Remuneração de três planos odontológicos da cidade de Maceió-AL em comparação à tabela VRPO-CFO / Remuneration of three dental plans from the city of Maceio-Al in comparison to the table VRPO-CFO

Objetivo: Investigar se o valor médio geral de remuneração ofertado por três planos odontológicos da cidade de Maceió-AL possuem defasagem, coerência ou ágio em relação ao estabelecido na tabela VRPO-CFO. Materiais e Métodos: foram utilizados três planos odontológicos da cidade de Maceió-AL,acreditando ser esses os de maior procura por parte dos profissionais, para uma comparação entre suas categorias de serviço e as da tabela VRPO, sendo calculado o valor percentual de acréscimo ou defasagem. Resultados: Nota-se que em todas as categorias de serviço, o plano que melhor remunerou foi o plano A, tendo as categorias prevenção, Endodontia, Radiologia e Dentística o menor percentual de defasagem, sendo eles 22%, 26%, 30% e 40%, respectivamente, as demais categorias apresentaram índice acima de 50%. O plano odontológico que pior remunerou, de acordo com a presente pesquisa, foio plano C, com média de defasagem geral de 65%, possuindo a categoria Diagnóstico como o serviço com maior defasagem (83%). Conclusão: Conclui-se que a remuneração dos procedimentos odontológicos,que envolvem todas as especialidades, oferecida por planos odontológicos de Maceió-AL aos Cirurgiões-Dentistas, estão abaixo dos valores determinados na tabela do VRPO-CFO.

Objective: To investigate whe ther the overall average amount of remuneration offered by three dental plans from the city of Maceió-AL have a discrepancy, consistency or goodwill in relation to the established VRPO-CFO table. Materials and Methods: three dental plans from the city of Maceió- ALwere used, believing that these are the most demanded by professionals, for a comparison betweentheir service categories and VRPO table, therefore calculating their increasement percentage valueor lag. Results: We notice that in all service categories, the plan that best remunerated was plan A,having the categories Prevention, Endodontics, Radiology and Dentistry the lowest percentage oflag, namely 22%, 26%, 30% and 40% respectively, the other categories had an index above 50%.The dental plan that pays worse, according to this research, was plan C, with an overall discrepancy average of 65%. Having the Diagnosis service category with the largest lag (83%). Conclusion: We conclude that the remuneration for dental procedures, involving all specialties offered by dental plans in Maceió (AL) to dentists, are lower than the ones determined on the VRPO-CFO table.

Medicare physician payment: change is in the air, but not on the ground.

There is little good news on the physician payment front for all of organized medicine in general, and for specifically nephrology. While the CHAMP bill is a clear indicator of recognition among some legislators that fundamental change is necessary in the near future, the factors complicating efforts to make that change happen are numerous and substantial. Details on the resolution of physician reimbursement issues for 2008 and how these issues may develop for 2009 will be outlined on the RPA website at www.renalmd.org as they become available.

The impending reimbursement revolution: how to prepare for future APN reimbursement.

Health care reimbursement reform is underway as part of a national effort to enhance quality outcomes and bring spiraling health care costs under control. Implications of pay-for-performance reimbursement are discussed along with ways to prepare for changes in APN reimbursement.

The economic environment of 2006: how safe is your practice and what you can do to protect it.

In 2006, there was no doubt that imaging was in the crosshairs of just about everyone who had a role in legislation, regulation, and payment involving these medical services. The information in this article was presented at the ACR's Annual Meeting and Chapter Leadership Conference in Washington, DC, on May 25, 2006. It describes the factors contributing to the current economic environment for medical imaging, the external responses to those factors, the dangers to practicing radiologists, and potential strategies to mitigate the damage.

The fundamentals of the US Medicare physician reimbursement process.

The Medicare program, enacted in 1965, is a federally funded health care coverage plan for people aged 65 years and older, for those who are disabled, and for those needing renal dialysis or kidney transplants for the treatment of end-stage renal disease. Today, nearly 40 million Americans rely on Medicare for their health care services. The purpose of the Medicare program is to increase access to quality care for the elderly while maintaining a financially viable federal fund from which health care reimbursements can be appropriately and efficiently allocated to health care providers. This paper has three main objectives: (1) introduce the functioning of the Medicare payment system, (2) explain in more detail how the program currently reimburses physicians, and (3) discuss the current challenges facing the physician reimbursement system.

Access to physicians' services for vulnerable Medicare beneficiaries.

This article examines whether changes in physician reimbursement under the Medicare Fee Schedule (MFS) had differential impacts on access to care for vulnerable and nonvulnerable Medicare beneficiaries. The quasi-experimental research design takes advantage of cross-sectional differences in the magnitude of the MFS impact on payments. We selected a stratified random sample to ensure adequate representation of vulnerable group members and constructed service-specific measures of the MFS payment change. While we found few effects on access attributable to the MFS, we did find substantial utilization gaps between vulnerable and nonvulnerable subpopulations for primary care services, as well as for high-cost procedures during episodes of care for acute myocardial infarctions.

Monitoring the impact of the Medicare Fee Schedule on access to care for vulnerable populations.

Implementation of the Medicare Fee Schedule (MFS) introduced concerns about the potential for reduced access to care, especially for vulnerable populations. These analyses show differences in access before and after the MFS that cannot be explained by health status. In particular, those without private or public supplementary insurance, those with low incomes, African Americans, and the oldest old had lower utilization before the MFS. The impact after implementation of the MFS on vulnerable populations was similar, for the most part, to that for other beneficiaries: reduced utilization in areas with fee increases and increased utilization in areas with fee decreases. An exception was that African Americans, those without supplemental insurance, and those with low incomes in areas of fee decrease saw reductions in the use of surgical services relative to their counterparts in areas with no fee change.

Medicare program: schedule of prospectively determined payment rates for skilled nursing facility inpatient routine service costs--HCFA. Final notice with comment period.

This final notice with comment period sets forth the schedule of payment rates for low Medicare volume skilled nursing facilities for prospective payments for routine service costs for Federal fiscal year 1997 (cost reporting periods beginning on or after October 1, 1996 and before October 1, 1997). Section 1888(d) of the Social Security Act requires the Secretary to establish and publish the prospectively determined payment rates 90 days prior to the beginning of the affected Federal fiscal year.