(1) Recent court decisions since the landmark Wickline v. The State of California case in 1987 have addressed this issue of shared liability between payors and providers.
(2) Even more worrisome to these institutions is the possibility of other third-party payors following Medicare's lead and converting to this reimbursement plan.
(3) Such requests arise from third-party payors such as insurance companies, state workers compensation departments, and other systems of disability determination.
(4) All adult medical admissions (N = 30,097) were analyzed for a three-year period at a large academic medical center using the DRG "all payor" classification scheme in effect for New York State.
(5) Medicare patients had (on average) a longer hospital length of stay and total hospital cost compared to patients from Medicaid, Blue Cross, and other commercial payors.
(6) These differences could not be explained by differences in age level and payor status of sample populations.
(7) The criteria should undergo complete specificity and sensitivity testing, be expanded to include more outcome measures, and be applied to other geographic areas before use by other third party payors.
(8) In an attempt to control costs and increase the efficiency of health care, it is being increasingly delivered in alternate health-care systems where third-party payors influence the access, use, and quality of that care.
(9) Analysis of 858 pulmonary medicine patients by payor (Medicare, Medicaid, Blue Cross, and commercial insurance) in these non-CC stratified pulmonary medicine DRGs for a three-year period demonstrated that patients with more CCs per DRG for each payor generated higher total hospital costs, a longer hospital length of stay, a greater percentage of procedures per patient, financial risk under DRG payment, more outliers, and a higher mortality, compared to patients in these same DRGs with fewer CCs.
(10) Analysis of 12,340 medical patients by payor (Medicare, Medicaid, Blue Cross, and commercial insurance) in these non-CC-stratified medical DRGs for a three-year period demonstrated that patients with more CCs per DRG for each payor generated higher total hospital costs, a longer hospital length of stay, a greater percentage of procedures per patient, higher financial risk under DRG payment, and a higher mortality, compared with patients in these same DRGs with fewer CCs.
(11) The forces of technology and changing payor requirements continue to move many surgical procedures to the ambulatory setting.
(12) This article examines factors contributing to this reduction in autonomy and reviews potential impacts on the profession, patients, payors, health care organizations, and managers.
(13) However, present financing of GME by Medicare is linked to payment for inpatient service, and few other payors pay explicitly for education.
(14) Diagnosis serves to differentiate the "products"; however, diagnoses are grouped by payor and similar treatment cost experiences to create a limited set of managerially meaningful case types.
(15) In All Payor Systems, Medicare, Medicaid, Blue Cross and other commercial insurers pay by the DRG mode; the state of New York has been All Payor since 1 January 1988.
(16) Our findings were as follows: (1) With charges as a measure of expense under both payment schemes, all clinical departments had large groups of unprofitable patients: Medicare, $12,895,038; all-payor system, $15,553,893.
(17) A changing clinical environment both because of diseases such as AIDS, which were not anticipated when these clinical codes were created, and because of the changing relationship between the physician, the patient, and the payor for the physician's care creates dilemmas concerning the rule of confidentiality.
(18) Both Medicare and Medicaid patients had (on average) a longer hospital stay and total hospital cost compared with patients from Blue Cross and other commercial payors.
(19) Developing a monolithic vocabulary would require a massive effort, and its existence would not guarantee its use by third-party payors, by practicing clinicians, or by developers of electronic medical information systems.
(20) In addition, the DRG system only applies to Medicare payments; the Norwegian experience demonstrates that this system may result in significant shifting of costs onto other payors.
Remitter
Definition:
(n.) One who remits.
(n.) One who pardons.
(n.) One who makes remittance.
(n.) The sending or placing back of a person to a title or right he had before; the restitution of one who obtains possession of property under a defective title, to his rights under some valid title by virtue of which he might legally have entered into possession only by suit.
Example Sentences:
(1) Complete remissions were relatively short, and 11 of 14 remitters relapsed after 2 to 11 months (median 4 months).
(2) In the postoperative period, he was complicated by remittent fever of 1 month's duration, which was finally controlled by antibiotics.
(3) With global remittances tripling over the past decade and now outstripping official aid, diaspora groups and international NGOs urgently need to find ways of working together more effectively.
(4) High levels of IC in CSF were detected only in the subgroup consisting of the relapsing-remittent patients in disease exacerbation when IC were determined by the C1q-binding test.
(5) More meetings between government officials, banks, remittance companies and NGOs are planned over the coming weeks.
(6) Hormone therapy is indicated in acute forms of disseminated sclerosis and in a remittent development in the stage of exacerbation in the II and III phases.
(7) As the locus of many migrants' investments, the village of Los Pinos has experienced a modest growth in the number of full-time jobs paying somewhat above the minimum urban wage and in a variety of petty entrepreneurial activities depending heavily on the patronage of migrant households, themselves heavily subsidized by remittances.
(8) Their history was not suggestive of a cyclic or remittent pattern of symptoms.
(9) Nearly a third had a remittent (32.8%) or relapsing cumulative (34%) course and 9% had a progressive course from the start.
(10) Remittances by African migrants provide many benefits to African households and governments.
(11) So we also need to be thinking internationally.” He said that included marshalling “everything the private sector has to give”, including overseas remittances by migrant workers, which the World Bank estimates reached $436bn in 2014 , and supporting plans by the Brics countries (Brazil, Russia, India, China and South Africa) to launch a development bank to finance infrastructure projects.
(12) One patient had suffered from severe postpartal hyperbilirubinemia, the other one presented with chronic hemolysis and remittent hyperbilirubinemia.
(13) As gold compounds are effective in treating spontaneous RA in dogs, these proposed actions may not be responsible for the remittive effects of chrysotherapy in this disease.
(14) These unchanging features were not found among the remitters.
(15) High rates of diffuse remittance were found for classical laser wavelengths such as the argon or the Nd:YAG II laser indicating only low rates of absorption.
(16) The government said it was committed to supporting a healthy and legitimate remittance sector while also ensuring a robust anti-money laundering regime.
(17) A drying up of remittance money to Somalia is the last thing the British government needs as it has invested much political effort in putting the country back on its feet.
(18) The opposition had warned, with each stage of the “normalization” – the release on both sides of political prisoners; a deal to allow telecom companies to strengthen the internet on the island and for US banks to do business there; a US agreement to expand remittances and ease travel restrictions – that too many opponents of the Castro regime remain in prisons, or remain sentenced to silence under threat of retribution.
(19) Remittance by mail of blood samples and subsequent time of permanency in mail boxes are not supposed to be best thermic conditions for dried blood samples in paper used for neonatal screening.
(20) Patients with TdT-positive AML had similar median survival (12 versus 10.5 months) and complete remission (CR) rates (53 versus 59%), but a greater frequency of long-term complete responders (60 of complete remitters versus 20%, p = 0.08) than TdT-negative patients.