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Related Experiment Videos

Charge profiles, RBRVS data and pre-estimates: a lesson in fee setting.

E J Harshman1

  • 1Automated Medical Claims Editing, Inc., New York City.

Benefits Quarterly
|December 9, 1993
PubMed
Summary
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This study presents a simple reimbursement level setting method. When combined with physician negotiation, it offers effective healthcare cost control.

Area of Science:

  • Health Economics
  • Healthcare Management

Background:

  • Healthcare costs are a significant concern.
  • Effective cost-control mechanisms are needed.

Purpose of the Study:

  • To describe a novel method for setting reimbursement levels.
  • To evaluate its potential as a cost-control mechanism.

Main Methods:

  • The study describes a method for setting reimbursement levels.
  • It considers combining this method with physician negotiation programs.

Main Results:

  • The described reimbursement method is simple.
  • It may be highly effective for cost control, especially with physician negotiation.

Conclusions:

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  • The proposed reimbursement level setting method is a potentially powerful and simple cost-control tool.
  • Its combination with physician negotiation enhances its effectiveness.