1st Edition

Paying for Medicare
The Politics of Reform

ISBN 9780202303949
Published December 31, 1992 by Routledge
286 Pages

USD $52.95

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Book Description

** Paying for Medicare received the American Risk and Insurance Association's Elizur Wright Award for itsoutstanding 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.

Table of Contents


1 Introduction

The Policy Environment

2 Prospective Payment System: Development

Hospital Cost Containment
A Decisive Turning Point
A Decade of Development
Developing a Proposal
Legislating the Prospective Payment System
Initial Implementation
Chronology: Prospective Payment System

3 Prospective Payment System: Implementation

Implementation Activities
Substantive Policy
PPS: The Future
Chronology: Implementation

4 Physician Payment Reform: Background

Medicare: Early Implementation
The Reagan Administration
Action by Congress
Chronological: Physicians Payment: Background

5 Physicians Payment: Designing the System

Introduction— The PPRC
Politics and the Deficit
Elements of a Fee Schedule
Legislating the Medicare Fee Schedule
Chronology: Physician Payment: Designing the System

6 Conclusion

Two Payment Reforms: Alike and Not Alike
Medicare and the American Political System

Major Legislation
Selected Bibliography

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