The success of medicare's end-stage renal-disease program: the case for profits and the private marketplace

The New England Journal of Medicine
E G Lowrie, C L Hampers

Abstract

The 92nd Congress extended Medicare benefits to patients with end-stage renal disease (ESRD), sparing patients the financial burden of treating this catastrophic illness. The costs of the ESRD program have been contained better than those of health care generally; payment was originally limited by a screen of $138 per dialysis but could be higher if higher cost was documented. About 48 per cent of patients receive dialysis in units outside hospitals. The majority of these units are operated for profit, in which physicians share. The payment to these facilities has remained constant while payment to the nonprofit hospitals' unit has increased markedly. Physicians in for-profit units have a strong incentive to learn about costs and control them. They are involved in medical economic management as well as clinical management; this results in integrated administration of health care. The success of the ESRD program in expanding service to meet demand while controlling costs and maintaining quality has been due primarily to the combined effect of setting a price and creating a system of incentives that involves physicians in the medical marketplace.

References

Apr 13, 1979·JAMA : the Journal of the American Medical Association·S J DresnickA Blum
Feb 6, 1981·JAMA : the Journal of the American Medical Association·R W EvansF A Bryan
Apr 24, 1981·Science·K T Brown
Oct 23, 1980·The New England Journal of Medicine·A S Relman
Nov 6, 1980·The New England Journal of Medicine·E Ginzberg

❮ Previous
Next ❯

Citations

Aug 1, 1987·Human Genetics·S T ReedersD J Weatherall
Jul 1, 1988·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·F A Flinter, M Bobrow
Feb 19, 2005·Health Care Management Science·Hacer Ozgen, Yasar A Ozcan
Feb 6, 2008·Nature Clinical Practice. Nephrology·Mobin MohteshamzadehChristopher F Wong
Feb 14, 2002·Kidney International·Ralph WitzgallNicholas Obermüller
Feb 11, 1982·The New England Journal of Medicine·W B SchwartzA P Williams
Apr 15, 1982·The New England Journal of Medicine·E Saward, A Sorensen
May 27, 1982·The New England Journal of Medicine·S G RostandB A Pate
May 27, 1982·The New England Journal of Medicine·A S Relman
Feb 28, 1985·The New England Journal of Medicine·R W EvansE G Lowrie
Oct 18, 1990·The New England Journal of Medicine·P S ParfreyS Somlo
Mar 29, 1986·British Medical Journal·S T ReedersD J Weatherall
Dec 15, 2010·Health Services Research·Yi ZhangMae Thamer
Jan 1, 1987·Image--the Journal of Nursing Scholarship·K R Jones
Jun 1, 1982·Experimental and Molecular Pathology·T Shimamura
Mar 10, 2001·Medical Care Research and Review : MCRR·A J KhouryC M Jarjoura
Aug 1, 1987·Annals of Neurology·M Natowicz, R I Kelley
Jan 30, 2007·Hemodialysis International·David W JohnsonNicole Maree Isbel
Oct 21, 1998·Revista de saúde pública·A ArredondoE de Icaza
Jun 1, 1999·Revista de saúde pública·A ArredondoE de Icaza
Jan 27, 2021·Genesis : the Journal of Genetics and Development·Mark E CorkinsRachel K Miller
Jun 29, 2002·Journal of the American Society of Nephrology : JASN·Nicholas ObermüllerRalph Witzgall

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.