ABSTRACT
The interplay between the financing, reimbursement, and cost-saving models in medicine has a major impact on the health care system. The financing model and the source of insurance determine who and what is covered. Reimbursement models, which determine how services are purchased and valued, influence the scope and quality of the health care delivered within the U.S. system. Cost-saving models, which affect the total cost of care for the economy and society at large, are intertwined with the insurance-financing and reimbursement models, and there are reciprocal effects among these three domains. This chapter reviews the evolution of these three dimensions over the last century as the health care system has responded to changes in the economic environment, demographics changes, and modes of delivery.
