cost containment Flashcards
two approaches
market or regulatory
market approach
competition and transparency. pt knowledge is needed
regulatory approacch
increase gov’t role in oversight, rate setting, quality control, less consumer choice
supply vs demand
supply: change provider incentives/limit availability, demand: change pt behavior. increase cost share, role in decisions
what worked/didn’t in the past
HMOs- backlash for less choice, doctors as gatekeepers, employer role
today cost containment ideas are either
finance, payment, organization, regulation, behavior
finance ideas (2)
single payer, global budget
payment ideas (6)
bundled payment, capitation, prescription drug purchase, all payer rate, global payment, episode bundles
organization ideas (3)
PCMH, ACO, High cost, high risk
why target organization>
match care delivery to new payment models
regulation
standardize. Feds can’t look at cost effectiveness
behavior
cost transparency, increase cost
canada uses
global budget
UK
national budget, generics, decreased tech
AUS
gov’t buys pharma
