Download or read book Benefit Design in Health Care Reform written by DIANE Publishing Company and published by . This book was released on 1994-05-01 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt: Examines the health services & economics research literature to learn what is known about how cost-sharing affects the use of health care services, expenditures, &, ultimately, health outcomes. Focuses on cost-sharing in the form of deductibles, coinsurance, & copayments for basic physician & hospital care. Photos, charts & tables.
Download or read book What s In What s Out written by Amanda Glassman and published by Brookings Institution Press. This book was released on 2017-10-10 with total page 542 pages. Available in PDF, EPUB and Kindle. Book excerpt: Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.
Download or read book Benefit Design In Health Care Reform written by DIANE Publishing Company and published by . This book was released on 1993-09-30 with total page 115 pages. Available in PDF, EPUB and Kindle. Book excerpt: Preventive health care services are often portrayed as "good investments" and thus are often considered potentially good candidates for health insurance coverage. This report examines this perception and considers the role that information regarding the efficacy of such services and their cost-effectiveness can, and cannot, play in choosing specific clinical preventive services to cover. Photos, charts and tables.
Download or read book Benefit design patient cost sharing written by United States. Congress. Office of Technology Assessment and published by DIANE Publishing. This book was released on 1993 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Benefit Design written by and published by . This book was released on 1993 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Benefit Design in Health Care Reform written by and published by . This book was released on 1994 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Benefit Design written by and published by . This book was released on 1993 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Download or read book Benefit design clinical preventive services written by and published by DIANE Publishing. This book was released on 1993 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essential Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 2012-02-17 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2010, an estimated 50 million people were uninsured in the United States. A portion of the uninsured reflects unemployment rates; however, this rate is primarily a reflection of the fact that when most health plans meet an individual's needs, most times, those health plans are not affordable. Research shows that people without health insurance are more likely to experience financial burdens associated with the utilization of health care services. But even among the insured, underinsurance has emerged as a barrier to care. The Patient Protection and Affordable Care Act (ACA) has made the most comprehensive changes to the provision of health insurance since the development of Medicare and Medicaid by requiring all Americans to have health insurance by 2016. An estimated 30 million individuals who would otherwise be uninsured are expected to obtain insurance through the private health insurance market or state expansion of Medicaid programs. The success of the ACA depends on the design of the essential health benefits (EHB) package and its affordability. Essential Health Benefits recommends a process for defining, monitoring, and updating the EHB package. The book is of value to Assistant Secretary for Planning and Evaluation (ASPE) and other U.S. Department of Health and Human Services agencies, state insurance agencies, Congress, state governors, health care providers, and consumer advocates.
Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Download or read book A Guide to Health Insurance Reform written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Benefit design the perspective from health financing policy written by and published by World Health Organization. This book was released on 2022-03-15 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: Given the central importance of public financing to make progress towards universal health coverage (UHC), government policy on benefit design, including both service entitlements and conditions of access, significantly influences health system performance. Benefit design considers how all public funds are used and should be based on evidence and developed through a systematic process involving key stakeholders. Reducing uncertainty over entitlements and conditions of access, in particular co-payments, both reduces barriers to accessing services and improves financial protection. Finally, aligning benefit design with a range of health financing policies, as well as service with delivery objectives, provides a powerful way through which policy makers can drive positive change in their health systems.
Download or read book Employer s Guide to Health Care Reform written by Brian M. Pinheiro and published by Aspen Publishers. This book was released on 2011-07-15 with total page 444 pages. Available in PDF, EPUB and Kindle. Book excerpt: Employer's Guide to Health Care Reform is a step-by-step practical guide for employers struggling to keep up with the rapid pace of changes affecting their health benefit plans. It will help you: Grasp every implication of Health Care Reform from the employer's perspective Meet all deadlines Achieve significant cost-savings Fully understand even the most complex new rules The 2011 Edition has been updated to include coverage of the latest health care reform developments, including these important topics: Legal challenges to the Affordable Care Act When is an employer-sponsored group health plan a "grandfathered" health plan - and how to keep it that way Whether a health plan covering solely retirees is subject to the Affordable Care Act design changes, such as the requirement to cover children through age 26 What types of subsidies and tax credits are available right now to employers that provide health coverage to employees Which health plans and benefits are currently subject to new prohibitions on annual and lifetime limits, and what exemptions are available How and when the Affordable Care Act restricts preexisting-condition exclusions When must a health plan provide full coverage for preventive health services without cost-sharing What are the consequences of offering health plan coverage to children up to age 26 What are the new claims and appeals processes mandated by the Affordable Care Act for health plans What additional changes to health plan design are going to be required beginning in 2014 How will employer-sponsored health plans and employers need to communicate with employees to address the Affordable Care Act requirements What new types of reporting will be required for health plans What is the "individual mandate" to enroll in health coverage Which employers will have to pay a penalty if they do not provide adequate and affordable health plan coverage What is a health care exchange, and how will it affect the U.S. health care system How the Affordable Care Act affects retiree prescription drug coverage under Medicare Part D and how the changes create new opportunities for employers How and when the new nondiscrimination rules apply to insured health benefits, and what are the consequences of discriminatory coverage Which employer-sponsored health plans are subject to auto-enrollment and when do the rules go into effect What are the new Form W-2 reporting requirements for employer-sponsored health plans and when do they go into effect When health care flexible spending accounts (Health FSAs) and health savings accounts (HSAs) may and may not pay reimbursements for over-the-counter medicines and drugs And much more!
Download or read book Learning from the States written by United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions and published by . This book was released on 2011 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
