Health Insurance In Practice

Author : Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance
Publisher : National Academies Press
Page : 213 pages
File Size : 54,6 Mb
Release : 2002-06-20
Category : Medical
ISBN : 9780309083430

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Care Without Coverage by Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance Pdf

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.

Author : Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance
Publisher : National Academies Press
Page : 204 pages
File Size : 55,9 Mb
Release : 2001-10-27
Category : Medical
ISBN : 9780309076098

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Coverage Matters by Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance Pdf

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.

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities
Publisher : National Academies Press
Page : 161 pages
File Size : 54,9 Mb
Release : 2018-04-02
Category : Medical
ISBN : 9780309469210

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Health-Care Utilization as a Proxy in Disability Determination by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities Pdf

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.

Author : William A. Glaser
Publisher : Jossey-Bass
Page : 582 pages
File Size : 54,6 Mb
Release : 1991
Category : Business & Economics
ISBN : STANFORD:36105041184792

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Health Insurance in Practice by William A. Glaser Pdf

Author : David Naylor
Publisher : McGill-Queen's Press - MQUP
Page : 337 pages
File Size : 47,8 Mb
Release : 1986-09-01
Category : History
ISBN : 9780773561113

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Private Practice, Public Payment by David Naylor Pdf

Naylor's particular concern is with the nature and extent of the medical profession's opposition at both the provincial and federal levels. He details various developments in medical politics and policies, including the dispute over state health insurance plans in British Columbia during the depression, the national health insurance program drafted by the King government, the doctors' strike in Saskatchewan, and the development and eventual governmental rejections of prepayment plans sponsored by organized medicine. The author concludes that physicians regarded medical insurance schemes over which they had little administrative control, or where coverage was not limited to the indigent or to those earning below a modest wage, as threats to professional incomes and autonomy. His analysis of the evolution of the professional perspectives, policies, and pressure group activities suggests that physicians are as likely to act in their own economic and social interest as any other group, and that they oppose legislation that would threaten these interests while supporting laws that strengthen them. Since the Medical Care Act became law, Ottawa has moved to strengthen health care plans in the provinces, and once again the medical profession has resisted. The final chapter in Naylor's book puts these current conflicts in historical perspective by linking them to their political precedents.

Author : Ruth Roemer,Milton Irwin Roemer
Publisher : Unknown
Page : 144 pages
File Size : 50,5 Mb
Release : 1977
Category : Health insurance
ISBN : MINN:20000003280548

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Health Manpower Policy Under National Health Insurance by Ruth Roemer,Milton Irwin Roemer Pdf

Author : Institute of Medicine,Committee on Employment-Based Health Benefits
Publisher : National Academies Press
Page : 381 pages
File Size : 46,6 Mb
Release : 1993-02-01
Category : Medical
ISBN : 9780309048279

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Employment and Health Benefits by Institute of Medicine,Committee on Employment-Based Health Benefits Pdf

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.

Author : National Research Council,Division of Behavioral and Social Sciences and Education,Committee on Population,Panel on Understanding Divergent Trends in Longevity in High-Income Countries
Publisher : National Academies Press
Page : 194 pages
File Size : 42,6 Mb
Release : 2011-06-27
Category : Social Science
ISBN : 9780309217101

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Explaining Divergent Levels of Longevity in High-Income Countries by National Research Council,Division of Behavioral and Social Sciences and Education,Committee on Population,Panel on Understanding Divergent Trends in Longevity in High-Income Countries Pdf

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages -- cancer and cardiovascular disease -- available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which -- unlike randomized controlled trials -- are subject to many biases.

Author : United States. Congress. House. Committee on Ways and Means
Publisher : Unknown
Page : 592 pages
File Size : 54,6 Mb
Release : 1974
Category : Health insurance
ISBN : STANFORD:36105111147596

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National Health Insurance Resource Book by United States. Congress. House. Committee on Ways and Means Pdf

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Roundtable on Health Literacy
Publisher : National Academies Press
Page : 129 pages
File Size : 51,5 Mb
Release : 2017-03-13
Category : Medical
ISBN : 9780309454766

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Health Insurance and Insights from Health Literacy by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Roundtable on Health Literacy Pdf

Since the passage of the Patient Protection and Affordable Care Act (ACA), health care reform has created major changes in the U.S. health care system. The ACA has brought millions of people into the system who had no previous access, and many of these newly enrolled individuals have had limited experience navigating the complex and complicated U.S. health system. In July 2016 the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine health insurance through the lens of health literacy, focusing on literacy related barriers to information and coverage as well as on possible solutions. Participants discussed the role of health literacy in accessing health care and remaining in treatment; delivery and financing system reforms that affect organizational health literacy; and quality and equity considerations. This publication summarizes the presentations and discussions from the workshop.

Author : Duncan M. MacIntyre
Publisher : Unknown
Page : 328 pages
File Size : 47,6 Mb
Release : 1962
Category : Health insurance
ISBN : UCAL:$B471432

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Voluntary Health Insurance and Rate Making by Duncan M. MacIntyre Pdf

Author : Alexander S. Preker,Marianne E. Lindner,Dov Chernichovsky,Onno P. Schellekens
Publisher : World Bank Publications
Page : 778 pages
File Size : 40,9 Mb
Release : 2013-05-31
Category : Business & Economics
ISBN : 9780821385791

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Scaling Up Affordable Health Insurance by Alexander S. Preker,Marianne E. Lindner,Dov Chernichovsky,Onno P. Schellekens Pdf

This book presents an in-depth review on the role of health care financing in improving access for low-income populations to needed care, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.

Author : Thomas G. McGuire,Richard C. Van Kleef
Publisher : Academic Press
Page : 648 pages
File Size : 46,7 Mb
Release : 2018-08-06
Category : Business & Economics
ISBN : 9780128113264

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Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets by Thomas G. McGuire,Richard C. Van Kleef Pdf

Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the world, including Australia, Belgium, Chile, China, Columbia, Germany, Ireland, Israel, the Netherlands, Russia, Switzerland and the United States. Authors discuss the evolution of these payment schemes, along with ongoing reforms and key lessons on the design of health plan payment. Provides a conceptual toolkit that describes the goals, design and evaluation of health plan payment systems in the context of policy paradigms, such as efficiency, affordability, fairness and avoidance of risk selection Brings together international experience from many different countries that apply regulated competition in different ways Delivers a practical toolkit for the evaluation of health plan payment modalities from the standpoint of efficiency and fairness

Author : Janet I. Beik
Publisher : Elsevier Health Sciences
Page : 439 pages
File Size : 44,5 Mb
Release : 2014-04-04
Category : Electronic
ISBN : 9780323293334

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Workbook for Health Insurance Today - E-Book by Janet I. Beik Pdf

Corresponding to the chapters in Health Insurance Today, 4th Edition, this workbook lets you practice the skills you will need to succeed as a health insurance professional. Practical assignments reinforce the information in the text, and learning activities and exercises challenge you to apply your knowledge to real-world situations. Case studies ask you to solve a real-world problem related to health insurance, such as completing a CMS-1500 claim form or explaining how HIPAA could affect someone recently out of work. Critical Thinking activities strengthen your ability to apply health insurance concepts to a variety of challenging situations. Performance objectives include hands-on, application-based learning activities in areas such as completing claim forms, posting payments to a patient's ledger, filling out Release to Return to Work forms, and filling out Medicare appeals. Chapter assessments test your knowledge of text content with multiple choice, true/false, short answer, fill-in-the-blank, and matching questions. Application exercises ask you to apply your knowledge and skills to real-world situations. Defining Chapter Terms help you review and understand key terms in each chapter. Problem solving/collaborative (group) activities emphasize the importance of teamwork in the health care field. In-class projects and discussion topics enhance your understanding of specific content from the text. Internet Exploration exercises in each chapter help you learn how to perform research online. NEW! Key coverage of new topics includes medical identity theft and prevention, National Quality Forum (NQF) patient safety measures, ACSX12 Version 5010 HIPAA transaction standards, EMS rule on mandatory electronic claims submission, and standards and implementation specifications for electronic health record technology. UPDATED! Additional ICD-10 coding content prepares you for the upcoming switch to the new coding system. UPDATED! Medicare chapter reflects updates and changes from the new presidential administration.

Author : Institute of Medicine and National Research Council,Institute of Medicine,Committee on Children, Health Insurance, and Access to Care
Publisher : National Academies Press
Page : 216 pages
File Size : 53,7 Mb
Release : 1998-10-27
Category : Medical
ISBN : 9780309173933

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America's Children by Institute of Medicine and National Research Council,Institute of Medicine,Committee on Children, Health Insurance, and Access to Care Pdf

America's Children is a comprehensive, easy-to-read analysis of the relationship between health insurance and access to care. The book addresses three broad questions: How is children's health care currently financed? Does insurance equal access to care? How should the nation address the health needs of this vulnerable population? America's Children explores the changing role of Medicaid under managed care; state-initiated and private sector children's insurance programs; specific effects of insurance status on the care children receive; and the impact of chronic medical conditions and special health care needs. It also examines the status of "safety net" health providers, including community health centers, children's hospitals, school-based health centers, and others and reviews the changing patterns of coverage and tax policy options to increase coverage of private-sector, employer-based health insurance. In response to growing public concerns about uninsured children, last year Congress voted to provide $24 billion over five years for new state insurance initiatives. This volume will serve as a primer for concerned federal policymakers and regulators, state agency officials, health plan decisionmakers, health care providers, children's health advocates, and researchers.