Document Detail

The Maryland experience and a practical proposal to expand existing models in ambulatory primary care.
MedLine Citation:
PMID:  1865546     Owner:  NLM     Status:  MEDLINE    
Two unique models for caring for the uninsured and underinsured are operating in Maryland. The first is a group practice, primary care model with a unique ambulatory Medicare waiver that has had a positive impact on patients and physicians. The second is a financial model--an all-payer prospective rate-setting system for all critical care inpatient hospitals that, during a 13-year period from 1977 through 1989, has saved the citizens of the state approximately $5.361 billion, has allowed hospitals to provide $1.657 billion of charity care and bad debts, and has earned $517 million in net profits. The reasons for the success of each of the models are discussed and form the basis for a practical and politically feasible proposal: merge the best aspects of each model into an ambulatory primary care-based model financed through an all-payer prospective charge system.
W A Riley; W A Schneckenburger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAMA     Volume:  266     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-09-11     Completed Date:  1991-09-11     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1118-22     Citation Subset:  AIM; IM    
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MeSH Terms
Ambulatory Care / economics,  organization & administration*
Community Health Centers / economics
Legislation, Hospital
Medicaid / organization & administration
Medical Indigency*
Medicare / organization & administration
Models, Theoretical
Primary Health Care / economics,  organization & administration*
Program Evaluation
Rate Setting and Review / legislation & jurisprudence
Referral and Consultation
State Health Plans / organization & administration*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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