The Impact Of Medical Loss Ratio Of Affordable Care Act

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Care Without Coverage

Author : Institute of Medicine
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.

Health-Care Utilization as a Proxy in Disability Determination

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

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.

Coverage Matters

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309076099
Total Pages : 204 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Coverage Matters by : Institute of Medicine

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.

America's Bitter Pill

Author : Steven Brill
Publisher : Random House
ISBN 13 : 0812996968
Total Pages : 528 pages
Book Rating : 4.8/5 (129 download)

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Book Synopsis America's Bitter Pill by : Steven Brill

Download or read book America's Bitter Pill written by Steven Brill and published by Random House. This book was released on 2015-01-05 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: NEW YORK TIMES BESTSELLER • A NEW YORK TIMES NOTABLE BOOK • “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times America’s Bitter Pill is Steven Brill’s acclaimed book on how the Affordable Care Act, or Obamacare, was written, how it is being implemented, and, most important, how it is changing—and failing to change—the rampant abuses in the healthcare industry. It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation. But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury. Praise for America’s Bitter Pill “An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.”—The New York Times Book Review “A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”—Los Angeles Times “A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”—The Daily Beast “One of the most important books of our time.”—Walter Isaacson “Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”—The New York Review of Books

Market Structure of the Health Insurance Industry

Author : D. Andrew Austin
Publisher : DIANE Publishing
ISBN 13 : 1437926460
Total Pages : 65 pages
Book Rating : 4.4/5 (379 download)

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Book Synopsis Market Structure of the Health Insurance Industry by : D. Andrew Austin

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:

Moral Hazard in Health Insurance

Author : Amy Finkelstein
Publisher : Columbia University Press
ISBN 13 : 0231538685
Total Pages : 161 pages
Book Rating : 4.2/5 (315 download)

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Book Synopsis Moral Hazard in Health Insurance by : Amy Finkelstein

Download or read book Moral Hazard in Health Insurance written by Amy Finkelstein and published by Columbia University Press. This book was released on 2014-12-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice

The Future of Nursing 2020-2030

Author : National Academies of Sciences Engineering and Medicine
Publisher :
ISBN 13 : 9780309685061
Total Pages : pages
Book Rating : 4.6/5 (85 download)

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Book Synopsis The Future of Nursing 2020-2030 by : National Academies of Sciences Engineering and Medicine

Download or read book The Future of Nursing 2020-2030 written by National Academies of Sciences Engineering and Medicine and published by . This book was released on 2021-09-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

Insuring America's Health

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309091055
Total Pages : 225 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Insuring America's Health by : Institute of Medicine

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.

Communities in Action

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 0309452961
Total Pages : 583 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Communities in Action by : National Academies of Sciences, Engineering, and Medicine

Download or read book Communities in Action written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-04-27 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Impact of Health Insurance in Low- and Middle-income Countries

Author : Maria-Luisa Escobar
Publisher : Brookings Institution Press
ISBN 13 : 0815705468
Total Pages : 239 pages
Book Rating : 4.8/5 (157 download)

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Book Synopsis Impact of Health Insurance in Low- and Middle-income Countries by : Maria-Luisa Escobar

Download or read book Impact of Health Insurance in Low- and Middle-income Countries written by Maria-Luisa Escobar and published by Brookings Institution Press. This book was released on 2010 with total page 239 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance-based care is key to the public policy debate of whether to extend insurance to low-income populationsand if so, how to do itor to serve them through other means.

Health Benefits Coverage Under Federal Law--.

Author :
Publisher :
ISBN 13 :
Total Pages : 108 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Health Benefits Coverage Under Federal Law--. by :

Download or read book Health Benefits Coverage Under Federal Law--. written by and published by . This book was released on 2010 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Obamacare Wars

Author : Daniel Béland
Publisher : University Press of Kansas
ISBN 13 : 0700635076
Total Pages : 248 pages
Book Rating : 4.7/5 (6 download)

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Book Synopsis Obamacare Wars by : Daniel Béland

Download or read book Obamacare Wars written by Daniel Béland and published by University Press of Kansas. This book was released on 2023-02-10 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: Not five minutes after the Affordable Care Act (ACA) was signed into law, in March 2010, Virginia’s attorney general was suing to stop it. And yet, the ACA rolled out, in infamously bumpy fashion, and rolled on, fought and defended at every turn—despite President Obama’s claim, in 2014, that its proponents and opponents could finally “stop fighting old political battles that keep us gridlocked.” But not only would the battles not stop, as Obamacare Wars makes acutely clear, they spread from Washington, DC, to a variety of new arenas. The first thorough account of the implementation of the ACA, this book reveals the fissures the act exposed in the American federal system. Obamacare Wars shows how the law’s intergovernmental structure, which entails the participation of both the federal government and the states, has deeply shaped the politics of implementation. Focusing on the creation of insurance exchanges, the expansion of Medicaid, and execution of regulatory reforms, Daniel Béland, Philip Rocco, and Alex Waddan examine how opponents of the ACA fought back against its implementation. They also explain why opponents of the law were successful in some efforts and not in others—and not necessarily in a seemingly predictable red vs. blue pattern. Their work identifies the role of policy legacies, institutional fragmentation, and public sentiments in each instance as states grappled with new institutions, as in the case of the exchanges, or existing structures, in Medicaid and regulatory reform. Looking broadly at national trends and specifically at the experience of individual states, Obamacare Wars brings much-needed clarity to highly controversial but little-understood aspects of the Affordable Care Act’s odyssey, with implications for how we understand the future trajectory of health reform, as well as the multiple forms of federalism in American politics.

The Affordable Care Act

Author : Tamara Thompson
Publisher : Greenhaven Publishing LLC
ISBN 13 : 0737771496
Total Pages : 130 pages
Book Rating : 4.7/5 (377 download)

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Book Synopsis The Affordable Care Act by : Tamara Thompson

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.

An American Sickness

Author : Elisabeth Rosenthal
Publisher : Penguin
ISBN 13 : 0698407180
Total Pages : 434 pages
Book Rating : 4.6/5 (984 download)

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Book Synopsis An American Sickness by : Elisabeth Rosenthal

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.

Health System Efficiency

Author : Jonathan Cylus
Publisher : Health Policy
ISBN 13 : 9789289050418
Total Pages : 264 pages
Book Rating : 4.0/5 (54 download)

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Book Synopsis Health System Efficiency by : Jonathan Cylus

Download or read book Health System Efficiency written by Jonathan Cylus and published by Health Policy. This book was released on 2016-12-15 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA)

Author : Suzanne M. Kirchhoff
Publisher : CreateSpace
ISBN 13 : 9781508902300
Total Pages : 32 pages
Book Rating : 4.9/5 (23 download)

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Book Synopsis Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA) by : Suzanne M. Kirchhoff

Download or read book Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA) written by Suzanne M. Kirchhoff and published by CreateSpace. This book was released on 2015-06-26 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requires certain health insurers to provide consumer rebates if they do not meet a set financial target known as a medical loss ratio (MLR). At its most basic, a MLR measures the share of health care premium dollars spent on medical benefits, as opposed to company expenses such as overhead or profits. For example, if an insurer collects $100,000 in premiums and spends $85,000 on medical care, the MLR is 85%. In general, the higher the MLR, the more value a policyholder receives for his or her premium dollar. The ACA requires an annual, minimum 80% MLR for individual and small group insurance plans, and an annual, minimum 85% MLR for large group plans. Congress imposed the MLR to provide "greater transparency and accountability around the expenditures made by health insurers and to help bring down the cost of health care."

Law, Explanation and Analysis of the Patient Protection and Affordable Care Act

Author : CCH Incorporated
Publisher : Wolters Kluwer
ISBN 13 : 0808022873
Total Pages : 2114 pages
Book Rating : 4.8/5 (8 download)

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Book Synopsis Law, Explanation and Analysis of the Patient Protection and Affordable Care Act by : CCH Incorporated

Download or read book Law, Explanation and Analysis of the Patient Protection and Affordable Care Act written by CCH Incorporated and published by Wolters Kluwer. This book was released on 2010-01-01 with total page 2114 pages. Available in PDF, EPUB and Kindle. Book excerpt: The One Resource That Explains EVERY Provision of the Single Most Sweeping Piece of Legislation in 50 Years! CCH's Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact provides employers, legal, legislative, health, and insurance professionals with comprehensive explanation and analysis of every aspect of health care reform legislation. The information is crucial, current, and reliable and offers complete, clear and practical guidance on every provision. This is one of the most high-impact pieces of legislation passed in decades. Taken together, the laws are over 2,800 pages long. Many hundreds of changes are made to existing laws and– over 600 changes to the Social Security Act alone (which contains all of the Medicare and Medicaid law), including almost 50 newly added provisions. Other laws affected include the Employee Retirement Income and Security Act (ERISA), the Public Health Service Act, the Internal Revenue Code, and even the Fair Labor Standards Act, among others. Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact include contains almost 500 expert explanations telling you what all those law changes mean. Only Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact includes: An editorially enhanced version of the Patient Protection and Affordable Care Act that integrates in place changes made to it by the Reconciliation Act of 2010 and Title X amendments Text of the Joint Committee on Taxation report that provides background information on the revenue-related provisions of the laws Finding devices to help navigate between analysis and official text Caution notes The legislation contains the most significant health care changes in decades. Topics covered include the following: For employers: Enhanced employer responsibility Insurance market reforms Health insurance exchanges Individual responsibility mandate For health providers and beneficiaries: Expanded eligibility rules for Medicaid and the Children's Health Insurance Program Reimbursement changes for physicians and hospitals to focus on primary and preventive care Reimbursement changes for hospitals to increase coverage in rural areas Expansion of existing value-based purchasing and quality programs EXCLUSIVE ONLINE FEATURE! With your purchase of the book, you'll receive access to a special website that gives you access to SSA, ERISA, and IRC provisions amended by the Patient Protection and Affordable Care Act and the Reconciliation Act of 2010, as well as other valuable Health Care Reform information and resources. Full text of both Acts will also be provided on this exclusive website.