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The catch-22's of cost containment. 1979

R K Babayan, and B Katzmann

While exploring the problem of escalation of health care expenditures in urology and analyzing various means to curtail this escalation, we noted a recurrent problem relating to the negative incentives inherent in presently used reimbursement mechanisms. Proposed solutions to a particular problem usually are accompanied by new economic difficulties arising from the solution. A series of Catch-22's are encountered in many different problems concerning economic health care delivery. We herein elucidate a number of these problems and propose a novel reimbursement system in which there are positive incentives provided to those urologists who make an honest effort at cost containment.

UI MeSH Term Description Entries
D007349 Insurance, Health, Reimbursement Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988) Health Insurance Reimbursement,Reimbursement, Health Insurance,Third-Party Payments,Third-Party Payers,Health Insurance Reimbursements,Insurance Reimbursement, Health,Insurance Reimbursements, Health,Payer, Third-Party,Payers, Third-Party,Payment, Third-Party,Payments, Third-Party,Reimbursements, Health Insurance,Third Party Payers,Third Party Payments,Third-Party Payer,Third-Party Payment
D012040 Regional Health Planning Planning for health resources at a regional or multi-state level. Annual Implementation Plans,Appropriateness Review,Areawide Planning,Comprehensive Health Planning,Review, Appropriateness,Annual Implementation Plan,Appropriateness Reviews,Health Planning, Comprehensive,Health Planning, Regional,Implementation Plan, Annual,Implementation Plans, Annual,Plan, Annual Implementation,Planning, Areawide,Planning, Comprehensive Health,Planning, Regional Health,Plans, Annual Implementation,Reviews, Appropriateness
D012051 Reimbursement Mechanisms Processes or methods of reimbursement for services rendered or equipment. Mechanism, Reimbursement,Mechanisms, Reimbursement,Reimbursement Mechanism
D002017 Budgets Detailed financial plans for carrying out specific activities for a certain period of time. They include proposed income and expenditures. Budgetary Control,Budget,Budgetary Controls,Control, Budgetary,Controls, Budgetary
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D003363 Cost Control The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed) Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D003365 Costs and Cost Analysis Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs. Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D004209 Disposable Equipment Apparatus, devices, or supplies intended for one-time or temporary use. Equipment, Disposable
D004469 Economics, Hospital Economic aspects related to the management and operation of a hospital. Hospital Economics,Economic, Hospital,Hospital Economic
D005102 Health Expenditures The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers. Expenditure,Expenditures, Health,Health Expenditure,Out Of Pocket Expenditure,Out-of-Pocket Cost,Out-of-Pocket Expense,Out-of-Pocket Payment,Expenditures,Expenditures, Direct,Expenditures, Indirect,Expenditures, Out-of-Pocket,Out-of Pocket Expenditures,Out-of-Pocket Costs,Out-of-Pocket Expenses,Out-of-Pocket Payments,Out-of-Pocket Spending,Cost, Out-of-Pocket,Costs, Out-of-Pocket,Direct Expenditure,Direct Expenditures,Expenditure, Direct,Expenditure, Health,Expenditure, Indirect,Expenditure, Out-of Pocket,Expenditure, Out-of-Pocket,Expenditures, Out of Pocket,Expenditures, Out-of Pocket,Expense, Out-of-Pocket,Expenses, Out-of-Pocket,Indirect Expenditure,Indirect Expenditures,Out of Pocket Cost,Out of Pocket Costs,Out of Pocket Expenditures,Out of Pocket Expense,Out of Pocket Expenses,Out of Pocket Payment,Out of Pocket Payments,Out of Pocket Spending,Out-of Pocket Expenditure,Out-of-Pocket Expenditure,Out-of-Pocket Expenditures,Payment, Out-of-Pocket,Payments, Out-of-Pocket,Spending, Out-of-Pocket

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