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 The US Health Insurance Market After the Affordable Care Act written by Pietro Tebaldi and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The recent nation-wide health reform -- Patient Protection and Affordable Care Act, or simply ACA -- drastically altered the functioning of the health insurance industry in the US, opening many questions about how the system should be designed and regulated. While previous literature largely focused on health insurance provided through public programs or employer-sponsored insurance, in this dissertation I study the health coverage provision for outsiders: the twenty-one percent of the US population who as of 2013 were not offered insurance through their job, were not covered by the government, and yet did not purchase coverage in the so-called individual market. After the ACA, market institutions were largely redesigned with attention to this group, and policymakers are still dealing with great uncertainty about the efficacy of the new system and its costs for taxpayers in future years. In this context, my research advances our knowledge in two directions. On the one hand I provide empirical results of immediate policy relevance; on the other, I develop economic and statistical models to be used in this novel institutional environment. I consider three of the main channels through which, since 2014, the government affects the individual market for health insurance. First, state authorities determine how the geography of the state is divided in the local geographic markets in which insurers can participate and compete. Second, the ACA limits premium adjustments based on age or other observable characteristics of buyers. Third, the Federal government provides a large premium subsidy for all buyers whose income is between 133 and 400% of the Federal povery level. My dissertation contains three chapters, each of them analyzing the interaction of these three policies with the incentives of private health insurers.
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 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 The Impacts of the Affordable Care Act on Preparedness Resources and Programs written by Institute of Medicine and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many of the elements of the Affordable Care Act (ACA) went into effect in 2014, and with the establishment of many new rules and regulations, there will continue to be significant changes to the United States health care system. It is not clear what impact these changes will have on medical and public health preparedness programs around the country. Although there has been tremendous progress since 2005 and Hurricane Katrina, there is still a long way to go to ensure the health security of the Country. There is a commonly held notion that preparedness is separate and distinct from everyday operations, and that it only affects emergency departments. But time and time again, catastrophic events challenge the entire health care system, from acute care and emergency medical services down to the public health and community clinic level, and the lack of preparedness of one part of the system places preventable stress on other components. The implementation of the ACA provides the opportunity to consider how to incorporate preparedness into all aspects of the health care system. The Impacts of the Affordable Care Act on Preparedness Resources and Programs is the summary of a workshop convened by the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events in November 2013 to discuss how changes to the health system as a result of the ACA might impact medical and public health preparedness programs across the nation. This report discusses challenges and benefits of the Affordable Care Act to disaster preparedness and response efforts around the country and considers how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities.
Download or read book Market Structure of the Health Insurance Industry written by D. Andrew Austin and published by DIANE Publishing. This book was released on 2010-04 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Affordable Care Act and Health Insurance Markets written by Christine Eibner and published by Rand Corporation. This book was released on 2013-08-29 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report, the authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states (Florida, Kansas, Louisiana, Minnesota, New Mexico, North Dakota, Ohio, Pennsylvania, South Carolina, and Texas) and for the nation overall, with a focus on outcomes in the nongroup and small group markets.
Download or read book Health Care Reform written by Jonathan Gruber and published by Macmillan. This book was released on 2011-12-20 with total page 162 pages. Available in PDF, EPUB and Kindle. Book excerpt: "A graphic explanation of the PPACA act"--Provided by publisher.
Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Download or read book An American Sickness written by Elisabeth Rosenthal and published by Penguin. This book was released on 2017-04-11 with total page 434 pages. Available in PDF, EPUB and Kindle. Book excerpt: A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Download or read book Insuring America s Health written by Institute of Medicine and published by National Academies Press. This book was released on 2004-02-14 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to the Census Bureau, in 2003 more than 43 million Americans lacked health insurance. Being uninsured is associated with a range of adverse health, social, and economic consequences for individuals and their families, for the health care systems in their communities, and for the nation as a whole. This report is the sixth and final report in a series by the Committee on the Consequences of Uninsurance, intended to synthesize what is known about these consequences and communicate the extent and urgency of the issue to the public. Insuring America's Health recommends principles related to universality, continuity of coverage, affordability to individuals and society, and quality of care to guide health insurance reform. These principles are based on the evidence reviewed in the committee's previous five reports and on new analyses of past and present federal, state, and local efforts to reduce uninsurance. The report also demonstrates how those principles can be used to assess policy options. The committee does not recommend a specific coverage strategy. Rather, it shows how various approaches could extend coverage and achieve certain of the committee's principles.
Download or read book The US Health Insurance Market written by Patrick L. Brockett and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This chapter presents an overview of the US health insurance market, reviews health insurance research literature, and examines premiums, medical expenses, medical service utilization, and data envelopment analysis (DEA) efficiency measures of health insurers from different perspectives. Results indicate that the Affordable Care Act (ACA), or Obamacare, bent the curve of medical costs. Another finding is that medical expense increase was due to medical service utilization increase instead of service price increase. Among states, we find inconsistency existed in medical service pricing. Efficiency analyses show that Medicaid managed care had the highest efficiency from both the consumer and societal perspectives, which displayed an increasing trend for the whole insurer post-ACA. Additionally, some ACA modifications by the Trump administration seemed to have helped with efficiency improvement. During the COVID-19 pandemic, societal efficiency changes suggested selection bias in delayed care and the following pick-up regarding the cost of medical services.
Download or read book Preparing for a Changing Healthcare Marketplace written by and published by National Academies. This book was released on 1995 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Insurer Market Behavior After the Affordable Care Act written by John Jacobi and published by . This book was released on 2017 with total page 71 pages. Available in PDF, EPUB and Kindle. Book excerpt: The primary goal of the Patient Protection and Affordable Care Act (“ACA”) is to connect Americans with affordable, medically necessary health care. The first step toward achieving that goal is insurance expansion. The ACA's first two years of insurance expansion have allowed millions of Americans to join the ranks of the insured. The second step recognizes that the content of health coverage matters, as appropriate insurance connects consumers with necessary care. The ACA therefore requires most plans offered in the individual and small-group markets to cover a slate of ten essential health benefits. There is a third necessary step in fulfilling the promise of the ACA, however. Once people are connected with insurance plans covering essential health benefits, it is vitally important that the plans deliver on the promise to provide necessary care in a timely, appropriate manner. The expanded health insurance markets, however, are built on the state-regulated, market-driven health insurance system that predated the passage of the ACA. Whether consumers fare well or poorly after the ACA will depend on the market behavior of the health insurers selling individual and small-group plans.This Article focuses on four aspects of the market behavior of private health insurance plans that have historically caused concern: (1) contractual exclusions of certain categories of care from coverage, (2) utilization review and “medical necessity” judgments, (3) restricted provider networks, and (4) discrimination in plan design and administration. With regard to all four aspects, this Article contends that there continues to be a need for monitoring by advocates, federal and state regulators, and others, as well as for targeted enforcement, to ensure that the promise of the ACA is fulfilled. Information derived from monitoring and enforcement should in turn create a feedback loop enabling federal and state policymakers to determine where regulatory reform is needed.
Download or read book Evaluating the Keep Your Health Plan Fix written by Evan Saltzman and published by Rand Corporation. This book was released on 2014-01-21 with total page 55 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report describes a comparative analysis of three proposals to allow Americans to keep their existing health plans under the Affordable Care Act (ACA). The proposals are evaluated based on their potential impact on the ACA-compliant market and the cost and coverage of health insurance. The possibility of each proposal causing a “death spiral” in the ACA-compliant market is also addressed.
Download or read book Section 1557 of the Affordable Care Act written by American Dental Association and published by American Dental Association. This book was released on 2017-05-24 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Download or read book State Health Insurance Market Reform written by Joel C. Cantor and published by Routledge. This book was released on 2012-09-25 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.
