View Research by Author - Margaret B. Sulvetta

Citation URL: http://www.urban.org/MargaretBSulvetta

There are two Highlights for each state. The Highlights that focus on health cover Medicaid, other public insurance programs, the health care marketplace, and the role of public providers. The Highlights capture policies in place and planned in 1996 and early 1997.

There are two Highlights for each state. The Highlights that focus on health cover Medicaid, other public insurance programs, the health care marketplace, and the role of public providers. The Highlights capture policies in place and planned in 1996 and early 1997.

This study addresses preliminary issues related to the development of a Medicare hospital outpatient department (OPD) prospective payment system based on ambulatory patient groups (APGs). It is limited to services provided in hospital outpatient departments and includes three tasks: classification of OPD according to the APG system; derivation of weights for each APG based on facility costs; and assessment of the financial impact on various groups of hospitals resulting from changing to an APG-based system. Included is a description of the characteristics of both a generic prospective payment system and of APGs.

The state reports describe the safety net and health care programs in place for low-income people on the eve of welfare reform. The reports also analyze the particular circumstances that are shaping the state's response to the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). The state reports are based on case studies in the respective state.

The state reports describe the safety net and health care programs in place for low-income people on the eve of welfare reform. The reports also analyze the particular circumstances that are shaping the state's response to the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). The state reports are based on case studies in the respective state.

This report explores the feasibility and possible structure of alternative approaches to developing an all-payer prospective system for reimbursing hospitals for inpatient care. Included are a discussion of the derivation of case mix indexes, a discussion on constructing estimates of the average cost of an inpatient discharge, and a discussion on achieving Medicare savings. Also covered is a payment simulation model that covers average payments per discharge by hospital type, aggregate payments by hospital type, and distribution effects by hospital type.

This paper raises a number of concerns about various options and offers a number of examples of ways to slow the growth of Medicare spending.

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