all-payer system

all-payer system

Managed care A proposed health care system in which all insurers would use the same fee schedule. See Health care reform.
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While Johns Hopkins Medicine was chosen to participate as an accountable care organization (ACO) in the Medicare Shared Savings Program, substantial interest in commercial ACOs is not expected as the all-payer system makes it difficult for them to gain traction.
The new RTA platform that we piloted was designed to be an all-payer system that enables payers that meet certain technological requirements to participate by interfacing to the vendor's back-end service network and operations.
First, the purpose of New York's regulatory activity, and in particular the purpose of the all-payer system introduced in 1983, was not simply to contain costs but also to broaden access and support distressed hospitals.
7] This health care reform proposal establishes an all-payer system of fee schedules and expenditure targets-capitation payments or salary, coupled with tax (as opposed to employment) financing.
Maryland has had the best experience with an all-payer system that was established 20 years ago, at the request of the Maryland Hospital Association, and is still operating today.
An all-payer system would cover the uninsured in a public plan.
New Jersey uses an all-payer system that reimburses on a per admission basis, adjusted for the patient's diagnosis-related group.
This would give the Provider direct connectivity to the Payer as well as an all-Payer system and give the Payer a complete electronic transaction system from the Provider to their network.
Or, as 9,000 providers do, they can use it to link for far more, including submitting claims to an all-payer system run by BCBSMA, entering inpatient and outpatient authorization requests, getting claims status and eligibility information in real time, or even performing credit card transactions.
All-payer system is one in which all payers of health care bills pay at rates set by the government for the medical services.
New Jersey included workers' compensation in its all-payer system which ceased to exist in January 1993.
In addition, the states may be given the authority to control the rate of premium increases through regulation, establishment of an all-payer system, ability to freeze the rate of premium increases, and/or establishment of a surcharge on high-cost health plans.