Sisäilmastoluokitusstrategioita ja trendejä Suomessa ja Kiinassa (original) (raw)
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Physician ownership of in-office ancillary services (IOASs) has come under increasing scrutiny. Advocates of argue that IOASs allow physicians to supervise the quality and coordination of care. Critics have argued that IOASs create financial incentives for physicians to increase ancillary service volume. In this paper we develop a conceptual framework to evaluate the tradeoffs associated with physician ownership of IOASs. There is some evidence supporting the existence of scope and transaction economies in IOASs. Improvement in flow and continuity of care are likely to generate scope economies and improvements in quality monitoring and reductions in consumer transaction costs are likely to generate transaction economies. Other factors include the capture of upstream and downstream profits, but these incentives are likely to be small compared to scope and transaction economies. Policy debates on the merits of IOASs should include an explicit assessment of these tradeoffs.This researc...
Defining the elusive 'medical practice
Rhode Island medical journal (2013), 2013
Rhode Island's small size creates unique opportunities for public health. We can easily imagine how the Rhode Island Department of Health (HEALTH) might partner with primary care and specialty physicians to bring effective prevention and treatment to the entire population. We can also imagine how we might use primary care medical assets in non-traditional ways during emergencies when mobility is restricted to care for our population in place. At present, however, we do not have the means formally to address Rhode Island's physicians above the individual provider level because the medical practices with which they are associated have been heretofore ill-defined. To be sure, we know a medical practice when we see one, but because "medical practices" are not defined by Rhode Island state law, and therefore have no formal relationship with state government, we do not know how many medical practices exist, where they are located, or who works in them. Also, because medical practices come in many shapes and sizes and have many kinds of legal structures, we do not really know how best to use the natural organization of the medical assets they contain. Finally-and vitally important to protecting the public's health-we do not know what people (patients) these heterogeneous medical practices serve. By partnering with practices, Rhode Island can make use of these collaborations to reduce the incidence and prevalence of disease, but first we need a good definition of a "medical practice."
Health progress (Saint Louis, Mo.)
T he age of the physician as customer is over. The notion of the independent entrepreneurial physician whose relationship to the hospital and health service setting is primarily that of a guest is an Industrial Age creation. In the 20th century, professionals in all fields sought identity and role clarity. As a result, they were anxious to establish a sustainable place for themselves. Physicians, like members of other disciplines, were eager to position themselves as primary decision makers projecting an image of independence and unilateral authority. Physicians worked throughout the past century to codify a common and rigorous curriculum and training program that would establish their primacy and independence. This attracted single-minded, willful, purposeful people to the profession. The physician's role in the health care system was established as one that was controlling, directing, and decisive. Legal structures were created to protect and ultimately promote that role.
University of Miami Business Law Review, 1999
Additionally Mr. Cohen was named "Best Health Care Attorney" at the 1995 Medical Business Health Care Awards and has been selected by his peers as the leading health care attorney. Mr. Cohen is a frequent lecturer and author on health care law topics. Jeff again thanks for being here. JAY MARTUS was, similarly, one of an initial group of significant practitioners to commit to this Symposium. Jay is a sincere supporter of the University of Miami and to any cause that will promote it. Jay is a graduate of the University of Miami School of Law, receiving his degree summa cum [Vol. 7:401 PHYSICIAN PRACTICE MANAGEMENT laude. He was a member of the University of Miami Law Review, president of the Moot Court Board, and a member of the Iron Arrow Honor Society. We are delighted to have him. Mr. Martus represents Sheridan Health Corp., serving as inhouse counsel since 1994. Jay, thanks for your help. With that, I will turn [the forum] over to the panelists. JEFF COHEN: Thanks very much Tim. I am going to introduce just very briefly the overview where I think we are going to go and what I hope you will walk away with. But, just to give you, those of you who aren't familiar with some of the panel members. You've really got a great representation of the industry. Jay [Martus] is probably the only person who has really been, that I know of involved with the single start to finish transmigration to PPMC business. And Marc [Auerbach], of course, has been involved primarily [on] the other side representing people doing business with that industry since its inception. So, it's a tremendous wealth of knowledge and experience and I'm very interested in particular to some of the things they have to say about, in particular, where the industry is going. What I would like to do is just give you an idea of some of the things that I'm doing and seeing in the industry. And then turn it over to Marc [Auerbach] and obviously to Jay [Martus]. And what I hope you walk away with and get a sense of where the PPM industry is today and where it's going some of the transmutations. Because it is, as you know, an industry in great turmoil and chaos and opportunity, depending on your perspective [... ]. For fun I looked up on the internet, in particular, the muscular-skeletal portion of the PPMC industry which is very hard hit. Just to give you an idea: the fifty-two week range for BMJ Medical Management is now trading at 1/16th; the highest was 8-8/75. It is now in Chapter 11 in Delaware... it has been subject of multiple shareholder derivative actions and underwriter derivative actions [.. .1 Integrated Orthopedics, fifty-two week range: 1-1/68 to 7.12; it is now at 1-13/16. ..-Obviously an industry that has been tremendously hit. In my opinion, and I am going to speak in broader terms, and try and stay away from some of the technical issues because I think they have been handled thoroughly well before we got herebut I think in some respect the industry has been hard hit in a deserving fashion in some respects and in a nondeserving fashion. There are those, myself among them, who feel that some of the PPMC businesses are grossly undervalued for what they do; and there are some parts of that industry, I feel but for the arbitrage portion of their business, never would have been in business, never will be in business and there is no place for them in the market. The services that physicians that we are looking for in affiliating with PPMCs were in my experience, in many respects, ghost 1999]
Competition and market power in physician private practices
Empirical Economics, 2013
This paper presents a theoretical and empirical model for analyzing competition in physician private practices using a conjectural variation framework. Our study uses the 1998 American Medical Association (AMA) Socioeconomic Monitoring Survey (SMS) to isolate the marginal cost of physician services at the physician practice level and tests for the degree of collusion and market power in physician private practices. The year 1998 is of particular interest due to charges filed in federal court by The United States Department of Justice (DOJ) against a variety of large physician practices, consequently ruling that physicians could no longer engage in joint negotiations. We investigate the grounds for the indictment by the DOJ, which was based primarily on anecdotal economic and legal observations, rather than the results of empirical evidence from accepted econometric modeling. Our results reveal that the behavior of physicians in medical subspecialties and surgical subspecialties is consistent with a Cournot oligopoly.
Commercialization of the activities of medical institutions — a steady trend
Buhuchet v zdravoohranenii (Accounting in Healthcare)
The features of the economic activity of budgetary institutions, including the restrictions and prohibitions established by the current legislation in relation to budgetary institutions, the interests of the state and medical institutions from the position of further improving the efficiency of their activities in the provision of paid medical services are considered. The analysis of the novelties of the legislation regulating paid services provided, including by budgetary medical institutions, is carried out; legislative initiatives to expand the independence of budgetary institutions, including in terms of the disposal of income received by them from income-generating activities; recent changes in the legal organization of medical activities, including clarification of the contractual mechanism for the provision of paid specialized services by medical institutions.