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VOLUME 17 , ISSUE 1 ( February, 2013 ) > List of Articles

REVIEW ARTICLE

Reimbursement for critical care services in India

Raja Jayaram

Keywords : Compensation, critical care, fee-for-service, health-care resource groups, intensive-care unit, intensivists, payment-by-results, pay for performance, pay-for-volume, reimbursement, third party administrators

Citation Information : Jayaram R. Reimbursement for critical care services in India. Indian J Crit Care Med 2013; 17 (1):1-9.

DOI: 10.4103/0972-5229.112141

License: CC BY-ND 3.0

Published Online: 01-04-2014

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

There are significant variations in critical care practices, costs, and reimbursements in various countries. Of note, there is a paucity of reliable information on remuneration and reimbursement models for intensivists in India. This review article aims to analyze the existing reimbursement models in United States and United Kingdom and propose a frame-work model that may be applicable in India.


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  1. Wikipedia.org. Can′t Buy Me Love, 1964. Available from: http://www.en.wikipedia.org/wiki/Can′t_Buy_Me_Love. (Last modified 2011 Dec 9).
  2. Knutson B, Adams CM, Fong GW, Hommer D. Anticipation of increasing monetary reward selectively recruits nucleus accumbens. J Neurosci 2001;21:RC159.
  3. Bjork JM, Knutson B, Fong GW, Caggiano DM, Bennett SM, Hommer DW. Incentive-elicited brain activation in adolescents: Similarities and differences from young adults. J Neurosci 2004;24:1793-802.
  4. Chaucer G. The Canterbury Tales. In: Murphy M, Lanham, editors. Maryland University Press of America; 1991.
  5. Edwards C. The Hammurabi Code. Port Washington, New York: Kennikat Press; 1971.
  6. Available from: http://www.isccm.org. [Last accessed on 04 Oct 2011].
  7. Available from: http://www.nejm.org. [Last accessed on 04 Oct 2011].
  8. Wikipedia.org. Health care in the United States, 2011. Available from: http://www.en.wikipedia.org/wiki/Health_care_in_the_United_States. (Last modified 2011 Dec 26).
  9. Committee on Quality of Health Care in America IoM. Crossing the Quality Chasm: Anew Health System for the 21 st Century. Washington DC: National Academy Press; 2001.
  10. Baumann MH, Dellert E. Performance measures and pay for performance. Chest 2006;129:188-91.
  11. Rosenthal MB, Frank RG, Li Z, Epstein AM. Early experience with pay-for-performance: From concept to practice. JAMA 2005;294:1788-93.
  12. Center for Medicare Advocacy, Inc. CMS to hospitals: If it should never happen, we will never pay, 2008. Available from: http://www.medicareadvocacy.org/InfoByTopic/Reform/Reform_08_09.25.NeverEvents.htm.
  13. CMS Hospital Pay-for-Performance Workgroup. U.S. Department of Health and Human Services. Medicare Hospital Value-Based Purchasing Plan Development. Issues paper. 1 st public listening session, January 17, 2007.
  14. Joint Commission on Principles for the construction of pay-for performance programs, 2004. Available from: http://www.jcaho.org.
  15. Centers for Medicare and Medicaid Services. CMS quality improvement roadmap, 2009. Available from: http://www.cms.hhs.gov/CouncilonTechInnov/downloads/qualityroadmap.pdf.
  16. Khanduja K, Scales DC, Adhikari NK. Pay for performance in the intensive care unit: Opportunity or threat? Crit Care Med 2009;37:852-8.
  17. Egol A, Shander A, Kirkland L, Wall MH, Dorman T, Dasta J, et al. Pay for performance in critical care: An executive summary of the position paper by the Society of Critical Care Medicine. Crit Care Med 2009;37:2625-31.
  18. Kahn JM, Scales DC, Au DH, Carson SS, Curtis JR, Dudley RA, et al. An official American Thoracic Society policy statement: Pay-for-performance in pulmonary, critical care, and sleep medicine. Am J Respir Crit Care Med 2010;181:752-61.
  19. Available from: http://www.nhs.uk/Pages/HomePage.aspx. [Last accessed on 04 Oct 2011].
  20. Available from: http://www.dh.gov.uk/en/index.htm. [Last accessed on 04 Oct 2011].
  21. Equity and excellence: Liberating the NHS, 2010. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_117353, http://www.dh.gov.uk.
  22. Wikipedia.org. NHS Primary Care Trust, 2005. Available from: http://www.en.wikipedia.org/wiki/NHS_primary_care_trust. (Last modified 2011 Nov 29).
  23. Ian Hughes. NHS. Adult Critical Care Levels 2 and 3 hGs, Version 3.6. Definitions Manual. Issue Date: 6 th May 2005. Available from: http://www.ic.nhs.uk/webfiles/Services/casemix/products/adultcritialcare_def_man.pdf. [Last accessed on 04 Oct 2011].
  24. Connectingforhealth.nhs.uk. Critical Care Minimum Data Set, Available from: http://www.connectingforhealth.nhs.uk/systemsandservices/data/nhsdmds/faqs/cds/admitpat/ccmds.
  25. Available from: http://www.networks.nhs.uk/nhs-networks/network_finder. [Last accessed on 04 Oct 2011].
  26. Prayag S. ICUs worldwide: Critical care in India. Crit Care 2002;6:479-80.
  27. Intensive Care Planning and Designing in India, Guidelines 2010. Available from: http://www.isccm.org/PDFfiles/Section1.pdf
  28. Wikipedia.org. Ministry of Health and Family Welfare (India), 1964. Available from: http://www.en.wikipedia.org/wiki/Health_care_system#India. (Last modified 2011 Dec 2).
  29. Divatia JV, Baronia AK, Bhagwati A, Chawla R, Iyer S, Jani CK, et al. Critical care delivery in intensive care units in India: Defining the functions, roles and responsibilities of a consultant intensivist. Indian J Crit Care Med 2006;10:53-63.
  30. Hsph.havard.edu. Takemi Program in International Health, 1983. Available from: http://www.hsph.harvard.edu/takemi/RP207.pdf.
  31. Jayaram R, Ramakrishnan N. Cost of intensive care in India. Indian J Crit Care Med 2008;12:55-61.
  32. Irda.gov.in. List of TPAs, 2005. Available from: http://www.irda.gov.in/ADMINCMS/cms/NormalData_Layout.aspx?page=PageNo646 and mid=9.5.7. (Last updated 2011 Oct 3).
  33. Cathell DW. The Physician Himself From Graduation to Old Age. Philadelphia: Davis; 2011, p. 1882.
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