Benefit design : patient cost-sharing

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Publisher : DIANE Publishing
ISBN 13 : 1428920803
Total Pages : 64 pages
Book Rating : 4.4/5 (289 download)

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Book Synopsis Benefit design : patient cost-sharing by : United States. Congress. Office of Technology Assessment

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:

Benefit Design

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Publisher :
ISBN 13 :
Total Pages : 76 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Benefit Design by :

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:

Benefit Design in Health Care Reform

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Publisher :
ISBN 13 : 9780788106651
Total Pages : 65 pages
Book Rating : 4.1/5 (66 download)

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Book Synopsis Benefit Design in Health Care Reform by : DIANE Publishing Company

Download or read book Benefit Design in Health Care Reform written by DIANE Publishing Company and published by . This book was released on 1994-03 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Benefit Design

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Publisher :
ISBN 13 : 9780849085451
Total Pages : pages
Book Rating : 4.0/5 (854 download)

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Book Synopsis Benefit Design by : Gordon Press Publishers

Download or read book Benefit Design written by Gordon Press Publishers and published by . This book was released on 1994-10 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Making Medicines Affordable

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Publisher : National Academies Press
ISBN 13 : 0309468086
Total Pages : 235 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Making Medicines Affordable by : National Academies of Sciences, Engineering, and Medicine

Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

Benefit Design. Patient Cost-sharing

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Publisher :
ISBN 13 :
Total Pages : 59 pages
Book Rating : 4.:/5 (476 download)

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Book Synopsis Benefit Design. Patient Cost-sharing by : Office of Technology Assessment. OTA

Download or read book Benefit Design. Patient Cost-sharing written by Office of Technology Assessment. OTA and published by . This book was released on 1993 with total page 59 pages. Available in PDF, EPUB and Kindle. Book excerpt: The cost-sharing literature makes very clear a basic lesson of human nature: people will use services less often when they have to pay for them. However, conventional wisdom to the contrary, there is no evidence that people make better choices and decisions about their health care when they bear some of the cost. In the Rand HIE, coinsurance deterred individuals from seeking all types of care, even potentially effective treatment and appropriate hospitalizations. In the HIE, once an individual sought medical attention, the amount and cost of their care was largely unaffected by cost-sharing and apparently was determined principally by their physician. Finally, the lack of information on how patient cost-sharing affects children and adults in poor health, regardless of their income, is worrisome and merits further investigation.

Care Without Coverage

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Publisher : National Academies Press
ISBN 13 : 0309083435
Total Pages : 213 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Care Without Coverage by : Institute of Medicine

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.

Essential Health Benefits

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Publisher : National Academies Press
ISBN 13 : 0309219140
Total Pages : 256 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Essential Health Benefits by : Institute of Medicine

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.

What's In, What's Out

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Publisher : Brookings Institution Press
ISBN 13 : 1944691057
Total Pages : 449 pages
Book Rating : 4.9/5 (446 download)

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Book Synopsis What's In, What's Out by : Amanda Glassman

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 449 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.

Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly

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Publisher :
ISBN 13 :
Total Pages : 49 pages
Book Rating : 4.:/5 (129 download)

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Book Synopsis Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly by : Amitabh Chandra

Download or read book Patient Cost-Sharing, Hospitalization Offsets, and the Design of Optimal Health Insurance for the Elderly written by Amitabh Chandra and published by . This book was released on 2010 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient cost-sharing for primary care and prescription drugs is designed to reduce the prevalence of moral hazard in medical utilization. Yet the success of this strategy depends on two factors: the elasticity of demand for those medical goods, and the risk of downstream hospitalizations by reducing access to beneficial health care. Surprisingly, we know little about either of these factors for the elderly, the most intensive consumers of health care in our country. We remedy both of these deficiencies by studying a policy change that raised patient cost-sharing for retired public employees in California. We find that physician office visits and prescription drug utilization are price sensitive, with implied arc-elasticities that are similar to those of the famous RAND Health Insurance Experiment (HIE). However, unlike the HIE, we find substantial quot;offsetquot; effects in terms of increased hospital utilization in response to the combination of higher copayments for physicians and prescription drugs. These offset effects are concentrated in patients for whom medical care is presumably efficacious: those with a chronic disease. Finally, we find that the savings from increased cost-sharing accrue mostly to the supplemental insurer, while the costs of increased hospitalization accrue mostly to Medicare; thus, there is a fiscal externality associated with cost-sharing increases by supplemental insurers. Our findings suggest that health insurance should be tied to underlying health status, with chronically ill patients facing lower cost-sharing. We also conclude that the externalities to Medicare from supplemental insurance coverage may be more modest than previously suggested due to these offsets.

The Medicare Handbook

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Publisher :
ISBN 13 :
Total Pages : 12 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Medicare Handbook by :

Download or read book The Medicare Handbook written by and published by . This book was released on 1992 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Benefit Design

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Publisher :
ISBN 13 :
Total Pages : 128 pages
Book Rating : 4.3/5 (121 download)

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Book Synopsis Benefit Design by :

Download or read book Benefit Design written by and published by . This book was released on 1993 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Pharmacy Benefits

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Publisher : International Foundation of Employee benefit
ISBN 13 : 9780891546962
Total Pages : 180 pages
Book Rating : 4.5/5 (469 download)

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Book Synopsis Pharmacy Benefits by : F. Randy Vogenberg

Download or read book Pharmacy Benefits written by F. Randy Vogenberg and published by International Foundation of Employee benefit. This book was released on 2011 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pharmaceuticals have become an integral component of medical treatment, with some medications completely transforming health care outcomes and delivery. Drug therapy has been proven to reduce health care costs, increase productivity and enhance the quality of life for many people. When was the last time you examined the prescription drug component of your health care benefits? This primer offers factors to consider when designing or modifying pharmacy benefits, including the pros and cons of carving benefits into a health plan as well as carving them out as a separate prescription drug plan. A practical checklist is provided in almost every chapter to help you focus on important issues, including what questions to ask potential vendors.

Employment and Health Benefits

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Publisher : National Academies Press
ISBN 13 : 0309048273
Total Pages : 381 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Employment and Health Benefits by : Institute of Medicine

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.

Rare Diseases and Orphan Products

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Publisher : National Academies Press
ISBN 13 : 0309158060
Total Pages : 442 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Rare Diseases and Orphan Products by : Institute of Medicine

Download or read book Rare Diseases and Orphan Products written by Institute of Medicine and published by National Academies Press. This book was released on 2011-04-03 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.

Rewarding Provider Performance

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Publisher : National Academies Press
ISBN 13 : 0309102162
Total Pages : 273 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Rewarding Provider Performance by : Institute of Medicine

Download or read book Rewarding Provider Performance written by Institute of Medicine and published by National Academies Press. This book was released on 2007-02-17 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: The third installment in the Pathways to Quality Health Care series, Rewarding Provider Performance: Aligning Incentives in Medicare, continues to address the timely topic of the quality of health care in America. Each volume in the series effectively evaluates specific policy approaches within the context of improving the current operational framework of the health care system. The theme of this particular book is the staged introduction of pay for performance into Medicare. Pay for performance is a strategy that financially rewards health care providers for delivering high-quality care. Building on the findings and recommendations described in the two companion editions, Performance Measurement and Medicare's Quality Improvement Organization Program, this book offers options for implementing payment incentives to provide better value for America's health care investments. This book features conclusions and recommendations that will be useful to all stakeholders concerned with improving the quality and performance of the nation's health care system in both the public and private sectors.

Cost-sharing for Emergency Room Care and Prescription Drugs

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Publisher :
ISBN 13 :
Total Pages : 226 pages
Book Rating : 4.:/5 (35 download)

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Book Synopsis Cost-sharing for Emergency Room Care and Prescription Drugs by : Mary Evelyn Reed

Download or read book Cost-sharing for Emergency Room Care and Prescription Drugs written by Mary Evelyn Reed and published by . This book was released on 2005 with total page 226 pages. Available in PDF, EPUB and Kindle. Book excerpt: