, cost-based approach by which Medicare had paid hospitals since the program began in 1966. Using primary and secondary sources, Smith weaves a compelling narrative that explains how Congress, the Health Care Financing Administration (which administers Medicare), and the nation's hospitals worked together to develop and implement the new system. Although concerned primarily with the political context, Smith does an excellent job of explaining the technical complexities of PPS. The result is a first-rate political history that can be recommended to any serious student of health policy. The second half of the book deals with physician payment reform, specifically the Medicare Resource-Based Relative Value Scale (RBRVS) enacted in 1989 and implemented in January 1992... Upper-division undergraduate and up.-

--B. C. Stuart, Choice "This is two books in one. The first reviews forces that shaped Medicare hospital reimbursement policy during the 1980s. In 1983, Congress adopted the prospective payment system (PPS), a radical departure from the retrospective, cost-based approach by which Medicare had paid hospitals since the program began in 1966. Using primary and secondary sources, Smith weaves a compelling narrative that explains how Congress, the Health Care Financing Administration (which administers Medicare), and the nation's hospitals worked together to develop and implement the new system. Although concerned primarily with the political context, Smith does an excellent job of explaining the technical complexities of PPS. The result is a first-rate political history that can be recommended to any serious student of health policy. The second half of the book deals with physician payment reform, specifically the Medicare Resource-Based Relative Value Scale (RBRVS) enacted in 1989 and implemented in January 1992... Upper-division undergraduate and up."

--B. C. Stuart, Choice "This is two books in one. The first reviews forces that shaped Medicare hospital reimbursement policy during the 1980s. In 1983, Congress adopted the prospective payment system (PPS), a radical departure from the retrospective, cost-based approach by which Medicare had paid hospitals since the program began in 1966. Using primary and secondary sources, Smith weaves a compelling narrative that explains how Congress, the Health Care Financing Administration (which administers Medicare), and the nation's hospitals worked together to develop and implement the new system. Although concerned primarily with the political context, Smith does an excellent job of explaining the technical complexities of PPS. The result is a first-rate political history that can be recommended to any serious student of health policy. The second half of the book deals with physician payment reform, specifically the Medicare Resource-Based Relative Value Scale (RBRVS) enacted in 1989 and implemented in January 1992... Upper-division undergraduate and up."

--B. C. Stuart, Choice

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