Download or read book High Risk Insurance Pool written by Mei-Ni Ng and published by . This book was released on 2017-01-27 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "High-risk Insurance Pool: a Systematic Review and Assessment on Efficiency and Equity in Healthcare" by Mei-ni, Ng, 吳美妮, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: To enable high-risk individuals to have access to private health insurance, the Hong Kong government has announced the establishment of a high-risk pool reinsurance mechanism. Under the voluntary and government-regulated insurance program, "Health Protection Scheme," the high-risk pool will accept individuals with pre-existing medical conditions or higher health risks. Critics have long expressed their concerns regarding the financial sustainability of Hong Kong''s healthcare system due to its heavy reliance on government subsidies and publicly funded services. Patients with pre-existing conditions are denied coverage by the private insurance sector, and have to rely heavily on the overburdened public healthcare system. Following the United States, the Hong Kong government suggests that a high-risk pool proposal will offer a relatively simpler approach compared to other alternatives. However, little is known about its applicability in Hong Kong or potential problems. Therefore, the objective of this study is to evaluate the effectiveness of high-risk pool in promoting healthcare efficiency, equity, and to make recommendations for the operations in Hong Kong. A systematic literature review was conducted on the MEDLINE database to study the overseas experience of high-risk insurance pools. Of the 52 articles included in the systematic review, the majority of the studies cover the operations in the United States. Results are analysed from the following eight perspectives. For efficiency, the studied areas include (1) fiscal sustainability, (2) adverse selection, (3) risk sharing and (4) cost containment. For equity, (5) insurance premium, (6) out-of-pocket expense, (7) enrolment barrier and (8) program awareness of the high-risk pools are analysed. Results of the systematic review show the inadequacies of the high-risk pool mechanisms in all of the above studied areas. In the United States, while industry assessment and government subsidization intend to facilitate risk sharing for high-risk population, insufficient funding and the industry''s deteriorated risk sharing capabilities undermine system efficiency. In addition, adverse selection and cost containment add to the already lengthy list of problems that high-risk pools have yet to address. Limited subsidies, high out-of-pocket payments, strict eligibility rules, and insufficient program awareness remain the four major barriers to health equity for the uninsurable. While studies on the overseas healthcare system have revealed several inadequacies regarding the high-risk pool mechanism, these uncertainties have to be resolved before Hong Kong can move forward to improve its healthcare efficiency and equity. More thoughts should be given on how the risk sharing capability can be enhanced within the insurance industry. Without a clear definition or a standardized underwriting rule that clearly defines "high-risk," the high-risk pool could become a platform to practice adverse selection and further deteriorate the already limited risk sharing among the population. For addressing the issue of cost containment, the DRG charging system and chronic disease management programs are pivotal components to be incorporated. The government should perform a concrete assessment to justify how the spending on high-risk pool can essentially promote a more equitable system in Hong Kong. By considering the impact on both private in

Download or read book Health Care Reform written by David P. Bernstein and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Current high-risk pools insure around 190,000 high-risk individuals at a total cost of around $9,400 per enrollee. Expanding high risk pools so they insure a total of one million individuals would necessitate raising an additional $7.6 billion in revenue through premiums, allocations on insurance firms, through government subsidies and other sources. A proposal under consideration by Congress would insure around 60,000 additional individuals. There are around 3.5 million people who are uninsured the entire year and cannot obtain private insurance because of health considerations. Health insurance plans offered by high-risk pools are generally too expensive for lower-income individuals. Efforts to reach lower-income individuals through high-risk pools would require larger subsidies, which would involve either more public funds or a reduction in the number of people insured. Current high-risk pools do not serve individuals who have offers of employer sponsored insurance (ESI) and will therefore not impact the price or availability of ESI from small firms.

Download or read book High Risk Health Insurance Pools written by Jenny Alvarez and published by Nova Science Publishers. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since 1975, a growing number of states have implemented high risk pools (HRPs), which offer non-profit health insurance to individuals who are unable to purchase affordable coverage in the private market because of pre-existing conditions. State HRPs often contract with a private health insurance carrier to administer the pool, and plan options can vary significantly both within pools and from state to state. This book examines the temporary federal high risk pool (HRP) program, also known as the Pre-Existing Condition Insurance Plan (PCIP); with a focus on enrolment, benefits and funding.

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 State High risk Pools written by Tanya Schwartz and published by . This book was released on 2010 with total page 10 pages. Available in PDF, EPUB and Kindle. Book excerpt: State high-risk pools are state programs that offer health insurance to residents who, because of pre-existing medical conditions, are unable to purchase affordable coverage in the individual market. High-risk pools operate in 34 states and provide health insurance to nearly 200,000 U.S. residents. Although high-risk pools have existed since 1976, they have received little national attention until recently. Health reform legislation passed in the House of Representatives and in the Senate creates a temporary national high-risk pool program to provide health coverage to people prior to the implementation of other coverage expansions included in the bills. As the national health reform debate continues, high-risk pools represent one strategy for providing coverage to people with pre-existing medical conditions.

Download or read book Pooling Health Insurance Risks written by Mark V. Pauly and published by American Enterprise Institute. This book was released on 1999 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt: Uncertainty about risks to health virtually requires that people have health insurance. But how is the cost of premiums determined? Should rates vary according to some indicators of risk? How much do premiums vary with risk? Do the young and the healthy actually subsidize the old and the unhealthy?

Download or read book Why a National High risk Insurance Pool is Not a Workable Alternative to the Marketplace written by Jean P. Hall and published by . This book was released on 2014 with total page 10 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Pre-Existing Condition Insurance Plan (PCIP) was a national high-risk pool established under the Affordable Care Act (ACA) to provide coverage for individuals with preexisting conditions who had been uninsured for at least six months. It was intended to be a temporary program: PCIPs opened in 2010 and closed in April 2014. At that point, those with preexisting conditions could shop for health insurance in the marketplaces, where plans are prevented from using applicants’ health status to deny coverage or charge more. This issue brief draws on the PCIP experience to outline why national high-risk pools, which continue to be proposed as policy alternatives to ACA coverage expansions, are expensive to enrollees as well as their administrators and ultimately unsustainable. The key lesson--and the principle on which the ACA is built--is that insurance works best when risk is evenly spread across a broad population.

Download or read book Health Insurance written by John E. Dicken and published by DIANE Publishing. This book was released on 2010-03 with total page 41 pages. Available in PDF, EPUB and Kindle. Book excerpt: A growing number of states -- 35 as of June 2009 -- have created high-risk health insurance pools (HRPs) to provide coverage to individuals whose health status limits their access to coverage in the private individual health insurance market. HRPs -- typically state-run nonprofit assoc. -- often contract with a private health insurance carrier to administer the pool and offer a range of health plan options to such individuals, who are commonly referred to as medically uninsurable. This report describes: (1) HRP enrollment and enrollee demographics; (2) HRP plans' cost-sharing provisions, coverage restrictions, and premiums, and comparable information for certain private market health plans; and (3) HRPs' governance, expenditures, and funding. Illus.

Download or read book Temporary Federal High Risk Health Insurance Pool Program written by and published by . This book was released on 2011 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Temporary Federal High Risk Health Insurance Pool Program written by Mark Newsom and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides an overview of the temporary federal high risk pool program and will be periodically updated to reflect any legislative or regulatory changes.

Download or read book Establishment of State Risk Pools to Provide Health Coverage for Uninsured Americans written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1989 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book High risk Insurance Pool written by 吳美妮 and published by . This book was released on 2014 with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book High risk Health Insurance Pools written by Cheryl Fish-Parcham and published by . This book was released on 2006 with total page 11 pages. Available in PDF, EPUB and Kindle. Book excerpt:

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 Choice of Health Insurance Plans by Enrollees of State High Risk Pool written by Mei-Mei Chen and published by . This book was released on 1995 with total page 476 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Health Insurance Resources written by Dorothy E. Northrop, MSW, ACSW and published by Demos Medical Publishing. This book was released on 2006-12-08 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second edition of Health Insurance Resources: A Guide for People with Chronic Disease and Disability continues to be a uniquely helpful reference for those who need and use health insurance most often but have the least access to it. The book was developed to assist individuals living with disability and chronic health conditions, as well as health care professionals, in understanding the health care system and maximizing their rights and entitlements within that system. The manual is completely updated throughout, and reflects the changes in the system since the first edition's publication in 2003. Crucially, the book includes new information about the new Medicare Prescription Drug Coverage plan, which took effect in January 2006. It also covers: Social Security Disability Insurance and Supplemental Security Income COBRA HIPAA State High Risk, Pools Insurance glossary State pharmacy assistance programs And much, much more! This essential guide contains information about a wide variety of options that will be of assistance to individuals who are uninsured, underinsured, or who have questions about insurance and don't know where to begin. It will also serve those who work with chronically ill individuals and their families, such as health care professionals and para-professionals, consumer and patient advocates, and the educators and institutions that serve them.

Download or read book The Future of Disability in America written by Institute of Medicine and published by National Academies Press. This book was released on 2007-10-24 with total page 619 pages. Available in PDF, EPUB and Kindle. Book excerpt: The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.