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Related Concept Videos

Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Introduction To Health Care Delivery System01:18

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Standards of Care I01:22

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Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
Ethical Issues01:27

Ethical Issues

Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:

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Related Experiment Video

Updated: Jun 12, 2026

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

Does Medicare have an implicit cost-effectiveness threshold?

James D Chambers1, Peter J Neumann, Martin J Buxton

  • 1Health Economics Research Group, Brunel University, Uxbridge, UK. jchambers@tuftsmedicalcenter.org

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|June 17, 2010
PubMed
Summary
This summary is machine-generated.

Centers for Medicare and Medicaid Services (CMS) covers interventions lacking cost-effectiveness, indicating potential resource misallocation. No implicit cost-effectiveness threshold was found in national coverage determinations (NCDs).

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Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
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Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

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Last Updated: Jun 12, 2026

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

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Published on: August 9, 2024

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

Area of Science:

  • Health economics
  • Health policy analysis
  • Medical technology assessment

Background:

  • Centers for Medicare and Medicaid Services (CMS) national coverage determinations (NCDs) traditionally exclude cost-effectiveness analysis.
  • Significant program costs necessitate evaluating resource allocation efficiency.

Purpose of the Study:

  • To investigate the existence of an implicit cost-effectiveness threshold in CMS NCDs.
  • To determine the extent to which economic evidence influences coverage decisions.

Main Methods:

  • Conducted a literature search for cost-effectiveness estimates linked to NCDs (1999-2007).
  • Reviewed 103 NCDs, focusing on the most representative economic evaluation for each.
  • Analyzed coverage decisions in relation to cost-effectiveness ratios (ICERs).

Main Results:

  • 49 of 64 NCDs with cost-effectiveness data received positive coverage.
  • Positive decisions included interventions with dominant cost-effectiveness, ICERs <$50,000, $50,000-$100,000, and >$100,000.
  • Only 14 NCD decision memos explicitly discussed cost-effectiveness.

Conclusions:

  • CMS covers interventions that may not be cost-effective, suggesting inefficient resource allocation.
  • While cost-effectiveness evidence is sometimes cited, no clear implicit threshold for NCDs was identified.