Department of Housing and Urban Development — The Office of Healthcare Programs (OHP), previously known as the Office of Insured Health Care Facilities, is located within the Office of Housing and administers...
Full Text Available Our paper empirically examines how the decision to purchase private insurance and hospitalization are made based on household income, socio-demographic factors, and private health insurance factors in both Japan and the USA. Using these two data-sets, we found some similarities and dissimilarities between Japan and the United States. As income of households rises, households have a positive effect on purchasing health insurance as a normal good. Another similarity between the two countries is seen in the income effect on risk of hospitalization, which is negative for both Japanese and US cases. For dissimilarity, the insurance premium effect on risk of hospitalization is positive for the Japanese case, while negative for the US case. Since the Japanese insurance data had variables such as payments per day of hospitalization if household gets hospitalized, insurance payments upon death of an insured person, and annuity payments at maturity, we tested to see if these characteristics affect the risk of hospitalization for households; we do not eliminate a possibility of adverse selection. For the US pure health issuance characteristics, an increase in premium of health insurance policies cause individuals to substitute more health capital investment which causes lower risk of hospitalization.
McCue, Michael J; McCluer, R Forrest
Few, if any, researchers have analyzed the performance indicators of companies that offer bond insurance to hospitals and healthcare systems. The authors of this study analyzed the key financial and operational indicators of independent hospitals and hospitals within large multihospital systems that are insured by the 5 major bond insurance companies. The authors examined 87 insured bond issues; the results of this study show that some insurers cover healthcare facilities that have strong operational traits and others focus on financial factors.
Trish, Erin E; Herring, Bradley J
The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.
Brooks, J M; Dor, A; Wong, H S
Employers' increased sensitivity to health care costs has forced insurers to seek ways to lower costs through effective bargaining with providers. What factors determine the prices negotiated between hospitals and insurers? The hospital-insurer interaction is captured in the context of a bargaining model, in which the gains from bargaining are explicitly defined. Appendectomy was chosen because it is a well-defined procedure with little clinical variation. Our results show that certain hospital institutional arrangements (e.g. hospital affiliations), HMO penetration, and greater hospital concentration improve hospitals' bargaining position. Furthermore, hospitals' bargaining effectiveness has diminished over time and varies across states.
Moriya, Asako S; Vogt, William B; Gaynor, Martin
There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.
This paper explores the impact of employer-provided health insurance on hospital competition and hospital mergers. Under employer-provided health insurance, employer executives act as agents for their employees in selecting health insurance options for their firm. The paper investigates whether a merger of hospitals favored by executives will result in a larger price increase than a merger of competing hospitals elsewhere. This is found to be the case even when the executive has the same opportunity cost of travel as her employees and even when the executive is the sole owner of the firm, retaining all profits. This is consistent with the Federal Trade Commission's findings in its challenge of Evanston Northwestern Healthcare's acquisition of Highland Park Hospital. Implications of the model are further tested with executive location data and hospital data from Florida and Texas.
Halbersma, R.S.; Mikkers, M.C.; Motchenkova, E.; Seinen, I.
In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transaction and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices in the first
... Facilities, and Hospital Mortgage Insurance Premiums for Fiscal Year (FY) 2014 AGENCY: Office of the... with HUD regulations, this Notice announces the mortgage insurance premiums (MIPs) for Federal Housing Administration (FHA) Multifamily, Healthcare Facilities, and Hospital mortgage insurance programs that have...
Cyber attacks on a hospital's computer network is a new crime to be reckoned with. Should your hospital consider internet insurance? The author explains this new phenomenon and presents a risk assessment for determining network vulnerabilities.
To examine the effects of hospital and insurer markets concentration on transaction prices for inpatient hospital services. Measures of hospital and insurer markets concentration derived from American Hospital Association and HealthLeaders-InterStudy data are linked to 2005-2008 inpatient administrative data from Truven Health MarketScan Databases. Uses a reduced-form price equation, controlling for cost and demand shifters and accounting for possible endogeneity of market concentration using instrumental variables (IV) technique. The findings suggest that greater hospital concentration raises prices, whereas greater insurer concentration depresses prices. A hypothetical merger between two of five equally sized hospitals is estimated to increase hospital prices by about 9 percent (p costs. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A
This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.
Wang, Chan; Nie, Pu-Yan
Poor medical care and high fees are two major problems in the world health care system. As a result, health care insurance system reform is a major issue in developing countries, such as China. Governments should take the effect of health care insurance system reform on the competition of hospitals into account when they practice a reform. This article aims to capture the influences of asymmetric medical insurance subsidy and the importance of medical quality to patients on hospitals competition under non-price regulation. We establish a three-stage duopoly model with quantity and quality competition. In the model, qualitative difference and asymmetric medical insurance subsidy among hospitals are considered. The government decides subsidy (or reimbursement) ratios in the first stage. Hospitals choose the quality in the second stage and then support the quantity in the third stage. We obtain our conclusions by mathematical model analyses and all the results are achieved by backward induction. The importance of medical quality to patients has stronger influence on the small hospital, while subsidy has greater effect on the large hospital. Meanwhile, the importance of medical quality to patients strengthens competition, but subsidy effect weakens it. Besides, subsidy ratios difference affects the relationship between subsidy and hospital competition. Furthermore, we capture the optimal reimbursement ratio based on social welfare maximization. More importantly, this paper finds that the higher management efficiency of the medical insurance investment funds is, the higher the best subsidy ratio is. This paper states that subsidy is a two-edged sword. On one hand, subsidy stimulates medical demand. On the other hand, subsidy raises price and inhibits hospital competition. Therefore, government must set an appropriate subsidy ratio difference between large and small hospitals to maximize the total social welfare. For a developing country with limited medical resources
Frese, Richard; Kitchen, Patrick
The hospital CFO often works with the hospital's actuary and external auditor to calculate the reserves recorded in financial statements. Hospital management, usually the CFO, needs to decide the discount rate that is most appropriate. A formal policy addressing the rationale for discounting and the rationale for selecting the discount rate can be helpful to the CFO, actuary, and external auditor.
Leblanc, Soline; Blein, Cécile; Andremont, Antoine; Bandinelli, Pierre-Alain; Galvain, Thibaut
OBJECTIVE To describe the hospital stays of patients with Clostridium difficile infection (CDI) and to measure the hospitalization costs of CDI (as primary and secondary diagnoses) from the French national health insurance perspective DESIGN Burden of illness study SETTING All acute-care hospitals in France METHODS Data were extracted from the French national hospitalization database (PMSI) for patients covered by the national health insurance scheme in 2014. Hospitalizations were selected using the International Classification of Diseases, 10 th revision (ICD-10) code for CDI. Hospital stays with CDI as the primary diagnosis or the secondary diagnosis (comorbidity) were studied for the following parameters: patient sociodemographic characteristics, mortality, length of stay (LOS), and related costs. A retrospective case-control analysis was performed on stays with CDI as the secondary diagnosis to assess the impact of CDI on the LOS and costs. RESULTS Overall, 5,834 hospital stays with CDI as the primary diagnosis were included in this study. The total national insurance costs were €30.7 million (US $33,677,439), and the mean cost per hospital stay was €5,267±€3,645 (US $5,777±$3,998). In total, 10,265 stays were reported with CDI as the secondary diagnosis. The total national insurance additional costs attributable to CDI were estimated to be €85 million (US $93,243,725), and the mean additional cost attributable to CDI per hospital stay was €8,295±€17,163, median, €4,797 (US $9,099±$8,827; median, $5,262). CONCLUSION CDI has a high clinical and economic burden in the hospital, and it represents a major cost for national health insurance. When detected as a comorbidity, CDI was significantly associated with increased LOS and economic burden. Preventive approaches should be implemented to avoid CDIs. Infect Control Hosp Epidemiol 2017;38:906-911.
Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory
Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.
C.A. Brandenburg (Claudia)
textabstractThe Dutch government has started a process of reformation in the Dutch healthcare. The goal of this reformation is cost efficient healthcare in the Netherlands. Hospitals and health insurance companies in the Netherlands experience changes in regulations and funding. They are expected
Han, Jung Mi; Boo, Eun Hee; Kim, Jung A; Yoon, Soo Jin; Kim, Seong Woo
Objectives This study evaluated the qualitative and quantitative performances of the newly developed information system which was implemented on November 4, 2011 at the National Health Insurance Corporation Ilsan Hospital. Methods Registration waiting time and changes in the satisfaction scores for the key performance indicators (KPI) before and after the introduction of the system were compared; and the economic effects of the system were analyzed by using the information economics approach. Results After the introduction of the system, the waiting time for registration was reduced by 20%, and the waiting time at the internal medicine department was reduced by 15%. The benefit-to-cost ratio was increased to 1.34 when all intangible benefits were included in the economic analysis. Conclusions The economic impact and target satisfaction rates increased due to the introduction of the new system. The results were proven by the quantitative and qualitative analyses carried out in this study. This study was conducted only seven months after the introduction of the system. As such, a follow-up study should be carried out in the future when the system stabilizes. PMID:23115744
Atinga Roger A
Full Text Available Abstract Background In 2003 Ghana introduced a social health insurance scheme which resulted in the separation of purchasing of health services by the health insurance authority on the one hand and the provision of health services by hospitals at the other side of the spectrum. This separation has a lot of implications for managing accredited hospitals. This paper examines whether decoupling purchasing and service provision translate into opportunities or challenges in the management of accredited hospitals. Methods A qualitative exploratory study of 15 accredited district hospitals were selected from five of Ghana’s ten administrative regions for the study. A semi-structured interview guide was designed to solicit information from key informants, Health Service Administrators, Pharmacists, Accountants and Scheme Managers of the hospitals studied. Data was analysed thematically. Results The results showed that under the health insurance scheme, hospitals are better-off in terms of cash flow and adequate stock levels of drugs. Adequate stock of non-drugs under the scheme was reportedly intermittent. The major challenges confronting the hospitals were identified as weak purchasing power due to low tariffs, non computerisation of claims processing, unpredictable payment pattern, poor gate-keeping systems, lack of logistics and other new and emerging challenges relating to moral hazards and the use of false identity cards under pretence for medical care. Conclusion Study’s findings have a lot of policy implications for proper management of hospitals. The findings suggest rationalisation of the current tariff structure, the application of contract based payment system to inject efficiency into hospitals management and piloting facility based vetting systems to offset vetting loads of the insurance authority. Proper gate-keeping mechanisms are also needed to curtail the phenomenon of moral hazard and false documentation.
Atinga, Roger A; Mensah, Sylvester A; Asenso-Boadi, Francis; Adjei, Francis-Xavier Andoh
In 2003 Ghana introduced a social health insurance scheme which resulted in the separation of purchasing of health services by the health insurance authority on the one hand and the provision of health services by hospitals at the other side of the spectrum. This separation has a lot of implications for managing accredited hospitals. This paper examines whether decoupling purchasing and service provision translate into opportunities or challenges in the management of accredited hospitals. A qualitative exploratory study of 15 accredited district hospitals were selected from five of Ghana's ten administrative regions for the study. A semi-structured interview guide was designed to solicit information from key informants, Health Service Administrators, Pharmacists, Accountants and Scheme Managers of the hospitals studied. Data was analysed thematically. The results showed that under the health insurance scheme, hospitals are better-off in terms of cash flow and adequate stock levels of drugs. Adequate stock of non-drugs under the scheme was reportedly intermittent. The major challenges confronting the hospitals were identified as weak purchasing power due to low tariffs, non computerisation of claims processing, unpredictable payment pattern, poor gate-keeping systems, lack of logistics and other new and emerging challenges relating to moral hazards and the use of false identity cards under pretence for medical care. Study's findings have a lot of policy implications for proper management of hospitals. The findings suggest rationalisation of the current tariff structure, the application of contract based payment system to inject efficiency into hospitals management and piloting facility based vetting systems to offset vetting loads of the insurance authority. Proper gate-keeping mechanisms are also needed to curtail the phenomenon of moral hazard and false documentation.
Background In 2003 Ghana introduced a social health insurance scheme which resulted in the separation of purchasing of health services by the health insurance authority on the one hand and the provision of health services by hospitals at the other side of the spectrum. This separation has a lot of implications for managing accredited hospitals. This paper examines whether decoupling purchasing and service provision translate into opportunities or challenges in the management of accredited hospitals. Methods A qualitative exploratory study of 15 accredited district hospitals were selected from five of Ghana’s ten administrative regions for the study. A semi-structured interview guide was designed to solicit information from key informants, Health Service Administrators, Pharmacists, Accountants and Scheme Managers of the hospitals studied. Data was analysed thematically. Results The results showed that under the health insurance scheme, hospitals are better-off in terms of cash flow and adequate stock levels of drugs. Adequate stock of non-drugs under the scheme was reportedly intermittent. The major challenges confronting the hospitals were identified as weak purchasing power due to low tariffs, non computerisation of claims processing, unpredictable payment pattern, poor gate-keeping systems, lack of logistics and other new and emerging challenges relating to moral hazards and the use of false identity cards under pretence for medical care. Conclusion Study’s findings have a lot of policy implications for proper management of hospitals. The findings suggest rationalisation of the current tariff structure, the application of contract based payment system to inject efficiency into hospitals management and piloting facility based vetting systems to offset vetting loads of the insurance authority. Proper gate-keeping mechanisms are also needed to curtail the phenomenon of moral hazard and false documentation. PMID:22726666
Grigorakis, Nikolaos; Floros, Christos; Tsangari, Haritini; Tsoukatos, Evangelos
The Greek state has reduced their funding on health as part of broader efforts to limit the large fiscal deficits and rising debt ratios to GDP. Benefits cuts and limitations of Social Health Insurance (SHI) reimbursements result in substantial Out of Pocket (OOP) payments in the Greek population. In this paper, we examine social health insurance's risk pooling mechanisms and the catastrophic impact that OOP payments may have on insured's income and well-being. Using data collected from a cross sectional survey in Greece, we find that the OOP payments for inpatient care in private hospitals have a positive relationship with SHI funding. Moreover, we show that the SHI funding is inadequate to total inpatient financing. We argue that the Greek health policy makers have to give serious consideration to the perspective of a SHI system which should be supplemented by the Private Health Insurance (PHI) sector. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Mostert, S; Njuguna, F; van de Ven, P M; Olbara, G; Kemps, L J P A; Musimbi, J; Strother, R M; Aluoch, L M; Skiles, J; Buziba, N G; Sitaresmi, M N; Vreeman, R C; Kaspers, G J L
Kenyan national policies for public hospitals dictate that patients are retained on hospital wards until their hospital bills are paid, but this payment process differs for patients with or without access to National Hospital Insurance Fund (NHIF) at diagnosis. Whether these differences impact treatment outcomes has not been described. Our study explores whether childhood cancer treatment outcomes in Kenya are influenced by health-insurance status and hospital retention policies. This study combined retrospective review of medical records with an illustrative case report. We identified children diagnosed with malignancies at a large Kenyan academic hospital between 2007 and 2009, their treatment outcomes, and health-insurance status at diagnosis. Between 2007 and 2009, 222 children were diagnosed with malignancies. Among 180 patients with documented treatment outcome, 54% abandoned treatment, 22% had treatment-related death, 4% progressive/relapsed disease, and 19% event-free survival. Health-insurance status at diagnosis was recorded in 148 children: 23% had NHIF and 77% had no NHIF. For children whose families had NHIF compared with those who did not, the relative risk for treatment abandonment relative to event-free survival was significantly smaller (relative-risk ratio = 0.31, 95% CI = 0.12-0.81, P = 0.016). The case report illustrates difficulties that Kenyan families might face when their child is diagnosed with cancer, has no NHIF, and is retained in hospital. Children with NHIF at diagnosis had significantly lower chance of abandoning treatment and higher chance of survival. Childhood cancer treatment outcomes could be improved by interventions that prevent treatment abandonment and improve access to NHIF. Hospital retention of patients over unpaid medical bills must stop. © 2013 Wiley Periodicals, Inc.
You, Chang Hoon; Choi, Ji Heon; Kang, Sungwook; Oh, Eun-Hwan; Kwon, Young Dae
Diabetes mellitus is a chronic disease with a high prevalence across the world as well as in South Korea. Most cases of diabetes can be adequately managed at physician offices, but many diabetes patients receive outpatient care at hospitals. This study examines the relationship between supplementary private health insurance (SPHI) ownership and the use of hospitals among diabetes outpatients within the universal public health insurance scheme. Data from the 2011 Korea Health Panel, a nationally representative sample of Korean individuals, was used. For the study, 6,379 visits for diabetes care were selected while controlling for clustered errors. Multiple logistic regression models were used to examine determinants of hospital outpatient services. This study demonstrated that the variables of self-rated health status, comorbidity, unmet need, and alcohol consumption significantly correlated with the choice to use a hospital services. Patients with SPHI were more likely to use medical services at hospitals by 1.71 times (95% CI 1.068-2.740, P = 0.026) compared to patients without SPHI. It was confirmed that diabetic patients insured by SPHI had more use of hospital services than those who were not insured. People insured by SPHI seem to be more likely to use hospital services because SPHI lightens the economic burden of care.
Hung, Jung-Hua; Chang, Li
Taiwan implemented the National Health Insurance system (NHI) in 1995. After the NHI, the insurance coverage expanded and the quality of healthcare improved, however, the healthcare costs significantly escalated. The objective of this study is to determine what factors have direct impact on the increased costs after the NHI. Panel data analysis is used to investigate changes and factors affecting cost containment at Taipei municipal hospitals from 1990 to 2001. The results show that the expansion of insured healthcare coverage (especially to the elderly and the treatment of more complicated types of diseases), and the increased competition (requiring the growth of new technology and the longer average length of stay) are important driving forces behind the increase of hospital costs, directly influenced by the advent of the NHI. Therefore, policymakers should emphasize health prevention activities and disease management programs for the elderly to improve cost containment. In addition, hospital managers should find ways to improve the hospital efficiency (shorten the LOS) to reduce excess services and medical waste. They also need to better understand their market position and acquire suitable new-tech equipment earlier, to be a leader, not a follower. Finally, policymakers should establish related benchmark indices for what drivers up hospital costs (micro-aspect) and to control healthcare expenditures (macro-level).
Andriyani Rahmah Fahriati
Full Text Available National health insurance is one of the government programs to facilitate health services for the people. The purpose of this research to determine whether there are effects of National Health Insurance program (JKN on profitability and service quality at Juanda Kuningan Hospital, of West Java. The method using the paired-t-test to analyze the difference between before and after the National Health Insurance program. The result showed that there is a difference in profitability and service quality between pre and post the implementation of national health insurance program. Gross profit margin measured the profitability, net profit margin, return on total assets, and return on equity. This result means that the value of the company's profitability is better when the program JKN yet takes place in the Juanda hospital. While on the service quality variable it is found that the mean value is higher when the JKN program has conducted at the hospital.DOI: 10.15408/etk.v17i1.7064
Morrisey, M A
To review the empirical literature on the effects of selective contracting and hospital competition on hospital prices, travel distance, services, and quality; to review the effects of managed care penetration and competition on health insurance premiums; and to identify areas for further research. Selective contracting has allowed managed care plans to obtain lower prices from hospitals. This finding is generalizable beyond California and is stronger when there is more competition in the hospital market. Travel distances to hospitals of admission have not increased as a result of managed care. Evidence on the diffusion of technology in hospitals and the extent to which hospitals have specialized as a result of managed care is mixed. Little research on the effects on quality has been undertaken, but preliminary evidence suggests that hospital quality has not declined and may have improved. Actual mergers in the hospital market have not affected hospital prices. Much less research has been focused on managed care markets. Greater market penetration and greater competition among managed care plans are associated with lower managed care premiums. Greater HMO penetration appears to be much more effective than PPO penetration in leading to lower premiums. While workers are willing to change plans when faced with higher out-of-pocket premiums, there is little evidence of the willingness of employers to switch plan offerings. Preliminary evidence suggests that greater managed care penetration has led to lower overall employer premiums, but the results differ substantially between employers with and without a self-insured plan. Much more research is needed to examine all aspects of managed care markets. In hospital markets, particular attention should be focused on the effects on quality and technology diffusion.
This doctoral thesis presents an analysis of regulated markets especially focusing on the behavior of the actors, the effects of regulatory interventions on market outcome, and the necessity of the regulation itself. With respect to the particular characteristics, three different markets are analyzed: the German market for photovoltaic capacity, the German hospital sector, and the market for health insurance with respect to outpatient care. Chapter two provides an analysis of the German system of feed-in tariffs for photovoltaic power with respect to effectiveness and efficiency. To ensure a certain volume of investment in photovoltaic capacity investors receive fixed feed-in tariffs for 20 years for each unit of energy they feed into the grid. This remuneration is reduced according to a certain cut-off scheme for devices which will be installed in the future. In the past view years, an enormous volume of photovoltaic devices has been installed, especially in the weeks before the cut-offs. To analyze the efficiency and the effectiveness of the German feed-in tariff system, first, the determinants of such investment are analyzed by estimating an Error Correction model. The results of the estimation are used to simulate alternative mechanisms of adjusting the feed-in tariffs and compare them to the current regime in terms of target achievement and social costs. One of the key results is that the current system causes early investments, but does not induce over-investment. Moreover, it is shown that a system of continuously adjusted feed-in tariffs could be more appropriate than the current regime and that the adjustment should be related to the investment costs. In chapter three, the German hospital market which is characterized by regulated treatment fees and several different ownership types is analyzed. This part of the thesis tries to answer the question how the existence of non-profit hospitals influences market outcome and welfare compared to a market where
Jiang, Ke; You, Daming; Li, Zhendong; Wei, Wei; Mainstone, Mitchell
The emergence of rural health insurance plays a crucial role in alleviating the pressure on rural medical expenditure. Under the current medical system in northern China, rural medical insurance may reduce the free referral of patients with chronic diseases among hospitals. This study was carried out based on the results of an investigation of rural chronically-ill patients in eight county hospitals in northern China, as well as through the comparison and analysis of patients with chronic diseases, considering whether they were with or without rural health insurance. The main results showed that both age ( χ 2 = 22.9, p rural peoples' willingness to buy health insurance. Meanwhile, both the quality of the hospital's treatment ( B = 0.555, p rural health insurance had weakened the three relationships upon which the aforementioned correlations were based.
Xie, Yang; Schreier, Günter; Chang, David C W; Neubauer, Sandra; Redmond, Stephen J; Lovell, Nigel H
Healthcare administrators worldwide are striving to both lower the cost of care whilst improving the quality of care given. Therefore, better clinical and administrative decision making is needed to improve these issues. Anticipating outcomes such as number of hospitalization days could contribute to addressing this problem. In this paper, a method was developed, using large-scale health insurance claims data, to predict the number of hospitalization days in a population. We utilized a regression decision tree algorithm, along with insurance claim data from 300,000 individuals over three years, to provide predictions of number of days in hospital in the third year, based on medical admissions and claims data from the first two years. Our method performs well in the general population. For the population aged 65 years and over, the predictive model significantly improves predictions over a baseline method (predicting a constant number of days for each patient), and achieved a specificity of 70.20% and sensitivity of 75.69% in classifying these subjects into two categories of 'no hospitalization' and 'at least one day in hospital'.
Shan, Linghan; Li, Ye; Ding, Ding; Wu, Qunhong; Liu, Chaojie; Jiao, Mingli; Hao, Yanhua; Han, Yuzhen; Gao, Lijun; Hao, Jiejing; Wang, Lan; Xu, Weilan; Ren, Jiaojiao
Deteriorations in the patient-provider relationship in China have attracted increasing attention in the international community. This study aims to explore the role of trust in patient satisfaction with hospital inpatient care, and how patient-provider trust is shaped from the perspectives of both patients and providers. We adopted a mixed methods approach comprising a multivariate logistic regression model using secondary data (1200 people with inpatient experiences over the past year) from the fifth National Health Service Survey (NHSS, 2013) in Heilongjiang Province to determine the associations between patient satisfaction and trust, financial burden and perceived quality of care, followed by in-depth interviews with 62 conveniently selected key informants (27 from health and 35 from non-health sectors). A thematic analysis established a conceptual framework to explain deteriorating patient-provider relationships. About 24% of respondents reported being dissatisfied with hospital inpatient care. The logistic regression model indicated that patient satisfaction was positively associated with higher level of trust (OR = 14.995), lower levels of hospital medical expenditure (OR = 5.736-1.829 as compared with the highest quintile of hospital expenditure), good staff attitude (OR = 3.155) as well as good ward environment (OR = 2.361). But patient satisfaction was negatively associated with medical insurance for urban residents and other insurance status (OR = 0.215-0.357 as compared with medical insurance for urban employees). The qualitative analysis showed that patient trust-the most significant predictor of patient satisfaction-is shaped by perceived high quality of service delivery, empathic and caring interpersonal interactions, and a better designed medical insurance that provides stronger financial protection and enables more equitable access to health care. At the core of high levels of patient dissatisfaction with hospital care is the lack of trust. The
Mao, Chun-Tai; Liu, Min-Hui; Hsu, Kuang-Hung; Fu, Tieh-Cheng; Wang, Jong-Shyan; Huang, Yu-Yen; Yang, Ning-I; Wang, Chao-Hung
Multidisciplinary disease management programmes (MDPs) for heart failure have been shown to be effective in Western countries. However, it is not known whether they improve outcomes in a high population density country with a national health insurance programme. In total, 349 patients hospitalized because of heart failure were randomized into control and MDP groups. All-cause death and re-hospitalization related to heart failure were analyzed. The median follow-up period was approximately 2 years. Mean patient age was 60 years; 31% were women; and 50% of patients had coronary artery disease. MDP was associated with fewer all-cause deaths [hazard ratio (HR) = 0.49, 95% confidence interval (CI) = 0.27-0.91, P = 0.02] and heart failure-related re-hospitalizations (HR = 0.44, 95% CI = 0.25-0.77, P = 0.004). MDP was still associated with better outcomes for all-cause death (HR = 0.53, 95% CI = 0.29-0.98, P = 0.04) and heart failure-related re-hospitalization (HR = 0.46, 95% CI = 0.26-0.81, P = 0.007), after adjusting for age, diuretics, diabetes mellitus, chronic kidney disease, hypertension, sodium, and albumin. However, MDPs' effect on all-cause mortality and heart failure-related re-hospitalization was significantly attenuated after adjusting for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers or β-blockers. A stratified analysis showed that MDP combined with guideline-based medication had synergistic effects. MDP is effective in lowering all-cause mortality and re-hospitalization rates related to heart failure under a national health insurance programme. MDP synergistically improves the effectiveness of guidelines-based medications for heart failure.
Wallace, Robyn A
Preventable poor health outcomes for adults with intellectual disability in health settings have been known about for years. Subsequent analysis and the sorts of reasonable adjustments required in health and disability support settings to address these health gaps are well described, but have not really been embedded in practice in any significant way in either setting. As far as health is concerned, implementation of the National Disability Insurance Scheme (NDIS, the Scheme) affords an opportunity to recognise individual needs of people with intellectual disability to provide reasonable and necessary functional support for access to mainstream health services, to build capacity of mainstream health providers to supply services and to increase individual capacity to access services. Together these strands have potential to transform health outcomes. Success of the Scheme, however, rests on as yet incompletely defined operational interaction between NDIS and mainstream health services and inherently involves the disability sector. This interaction is especially relevant for adults with intellectual disability, known high users of hospitals and for whom hospital outcomes are particularly poor and preventable. Keys to better hospital outcomes are first, the receiving of quality person-centred healthcare from physicians and hospitals taking into account significance of intellectual disability and second, formulation of organised quality functional supports during hospitalisation. Achieving these require sophisticated engagement between consumers, the National Disability Insurance Agency, Commonwealth, State and Territory government leaders, senior hospital and disability administrators, NDIS service providers and clinicians and involves cross fertilisation of values, sharing of operational policies and procedures, determination of boundaries of fiscal responsibility for functional supports in hospital. © 2018 Royal Australasian College of Physicians.
Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services.
... available through other sources, and to eliminate from eligibility hospitals with poor financial performance... terminology, based on experience to date, to facilitate understanding how the Section 242 program works. C... divide other. Additionally, revises certain threshold factors that make an initial determination of a...
Dominggus N. Sani; A. L. Rantetampang; Agus Zainuri
Improved access for the public in order to ensure that the efforts of personal health services that provide inpatient, outpatient, emergency, and other supporting services. To get health insurance better and thorough, the government issued a health insurance, so that it can be felt by all walks of life and can improve patient satisfaction. Hospitals type D Primaries only provide care services Grade 3 (three) to increase access for the public in order to guarantee health care efforts and a pro...
Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding
Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…
Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.
Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka
Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to
Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.
Full Text Available Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private and out of pocket (OOP expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members of the 2014 National Sample Survey (71st Round on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure. The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests
Klek, Stanislaw; Chourdakis, Michael; Abosaleh, Dima Abdulqudos; Amestoy, Alejandra; Baik, Hyun Wook; Baptista, Gertrudis; Barazzoni, Rocco; Fukushima, Ryoji; Hartono, Josef; Jayawardena, Ranil; Garcia, Rafael Jimenez; Krznaric, Zeljko; Nyulasi, Ibolya; Parallada, Gabriela; Francisco, Eliza Mei Perez; Panisic-Sekeljic, Marina; Perman, Mario; Prins, Arina; Del Rio Requejo, Isabel Martinez; Reddy, Ravinder; Singer, Pierre; Sioson, Marianna; Ukleja, Andrew; Vartanian, Carla; Fuentes, Nicolas Velasco; Waitzberg, Dan Linetzky; Zoungrana, Steve Leonce; Galas, Aleksander
Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings. An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition (PEN) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and PN. The prevalence of malnutrition was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and PN were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor PN use depended on GDP, but was associated with increased use of EN and PN in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for PN (p=0.019). A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.
El Enein, Nagwa Younes Abou; Zaghloul, Ashraf Ahmad
Nurses' knowledge of pressure ulcer prediction, prevention and management plays a very important role in the incidence and prevalence of pressure ulcers in health-care systems. The aim of the current study was to assess the nurse's knowledge about prevention and management of pressure ulcer at one of the largest health insurance hospitals in Alexandria. A descriptive cross-sectional study using an interview questionnaire format to assess the nurses' knowledge (n = 122) regarding prevention of pressure ulcers. The overall mean per cent score for nurses was below the minimum acceptable level. The mean per cent score for nurses was below 70% for nine measures of the 15 correct measures, which accounted for 60% of the measures of pressure ulcer prevention. Correct answers for non-useful measures for preventing pressure ulcers accounted for 66% of the non-useful measures on the questionnaire. It had been concluded that the nurses' knowledge regarding pressure ulcer prevention is below the acceptable levels. © 2011 Blackwell Publishing Asia Pty Ltd.
Grigorakis, Nikolaos; Floros, Christos; Tsangari, Haritini; Tsoukatos, Evangelos
The high level of out of pocket (OOP) payments constitutes a major concern for Greece and several other European and OECD countries as a result of the significant down turning of their public health finances due to the 2008 financial crisis. The basic objective of this study is to provide empirical evidence on the effect of combining social health insurance (SHI) and private health insurance (PHI) on OOP payments. Further, this study examines the catastrophic impact of OOP payments on insured's welfare using the incidence and intensity methodological approach of measuring catastrophic health care expenditures. Conducting a cross-sectional survey in Greece in 2013, we find that the combination of SHI-PHI has a strong negative influence on insured OOP payments for inpatient health care in private hospitals. Furthermore, our results indicate that SHI coverage is not sufficient by itself to manage with this issue. Moreover, we find that poor people present a greater tendency to incur catastrophic OOP expenditures for hospital health care in private providers. Drawing evidence from Greece, a country with huge fiscal problems that has suffered the consequences of the economic crisis more than any other, could be a starting point for policymakers to consider the perspective of SHI-PHI co-operation against OOP payments more seriously.
Munge, Kenneth; Mulupi, Stephen; Barasa, Edwine W; Chuma, Jane
Purchasing refers to the process by which pooled funds are paid to providers in order to deliver a set of health care interventions. Very little is known about purchasing arrangements in low- and middle-income countries (LMICs), and certainly not in Kenya. This study aimed to critically analyse purchasing arrangements in Kenya, using the National Hospital Insurance Fund (NHIF) as a case study. We applied a principal-agent relationship framework, which identifies three pairs of principal-agent relationships (government-purchaser, purchaser-provider, and citizen-purchaser) and specific actions required within them to achieve strategic purchasing. A qualitative case study approach was applied. Data were collected through document reviews (statutes, policy and regulatory documents) and in-depth interviews (n=62) with key informants including NHIF officials, Ministry of Health (MoH) officials, insurance industry actors, and health service providers. Documents were summarised using standardised forms. Interviews were recorded, transcribed verbatim, and analysed using a thematic framework approach. The regulatory and policy framework for strategic purchasing in Kenya was weak and there was no clear accountability mechanism between the NHIF and the MoH. Accountability mechanisms within the NHIF have developed over time, but these emphasized financial performance over other aspects of purchasing. The processes for contracting, monitoring, and paying providers do not promote equity, quality, and efficiency. This was partly due to geographical distribution of providers, but also due to limited capacity within the NHIF. There are some mechanisms for assessing needs, preferences, and values to inform design of the benefit package, and while channels to engage beneficiaries exist, they do not always function appropriately and awareness of these channels to the beneficiaries is limited. Addressing the gaps in the NHIF's purchasing performance requires a number of approaches
Kim, Sungjae; Kim, Jinhyun
The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.
Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E; Rula, Elizabeth Y
Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with coronary artery disease, heart failure, diabetes, or chronic obstructive pulmonary disease who consented to participate in the chronic care management program. Intervention (n = 17,319) and Comparison (n = 5668) groups were defined based on records of participating (or not participating) in telephonic interactions. Changes in admission rates were calculated from the year prior to (Base) and year after program commencement. Comparative analyses were adjusted for age, sex, region of residence, and disease severity (stratification of 3 [least severe] to 1 [most severe]). Overall, the admission rate in the Intervention group decreased by 6.2% compared with a 14.9% increase in the Comparison group (P management care calls can help reduce hospital admissions among German health insurance members with chronic disease.
Full Text Available Background and Objectives: Annually, a large amount of fees that are paid by hospitals, will not be reimbursed as deductions by health insurance which imposes irreparable financial losses on hospitals. The purpose of this study was to determine the amount of deductions imposed on social security and health insurance`s bills and its causes related to inpatients in two hospitals affiliated with Tabriz University of Medical Sciences. Material and Methods: This was a cross-sectional study conducted in Alavi and Madani hospitals affiliated with Tabriz University of Medical Sciences by using 2015 data. Researcher-designed checklist was used for data collecting. According to population size, census method and random sampling were used in Alavi and Madani hospitals, respectively. Gathered data were analyzed through descriptive statistics assisted by Excel v.13 software. Results: In the studied hospitals, most of the deductions in the Alavi and Madani hospitals were related to charge of surgeon and angioplasty, respectively. Also, in Alavi Hospital among deductions factors, the most repeated one was extra application in contrary to determined tariffs. In both hospitals, the role of the human factor in cases of error cannot be denied. Extra applications, inaccuracy in registration costs and lack of knowledge of the approved insurance tariffs are the main important factors influential on the deduction. Conclusion: Due to high rates of preventable deductions in both hospitals and being given the multiplicity and variety of services offered at the health centers, establishing income monitoring unit in hospitals and use of experienced staff is inevitable.
Brals, Daniëlla; Aderibigbe, Sunday A; Wit, Ferdinand W; van Ophem, Johannes C M; van der List, Marijn; Osagbemi, Gordon K; Hendriks, Marleen E; Akande, Tanimola M; Boele van Hensbroek, Michael; Schultsz, Constance
Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. We used an interrupted time-series design, including a control group. The intervention consisted of providing voluntary health insurance covering primary and secondary healthcare, including antenatal and obstetric care, combined with improving the quality of healthcare facilities. We compared changes in hospital deliveries from 1 May 2005 to 30 April 2013 between the programme area and control area in a difference-in-differences analysis with multiple time periods, adjusting for observed confounders. Data were collected through household surveys. Eligible households ( n = 1500) were selected from a stratified probability sample of enumeration areas. All deliveries during the 4-year baseline period ( n = 460) and 4-year follow-up period ( n = 380) were included. Insurance coverage increased from 0% before the insurance was introduced to 70.2% in April 2013 in the programme area. In the control area insurance coverage remained 0% between May 2005 and April 2013. Although hospital deliveries followed a common stable trend over the 4 pre-programme years ( P = 0.89), the increase in hospital deliveries during the 4-year follow-up period in the programme area was 29.3 percentage points (95% CI: 16.1 to 42.6; P health insurance but who could make use of the upgraded care delivered significantly more often in a hospital during the follow-up period than women living in the control area ( P = 0.04). Voluntary health insurance combined with quality healthcare services is highly effective in increasing hospital deliveries in rural Nigeria, by improving access to healthcare for insured and uninsured women in the programme area. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and
Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand
Information about use of major surgery in India is scarce. This study aims to bridge this gap by auditing hospital claims from the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) that provides access to free tertiary care for major surgery through state-funded insurance to 68 million beneficiaries with limited household incomes-81% of population in states of Telangana and Andhra Pradesh (combined Human Development Index 0·485). Beneficiary households receive an annual coverage of INR 200 000 (US$3333) for admissions to any empanelled public or private hospital. Publicly available deidentified hospital claim data for all surgical procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. 677 332 surgical admissions (80% at private hospitals) were recorded at a mean annual rate of 259 per 100 000 beneficiaries (95% CI 235-283), excluding cataract and caesarean sections as these were not covered under the insurance programme. Men accounted for 56% of admissions. Injury was the most common cause for surgical admission (185 733; 27%) with surgical correction of long bone fractures being the most common procedure (144 997; 20%) identified in the audit. Diseases of digestive (110 922; 16%), genitourinary (82 505; 12%), and musculoskeletal system (70 053; 10%) were other leading causes for surgical admissions. Most hospital bed-days were used for injuries (584 days per 100 000 person years; 31%), digestive diseases (314 days; 17%), and musculoskeletal system (207 days; 11%), costing 19% (INR 4·4 billion), 13% (3·03 billion), and 11% (2·5 billion) of claims, respectively. Cardiovascular surgeries (53 023; 8%) alone accounted for 21% (INR 4·9 billion) of cost. Annual per capita cost of surgical claims was US$1·49 (95% CI 1·32-1·65). Our findings are limited to a population socioeconomically representative of India and other countries with low-income and middle
N. Ele Grace; O. Ogbonna Brian; M. Ochei Uche; U. Odili Valentine
Background: The fundamental concept of health insurance is risk sharing and burden bearing. The scheme is undermined by limitations ranging from very frequent use of the services more than necessary by enrollees, to cost escalation, poor management, and skimming. Assessment of services is a quality control measure in patients’ care and service delivery. It helps to identify gaps for improvement of care and services. Objective: This study assessed the effectiveness of NHIS from the perspec...
Curtis Lesley H
Full Text Available Abstract Background The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA of 1996 gave states the option to withdraw Medicaid coverage of nonemergency care from most legal immigrants. Our goal was to assess the effect of PRWORA on hospital uncompensated care in the United States. Methods We collected the following state-level data for the period from 1994 through 1999: foreign-born, noncitizen population and health uninsurance rates (US Census Current Population Survey; percentage of teaching hospitals (American Hospital Association Annual Survey of Hospitals; and each state's decision whether to implement the PRWORA Medicaid bar for legal permanent residents or to continue offering nonemergency Medicaid coverage using state-only funds (Urban Institute. We modeled uncompensated care expenditures by state (also from the Annual Survey of Hospitals in both univariate and multivariable regression analyses. Results When measured at the state level, there was no significant relationship between uncompensated care expenditures and states' percentage of noncitizen immigrants. Uninsurance rates were the only significant factor in predicting uncompensated hospital care expenditures by state. Conclusions Reducing the number of uninsured patients would most surely reduce hospital expenditures for uncompensated care. However, data limitations hampered our efforts to obtain a monetary estimate of hospitals' financial losses due specifically to the immigrant eligibility changes in PRWORA. Quantifying the impact of these provisions on hospitals will require better data sources.
Pressley, Joyce C; Dawson, Patrick; Carpenter, Dustin J
Military deployment of one or both parents is associated with declines in school performance, behavioral difficulties, and increases in reported mental health conditions, but less is known regarding injury risks in pediatric military dependents. Kid Health Care Cost and Utilization Project 2006 (KID) was used to identify military dependents aged 0.1 year to 17 years through expected insurance payer being CHAMPUS, Tricare, or CHAMPVA (n = 12,310) and similarly aged privately insured nonmilitary in CHAMPUS, Tricare, or CHAMPVA states (n = 730,065). Mental health diagnoses per 1,000 hospitalizations and mechanisms of injury per 1,000 injury-related hospitalizations are reported. Unweighted univariate analyses used Fisher's exact, χ(2), and analysis of variance tests for significance. Odds ratios are age and sex adjusted with 95% confidence intervals. Injury-related admissions were higher in military than in nonmilitary dependents (15.5% vs. 13.2%, p sex-adjusted motor vehicle occupant and pedestrian injuries were significantly lower in all-age military dependents but not in age-stratified categories. Very young military dependents had higher all-cause injury admissions (p < 0.0001), drowning/near drowning (p < 0.0001), and intracranial injury (p < 0.0001) and showed a tendency toward higher suffocation (p = 0.055) and crushing injury (p = 0.065). Military adolescents and teenagers had higher suicide/suicide attempts (p = 0.0001) and poisonings from medicinal substances (p = 0.0001). Mental health diagnoses were significantly higher in every age category of military dependents. All-cause in-hospital mortality tended to be greater in military than in nonmilitary dependents (p = 0.052). This study suggests that military dependents are a vulnerable population with special needs and provides clues to areas where injury prevention professionals might begin to address their needs. Prognostic/epidemiologic study, level II.
Yan, Yu-Hua; Lu, Chen-Luan
National Health Insurance Administration established Pharma Cloud System in July 2014. The purpose is to decrease therapeutic duplications and enhance public medication safety. Comparison will be made among individual hospitals and the administering branches of National Health Insurance Bureau (NHIB) on the statistical data on the inquiry of the cloud medication history record system to understand the result of the installation and advocacy of this system. The results show (1) there were 2,329,846 entries of data collected from the branches of the NHIB from 2015 on cloud medication history record and 50,224 entries of data from individual hospitals. (2) The inquiry rate at the branches of the NHIB was 43.2% from January to April, 2015 and at individual hospitals was 18.8%. (3) The improvement rate at the branches of the NHIB was 32.5% and at the individual hospitals was 47.0% from January to April, 2015.
Granting public hospitals greater autonomy and creating organizational arrangements that mimic the private sector and encourage competition is often promoted as a way to increase efficiency and public accountability and to improve quality of care at these facilities. The existence of good-quality health infrastructure, in turn, encourages the population to join and support the social health insurance system and achieve universal coverage. This article provides a critical review of hospital autonomization, using Vietnam's experience to assess the influence of hospital autonomy on the sustainability of Vietnam's social health insurance. The evidence suggests that a reform process based on greater autonomy of resource mobilization and on the retention and use of own-source revenues can create perverse incentives among managers and health care providers, leading to the development of a two-tiered provision of clinical care, provider-induced supply of an inefficient service mix, a high degree of duplication, wasteful investment, and cost escalation. Rather than complementing social health insurance and helping the country to achieve universal coverage, granting public hospitals greater autonomy that mimics the private sector may indeed undermine the legitimacy and sustainability of social health insurance as health care costs escalate and higher quality of care remains elusive.
Full Text Available Objective: Mental health is an important part of individual, social and occupational life. World Health Organization defines mental health as absolute ability of performing social, physical and mental roles. Inattention to mental health is one of the important factors that lowers efficacy, uses up human powers, causes physical and mental complications and job exhaustion, especially in professional services. As health personnel is major part of health services and their high job incentive is a necessity for their health insurance, this research was implemented to assess their mental health quality. Materials and Methods: This is a descriptive cross-sectional, correlative study which is conducted on 190 health personnel. The questionnaire consisted of two parts: Demographic characteristics and Goldenberg general health questionnaire-28 data analysis was performed by using SPSS and statistical methods were independent samples t-test, chi-square, one-way ANOVA and Pearson correlative index. Results: Two-third of cases were female, mean age was 32.22. 76.3% were married, 49.5% had no child, and most of the others had one child. 32.2% of cases had mental disorders (score > 23. Conclusion: Mean score of cases was 21, this score comparing with the general population of Iran is high. Mental health of health personnel for many reasons is at risk. According to these findings, great stressors of such jobs are: Facing with unexpected situations, work turns, especially night turns, organizational and individual factors.
Kinney, E D; Lefkowitz, B
Issues in current capital cost reimbursement to community hospitals by Medicare and Medicaid are described, and options for change analyzed. Major reforms in the way the federal government pays for capital costs--in particular substitution of other methods of payment for existing depreciation reimbursement--could have significant impact on the structure of the health care system and on government expenditures. While such reforms are likely to engender substantial political opposition, they may be facilitated by broader changes in the reimbursement system.
Liu, Chien-Tsai; Yang, Pei-Tun; Yeh, Yu-Ting; Wang, Bin-Long
To investigate the impacts of the first phase of Taiwan's Bureau of National Health Insurance (TBNHI) smart card project on existing hospital information systems. TBNHI has launched a nationwide project for replacement of its paper-based health insurance cards by smart cards (or NHI-IC cards) since November 1999. The NHI-IC cards have been used since 1 July 2003, and they have fully replaced the paper-based cards since 1 January 2004. Hospitals must support the cards in order to provide medical services for insured patients. We made a comprehensive study of the current phase of the NHI-IC card system, and conducted a questionnaire survey (from 1 October to 30 November, 2003) to investigate the impacts of NHI-IC cards on the existing hospital information systems. A questionnaire was distributed by mail to 479 hospitals, including 23 medical centers, 71 regional hospitals, and 355 district hospitals. The returned questionnaires were also collected by prepaid mail. The questionnaire return rates of the medical centers, regional hospitals and district hospitals were 39.1, 29.6 and 20.9%, respectively. In phase 1 of the project, the average number of card readers purchased per medical center, regional hospital, and district hospital were 202, 45 and 10, respectively. The average person-days for the enhancement of existing information systems of a medical center, regional hospital and district hospital were 175, 74 and 58, respectively. Three months after using the NHI-IC cards most hospitals (60.6%) experienced prolonged service time for their patients due to more interruptions caused mainly by: (1) impairment of the NHI-IC cards (31.2%), (2) failure in authentication of the SAMs (17.0%), (3) malfunction in card readers (15.3%) and (4) problems with interfaces between the card readers and hospital information systems (15.8%). The overall hospital satisfaction on the 5-point Likert scale was 2.86. Although most hospitals were OK with the project, there was about 22
Cosic, Filip; Porter, Tabitha; Norsworthy, Cameron; Price, Rohan; Bedi, Harvinder
Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. Results In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including
Shaikh, Maaz; Woodward, Mark; Rahimi, Kazem; Patel, Anushka; Rath, Santosh; MacMahon, Stephen; Jha, Vivekanand
Information on the use of major surgery in India is scarce. In this study we aimed to bridge this gap by auditing hospital claims from Rajiv Aarogyasri Community Health Insurance Scheme, which provides access to free hospital care through state-funded insurance to 68 million beneficiaries, an estimated 81% of population in the states of Telangana and Andhra Pradesh. Publicly available deidentified hospital claim data for all surgery procedures conducted between mid-2008 and mid-2012 were compiled across all 23 districts in Telangana and Andhra Pradesh. A total of 677,332 operative admissions (80% at private hospitals) were recorded at an annual rate of 259 per 100,000 beneficiaries, with male subjects accounting for 56% of admissions. Injury was the most common cause for operative admission (27%) with operative correction of long bone fractures being the most common procedure (20%) identified in the audit. Diseases of the digestive (16%), genitourinary (12%), and musculoskeletal (10%) systems were other leading causes for operative admissions. Most hospital bed-days were used by admissions for injuries (31%) and diseases of the digestive (17%) and musculoskeletal system (11%) costing 19%, 13%, and 11% of reimbursement. Operations on the circulatory system (8%) accounted for 21% of reimbursements. Annual per capita cost of operative claims was US$1.48. The use of surgery by an insured population in India continued to be low despite access to financing comparable with greater spending countries, highlighting need for strategies, beyond traditional health financing, that prioritize improvement in access, delivery, and use of operative care. Copyright © 2015 Elsevier Inc. All rights reserved.
Yalda Mousa Zadeh
Full Text Available Background and Objectives: Today, a major part of health system resources are allocated to hospitals. So, the control of these resources and correct and efficient use of them are the important tasks of management. This study was conducted to determine the deductions of Iran health insurance in the first half of 2014 in a public hospital in Tabriz. Material and Methods: This was a cross sectional study. The study population included records of patients hospitalized in the first half of 2014. All cases with deduction were selected as sample. Data collection was performed using a researcher-made checklist. Checklist information was collected through records of patients and interview. Then, data were analyzed using Excel software. Results: Most deductions were related to physician visits (61116000 Rials, laboratory (46881797 Rials and surgery commission (26114487 Rials, respectively. Most of the deductions were in October (70613244 Rials and lowest deductions were in February (6838945 Rials. The most important factor of deductions was related to additional request. Conclusion: According to deduction cases and the most important factor related to it (additional request, It can be concluded that greatest amount of deductions are due to employees' mistakes. In this regard, emphasis on clinical guidelines and physicians’ training is necessary. Negotiations and clarifying the amount of liability of insurance organizations can prevent deductions.
Full Text Available BackgroundWe assessed the association of dipeptidyl peptidase 4 inhibitors (DPP4i with hospitalization for heart failure (HF using the Korean Health Insurance claims database.MethodsWe collected data on newly prescribed sitagliptin, vildagliptin, and pioglitazone between January 1, 2009 and December 31, 2012 (mean follow-up of 336.8 days to 935,519 patients with diabetes (518,614 males and 416,905 females aged 40 to 79 years (mean age of 59.4 years.ResultsDuring the study, 998 patients were hospitalized for primary HF (115.7 per 100,000 patient-years. The incidence rate of hospitalization for HF was 117.7 per 100,000 per patient-years among patients on pioglitazone, 105.7 for sitagliptin, and 135.8 for vildagliptin. The hospitalization rate for HF was greatest in the first 30 days after starting the medication, which corresponded to a significantly higher incidence at days 0 to 30 compared with days 31 to 360 for all three drugs. The hazard ratios were 1.85 (pioglitazone, 2.00 (sitagliptin, and 1.79 (vildagliptin. The incidence of hospitalization for HF did not differ between the drugs for any time period.ConclusionThis study showed an increase in hospitalization for HF in the initial 30 days of the DPP4i and pioglitazone compared with the subsequent follow-up period. However, the differences between the drugs were not significant.
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...
Conclusions: This study revealed that the volume of THAs performed by individual surgeons was a more important determinant of hospital utilization than hospital volume. Perioperative adverse events were associated with patients' age and comorbidity.
Yawson, A E; Biritwum, R B; Nimo, P K
In 2003, Ghana introduced the national health insurance scheme (NHIS) to promote access to healthcare. This study determines consumer and provider factors which most influence the NHIS at a municipal health facility in Ghana. This is an analytical cross-sectional study at the Winneba Municipal Hospital (WHM) in Ghana between January-March 2010. A total of 170 insured and 175 uninsured out-patients were interviewed and information extracted from their folders using a questionnaire. Consumers were from both the urban and rural areas of the municipality. The mean number of visits by insured consumers to a health facility in previous six months was 2.48 +/- 1.007 and that for uninsured consumers was 1.18 +/- 0.387(p-valueconsumers visited the health facility at significantly more frequent intervals than uninsured consumers (χ(2) = 55.413, p-valueconsumers received more different types of medications for similar disease conditions and more laboratory tests per visit than the uninsured. In treating malaria (commonest condition seen), providers added multivitamins, haematinics, vitamin C and intramuscular injections as additional medications more for insured consumers than for uninsured consumers. Findings suggest consumer and provider moral hazard may be two critical factors affecting the NHIS in the Effutu Municipality. These have implications for the optimal functioning of the NHIS and may affect long-term sustainability of NHIS in the municipality. Further studies to quantify financial/ economic cost to NHIS arising from moral hazard, will be of immense benefit to the optimal functioning of the NHIS.
Dutta, Mousumi; Husain, Zakir
In recent years universal health coverage has become an important issue in developing countries. Successful introduction of such a social security system requires knowledge of the relationship between socio-economic status and usage of health care services. This paper examines this relationship, and analyzes the impact of introducing health insurance into the model, using data for India, a major developing country with poor health outcomes. In contrast to similar works undertaken for develope...
Health insurance helps protect you from high medical care costs. It is a contract between you and your ... Many people in the United States get a health insurance policy through their employers. In most cases, the ...
Lin, Jin-Ding; Hung, Wen-Jiu; Lin, Lan-Ping; Lai, Chia-Im
There were not many studies to provide information on health access and health utilization of people with autism spectrum disorders (ASD). The present study describes a general profile of hospital admission and the medical cost among people with ASD, and to analyze the determinants of medical cost. A retrospective study was employed to analyze…
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...
The article discusses the effects of financing and technology advances on the availability of insurance for independent power producers operating gas turbines. Combined cycle units which require new materials and processes make it difficult to assess risk. Insurers are denying coverage, or raising prices and deductibles. Many lenders, however, are requiring insurance prior to financing. Some solutions proposed include information sharing by industry participants and insurers and increased risk acceptance by plant owners/operators
Wakker, P.P.; Thaler, R.H.; Tversky, A.
Probabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in premium to compensate for a 1% default risk. These observations cannot be
P.P. Wakker (Peter); R.H. Thaler (Richard); A. Tversky (Amos)
textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these
Hsu, Min-Huei; Yeh, Yu-Ting; Chen, Chien-Yuan; Liu, Chien-Hsiang; Liu, Chien-Tsai
Doctor shopping (or hospital shopping), which means changing doctors (or hospitals) without professional referral for the same or similar illness conditions, is common in Hong Kong, Taiwan and Japan. Due to the lack of infrastructure for sharing health information and medication history among hospitals, doctor-shopping patients are more likely to receive duplicate medications and suffer adverse drug reactions. The Bureau of National Health Insurance (BNHI) adopted smart cards (or NHI-IC cards) as health cards in Taiwan. With their NHI-IC cards, patients can freely access different medical institutions. Because an NHI-IC card carries information about a patient's prescribed medications received from different hospitals nationwide, we used this system to address the problem of duplicate medications for outpatients visiting multiple hospitals. A computerized physician order entry (CPOE) system was enhanced with the capability of accessing NHI-IC cards and providing alerts to physicians when the system detects potential duplicate medications at the time of prescribing. Physician responses to the alerts were also collected to analyze changes in physicians' behavior. Chi-square tests and two-sided z-tests with Bonferroni adjustments for multiple comparisons were used to assess statistical significance of differences in actions taken by physicians over the three months. The enhanced CPOE system for outpatient services was implemented and installed at the Pediatric and Urology Departments of Taipei Medical University Wan-Fang Hospital in March 2007. The "Change Log" that recorded physician behavior was activated during a 3-month study period from April to June 2007. In 67.93% of patient visits, the physicians read patient NHI-IC cards, and in 16.76% of the reads, the NHI-IC card contained at least one prescribed medication that was taken by the patient. Among the prescriptions issued by physicians, on average, there were 2.36% prescriptions containing at least one
The yearbook contains among others the figures of the nuclear insurance line. According to these these the DKVG (German nuclear power plant insurance association) has 102 member insurance companies all registered in the Federal Republic of Germany. By using reinsurance capacities of the other pools at present property insurance amounts to 1.5 billion DM and liability insurance to 200 million DM. In 1991 the damage charges on account of DKV amounted to 3.1 (1990 : 4.3) million DM. From these 0.6 million DM are apportioned to payments and 2.5 million DM to reserves. One large damage would cost a maximum gross sum of 2.2 billion DM property and liability insurance; on account of DKVG 750 million DM. (orig./HSCH) [de
Wakker, P.P.; Thaler, R.H.; Tversky, A.
textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these preferences are intuitively appealing they are difficult to reconcile with expected utility theory. Under highly plausible assumptions about the utility function, willingness to pay for probabilistic i...
Marius Dan GAVRILETEA
Full Text Available Insurance industry in Romania is facing for a few years a continuous decreasing in Gross Written Premium. The negative trend may be caused by the effects of financial crises for companies and also for individuals. In order to keep theirs market share, insurance companies must identify new opportunities to increase theirs’ GWP. Among these new market niches hospitality industry may represent an option to be followed. In this paper, we will analyze the types of insurance policies available for hospitality industry (except mandatory motors’ third party liability and motors’ own vehicle insurance. The conclusion represents solution both for insurance companies and for hotel as a part of theirs’ risk financing process.
The importance of insurance in the school budget is the theme of this comprehensive bulletin on the practices and policies for Texas school districts. Also considered is the development of desirable school board policies in purchasing insurance and operating the program. Areas of discussion are: risks to be covered, amount of coverage, values,…
Ellis T. Williams
Standing timber is one of the few important kinds of property that are not generally covered by insurance. Studies made by the Forest Service and other agencies have indicated that the risks involved in the insurance of timber are not unduly great, provided they can be properly distributed. Such studies, however, have thus far failed to induce any notable development...
Hypoglycemia hospitalization frequency in patients with type 2 diabetes mellitus: a comparison of dipeptidyl peptidase 4 inhibitors and insulin secretagogues using the French health insurance database
Full Text Available Bruno Detournay,1 Serge Halimi,2,3 Julien Robert,1 Céline Deschaseaux,4 Sylvie Dejager5,6 1Cemka-Eval, Bourg-la Reine, France; 2Department of Diabetology, Endocrinology and Nutrition, Grenoble University Hospital Center, Grenoble, France; 3University Joseph Fourier, Grenoble, France; 4Novartis Pharma SAS, Market Access Department, Rueil-Malmaison, France; 5Novartis Pharma SAS, Medical and Scientific Affairs, Rueil Malmaison, France; 6Department of Diabetology, Metabolism and Endocrinology, Pitié-Salpétrière Hospital, Paris, France Aim: We aimed to compare the frequency of severe hypoglycemia leading to hospitalization (HH and emergency visits (EV for any cause in patients with type 2 diabetes mellitus exposed to dipeptidyl peptidase 4 (DPP4 inhibitors (DPP4-i versus those exposed to insulin secretagogues (IS; sulfonylureas or glinides. Methods: Data were extracted from the EGB (Echantillon Généraliste des Bénéficiaires database, comprising a representative sample of ~1% of patients registered in the French National Health Insurance System (~600,000 patients. Type 2 diabetes mellitus patients exposed to regimens containing either a DPP4-i (excluding treatment with IS, insulin, or glucagon-like peptide 1 analog or IS (excluding treatment with insulin and any incretin therapy between 2009 and 2012 were selected. HH and EV during the exposure periods were identified in both cohorts. A similar analysis was conducted considering vildagliptin alone versus IS. Comparative analyses adjusting for covariates within the model (subjects matched for key characteristics and using multinomial regression models were performed. Results: Overall, 7,152 patients exposed to any DPP4-i and 1,440 patients exposed to vildagliptin were compared to 10,019 patients exposed to IS. Eight patients (0.11% from the DPP4-i cohort and none from the vildagliptin cohort (0.0% were hospitalized for hypoglycemia versus 130 patients (1.30% from the IS cohort (138
Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...
Full Text Available The actual Civil code regulates for the first time in the Romanian legislation the intermediation contract, until its entering into force existing multiple situations that lent themselves to this legal operation, but did not benefit of such particular legal rules. Yet, the case law has shown that the situations that arise in the activity of the legal or natural persons are much more complex, this leading, in time, to the reglementation of such particular rules. Such a case is that found in the matter of insurance contracts, the position of the insurance intermediaries being regulated especially by Law no. 32/2000, according to which they represent the natural or legal persons authorized in the conditions of the above mentioned legal document, that perform intermediation activities in the insurance field, in exchange of a remuneration, as well as the intermediaries from the EU member states that perform such an activity on the Romanian territory, in accordance with the freedom in performing services. Therefore, the present paper aims to analyze the conclusion of such insurance contracts and to underline the particular position of the insurance brokers, having the following structure: 1 Introduction; 2 The reglementation of the intermediation contract/brokerage agreement in the Romanian Law; 3 The importance of the intermediaries in the insurance contracts; 4 The conclusion of the insurance contracts; 5 Conclusions.
Jung Hoon Woo
Full Text Available The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1% were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p < 0.001 for each. Moreover, frequent ED users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED.
Woo, Jung Hoon; Grinspan, Zachary; Shapiro, Jason; Rhee, Sang Youl
The Korean National Health Insurance, which provides universal coverage for the entire Korean population, is now facing financial instability. Frequent emergency department (ED) users may represent a medically vulnerable population who could benefit from interventions that both improve care and lower costs. To understand the nature of frequent ED users in Korea, we analyzed claims data from a population-based national representative sample. We performed both bivariate and multivariable analyses to investigate the association between patient characteristics and frequent ED use (4+ ED visits in a year) using claims data of a 1% random sample of the Korean population, collected in 2009. Among 156,246 total ED users, 4,835 (3.1%) were frequent ED users. These patients accounted for 14% of 209,326 total ED visits and 17.2% of $76,253,784 total medical expenses generated from all ED visits in the 1% data sample. Frequent ED users tended to be older, male, and of lower socio-economic status compared with occasional ED users (p users had longer stays in the hospital when admitted, higher probability of undergoing an operative procedure, and increased mortality. Among 8,425 primary diagnoses, alcohol-related complaints and schizophrenia showed the strongest positive correlation with the number of ED visits. Among the frequent ED users, mortality and annual outpatient department visits were significantly lower in the alcohol-related patient subgroup compared with other frequent ED users; furthermore, the rate was even lower than that for non-frequent ED users. Our findings suggest that expanding mental health and alcohol treatment programs may be a reasonable strategy to decrease the dependence of these patients on the ED. PMID:26809051
Special technical terms used in the world of insurance can hardly be found in general dictionaries. This is a gap which the 'Insurance dictionary' now presented is designed to fill. In view of its supplementary function, the number of terms covered is limited to 1200. To make this dictionary especially convenient for ready reference, only the most commonly used translations are given for each key word in any of the four languages. This dictionary is subdivided into four parts, each containing the translation of the selected terms in the three other languages. To further facilitate the use of the booklet, paper of different colours was used for the printing of the German, English, French and Greek sections. The present volume was developed from a Swedish insurance dictionary (Fickordbok Foersaekring), published in 1967, which - with Swedish as the key language- offers English, French and German translations of the basic insurance terms. (orig./HP) [de
Full Text Available In 2006, the Netherlands commenced market based reforms in its health care system. The reforms included selective contracting of health care providers by health insurers. This paper focuses on how health insurers may increase their market share on the health insurance market through selective contracting of health care providers. Selective contracting is studied by eliciting the preferences of health care consumers for attributes of health care services that an insurer could negotiate on behalf of its clients with health care providers. Selective contracting may provide incentives for health care providers to deliver the quality that consumers need and demand. Selective contracting also enables health insurers to steer individual patients towards selected health care providers. We used a stated preference technique known as a discrete choice experiment to collect and analyze the data. Results indicate that consumers care about both costs and quality of care, with healthy consumers placing greater emphasis on costs and consumers with poorer health placing greater emphasis on quality of care. It is possible for an insurer to satisfy both of these criteria by selective contracting health care providers who consequently purchase health care that is both efficient and of good quality.
The German Nuclear Power Plant Insurance (DKVG) Association was able to increase its net capacity in property insurance to 637 million marks in 1993 (1992: 589 million). The reinsurance capacity of the other pools included, the total amount covered now amounts to 2 billion marks in property incurance and 200 million marks in liability incurance. As in the year before the pool can reckon with a stable gross premium yield around 175 million marks. The revival of the US dollar has played a decisive role in this development. In 1993 in the domestic market, the DKVG offered policies for 22 types of property risk and 43 types to third-party risk, operating with a gross target premium of 65 million marks and 16 million marks, respectively. The DKVG also participated in 540 foreign insurance contracts. (orig./HSCH) [de
A contract to insure $1 against inflation is equivalent to a European call option on the consumer price index. When there is no deductible this call option is equivalent to a forward contract on the CPI. Its price is the difference between the prices of a zero coupon real bond and a zero coupon nominal bond, both free of default risk. Provided that the risk-free real rate of interest is positive, the price of such an inflation insurance policy first rises and then falls with time to maturity....
Ye, Ting; Wu, Yue; Zhang, Liang
Background: Health insurance coverage is of great importance; yet, it is unclear whether there is some geographic variation in health insurance benefit for urban and rural patients covered by a same basic health insurance, especially in China.Objective: To identify the potential geographic variation in health insurance benefit and its possible socioeconomic and geographical factors at the town level.Methods: All the beneficiaries underthe health insurance who had the in-hospital experience in...
The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...
Ward, Erin P; Unkart, Jonathan T; Bryant, Alex; Murphy, James; Blair, Sarah L
We evaluated the impact of travel distance and insurance status on contralateral prophylactic mastectomy (CPM) rates in breast cancer. We queried the National Cancer Data Base (NCDB) for women >18 years of age with a nonmetastatic primary breast cancer of ductal, lobular, or mixed histology. Patient- and facility-specific CPM rates were calculated based on insurance, race, and distance to treatment center. Standard univariable and multivariable regression analysis was performed. Overall, the CPM rate was 6.5% for the 864,105 patients identified. Most patients traveled CPM. However, distance to the treatment center and insurance type had a greater absolute impact on rates of CPM for Black and Hispanic patients. Absolute CPM rate increases for patients >100 miles from a treatment center compared with those CPM rates. Increased travel distance is independently associated with increased rates of CPM for all patients and increased facility-specific rates of CPM. Black and Hispanic patients were found to be more vulnerable to the impact of travel distance and insurance status on rates of CPM.
Full Text Available The issue of crop protection is very important because of a variety of risks that could cause difficult consequences. One type of risk protection is insurance. The author in the paper states various models of insurance in some EU countries and the systems of subsidizing of insurance premiums by state. The author also gives a picture of crop insurance in the U.S., noting that in this country pays great attention to this matter. As for crop insurance in Serbia, it is not at a high level. The main problem with crop insurance is not only the risks but also the way of protection through insurance. The basic question that arises not only in the EU is the question is who will insure and protect crops. There are three possibilities: insurance companies under state control, insurance companies that are public-private partnerships or private insurance companies on a purely commercial basis.
Change of name for AUSTRIA As of October 1, the AUSTRIA Assurances S.A. company will change its name to: UNIQA Assurances S.A. It inherits the same name as its parent Austrian company, which adopted it towards the end of 1999. This change has no effect on the contract which binds it to CERN for the administration of our Health Insurance Scheme. New insurance cards will be sent to you by UNIQA and the printed forms and envelopes will gradually be updated with the new name. Postal and phone addresses remain unaffected by the change. You should address your postal mail to: UNIQA Assurances rue des Eaux Vives 94 case postale 6402 1211 Genève 6 You may telephone your usual contact persons at the same numbers as before and send e-mails to the UNIQA office at CERN at: UNIQA.Assurances@cern.ch
These notes are intended as a general guide for the use of members of the Canadian Nuclear Association who are, or may become, involved in supplying goods or services or contracting/ erecting as part of a contract to supply a nuclear facility to an overseas country. They give information to the type of insurances needed and available, the parties normally responsible for providing the coverages, the intent and operation of the various policies, general methods of charging premiums, and main exclusions
The CERN-AUSTRIA Agreement, which implemented CERN's health insurance scheme, expired on 31 December 1999.In accordance with CERN's rules, a call for tenders for the management of the health insurance scheme was issued and the contract was once again awarded to AUSTRIA. In June 1999, the Finance Committee thus authorised the Management to conclude a new contract with AUSTRIA, which came into force on 1st January 2000.Continuity is thus assured on favourable conditions and the transition from one contract to the other will entail no substantial changes in the system for those insured at CERN except for a few minor and purely formal amendmentsWHAT REMAINS UNCHANGEDThe list of benefits, i.e. the 'cover' provided by the system, is not changed;Neither is the reimbursement procedure.AUSTRIA's office at CERN and its opening hours as well as its city headquarters remain the same. The envelopes containing requests for reimbursement have had to be sent (since the end of 1998) to :Rue des Eaux-Vives 94Case postale 64021...
Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health Insurance Scheme
Iloh, GUP; Ofoedu, JN; Njoku, PU; Okafor, GOC; Amadi, AN; Godswill-Uko, EU
Background: The increasing importance of the concept of patients’ satisfaction as a valuable tool for assessing quality of care is a current global healthcare concerns as regards consumer-oriented health services. Aim: This study assessed satisfaction with quality of care received by patients without national health insurance (NHI) attending a primary care clinic in a resource-poor environment of a tertiary hospital in South-Eastern Nigeria. Subject and Methods: This was a cross-sectional study carried out on 400 non-NHI patients from April 2011 to October 2011 at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Adult patients seen within the study period were selected by systematic sampling using every second non-NHI patient that registered to see the physicians and who met the selection criteria. Data were collected using pretested, structured interviewer administered questionnaire designed on a five points Likert scale items with 1 and 5 indicating the lowest and highest levels of satisfaction respectively. Satisfaction was measured from the following domains: patient waiting time, patient–staff communication, patient-staff relationship, and cost of care, hospital bureaucracy and hospital environment. Operationally, patients who scored 3 points and above in the assessed domain were considered satisfied while those who scored less than 3 points were dissatisfied. Results: The overall satisfaction score of the respondents was 3.1. Specifically, the respondents expressed satisfaction with patient–staff relationship (3.9), patient–staff communication (3.8), and hospital environment (3.6) and dissatisfaction with patient waiting time (2.4), hospital bureaucracy (2.5), and cost of care (2.6). Conclusion: The overall non-NHI patient's satisfaction with the services provided was good. The hospital should set targets for quality improvement in the current domains of satisfaction while the cost of care has implications for government
... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Regulatory Agreement, Accounting and Reporting, and Financial...
Presswala, R G
In India, indemnity health insurance started about 3 decades ago. Mediclaim was the most popular product. Indian insurers and multinational companies have not been enthusiastic about starting health insurance in spite of the availability of a good market because health insurers have historically incurred losses. Losses have been caused by poor administration. Because it is a small portion of their total businesses, insurers have never tried sincerely to improve deficiencies or taken special interest. Hospital management and medical specialists have the spirit of entrepreneurship and are prepared to learn quickly and follow managed care principles, though they are not currently practiced in India. Actuarial data from the health insurance industry is sparse, but data from alternative sources will be helpful for starting managed healthcare. In my opinion, if properly administered, a "limited" managed care product with appropriate precautions and premium levels will be successful and profitable and will compete with present indemnity products in India.
Department of Homeland Security — The Summary of Deposits (SOD) is the annual survey of branch office deposits for all FDIC-insured institutions including insured U.S. branches of foreign banks. Data...
Social Security Administration — The Unemployment Insurance Query (UIQ) provides State Unemployment Insurance agencies real-time online access to SSA data. This includes SSN verification and Title...
Kutscher, Beth; Barr, Paul; Zigmond, Jessica
Top executives at investor-owned hospital chains saw their compensation packages take a hit last year, amid the debt-ceiling crisis and concerns over how it might affect Medicare. Wayne Smith at Community Health Systems led the pack in that sector, with a $21 million payday, while Trevor Fetter, left, of Tenet, came in a distant second with $10.7 million.
... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...
Keiding, Hans; Hansen, Bodil O.
In this paper, we present a simple model of health insurance with asymmetric information, where we compare two alternative ways of organizing the insurance market. Either as a competitive insurance market, where some risks remain uninsured, or as a compulsory scheme, where however, the level...... competitive insurance; this situation turns out to be at least as good as either of the alternatives...
... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...
Harmon, C; Nolan, B
The numbers buying private health insurance in Ireland have continued to grow, despite a broadening in entitlement to public care. About 40% of the population now have insurance, although everyone has entitlement to public hospital care. In this paper, we examine in detail the growth in insurance coverage and the factors underlying the demand for insurance. Attitudinal responses reveal the importance of perceptions about waiting times for public care, as well as some concerns about the quality of that care. Individual characteristics, such as education, age, gender, marital status, family composition and income all influence the probability of purchasing private insurance. We also examine the relationship between insurance and utilization of hospital in-patient services. The positive effect of private insurance appears less than that of entitlement to full free health care from the state, although the latter is means-tested, and may partly represent health status. Copyright 2001 John Wiley & Sons, Ltd.
Risk of new acute myocardial infarction hospitalization associated with use of oral and parenteral non-steroidal anti-inflammation drugs (NSAIDs: a case-crossover study of Taiwan's National Health Insurance claims database and review of current evidence
Full Text Available Abstract Background Previous studies have documented the increased cardiovascular risk associated with the use of some nonsteroidal anti-inflammatory drugs (NSAIDs. Despite this, many old NSAIDs are still prescribed worldwide. Most of the studies to date have been focused on specific oral drugs or limited by the number of cases examined. We studied the risk of new acute myocardial infarction (AMI hospitalization with current use of a variety of oral and parenteral NSAIDs in a nationwide population, and compared our results with existing evidence. Methods We conducted a case-crossover study using the Taiwan's National Health Insurance claim database, identifying patients with new AMI hospitalized in 2006. The 1-30 days and 91-120 days prior to the admission were defined as case and matched control period for each patient, respectively. Uses of NSAIDs during the respective periods were compared using conditional logistic regression and adjusted for use of co-medications. Results 8354 new AMI hospitalization patients fulfilled the study criteria. 14 oral and 3 parenteral NSAIDs were selected based on drug utilization profile among 13.7 million NSAID users. The adjusted odds ratio, aOR (95% confidence interval, for risk of AMI and use of oral and parenteral non-selective NSAIDs were 1.42 (1.29, 1.56 and 3.35 (2.50, 4.47, respectively, and significantly greater for parenteral than oral drugs (p for interaction Conclusions The collective evidence revealed the tendency of increased AMI risk with current use of some NSAIDs. A higher AMI risk associated with use of parenteral NSAIDs was observed in the present study. Ketorolac had the highest associated risk in both oral and parenteral NSAIDs studied. Though further investigation to confirm the association is warranted, prescribing physicians and the general public should be cautious about the potential risk of AMI when using NSAIDs.
Insurance for large nuclear installations covers mainly four types of risk: third party liability which in accordance with the nuclear conventions, is borne by a nuclear operator following an incident occurring in his installation or during transport of nuclear substances; material damage to the installation itself, which precisely is not covered by third party liability insurance; machinery breakdown, i.e. accidental damage or interruption of operation. Only the first category must be insured. In view of the magnitude of the risk, nuclear insurance resorts to co-insurance and reinsurance techniques which results in a special organisation of the nuclear insurance market, based on national nuclear insurance pools and on the Standing Committee on Atomic Risk of the European Insurance Committee. Conferences of the chairmen of nuclear insurance pools are convened regularly at a worldwide level. (NEA) [fr
为解决医疗费用过快上涨、医保对供方行为约束不足、基金运行风险加剧等问题,人力资源和社会保障部等要求在统筹地区开展以总额控制为主的医保支付方式改革.总额控制对城市大型公立医院的经营管理产生了较大的影响.按照总额控制政策,提出3个层面的转型策略.在发展战略方面,转变增长方式,发挥医联体作用,增强辐射能力;在业务管理方面,确保医疗质量和安全,落实临床路径,优化服务流程;在行政管理方面,强化成本控制,加强信息化建设,转变管理职能.%To address such challenges as the rapid rise in health care costs,insufficient constraints on supply-side behavior by medical insurance,and rising risk exposure of the insurance foundation,the Ministry of Human Resources and Social Security has proposed a payment mode reform featuring total reimbursement control.Such a total control policy will affect significantly the business operation of urban public hospitals.To adapt to the impacts so incurred,a three-level transformation strategy is recommended as follows.A development strategy calling for a new growth model,greater role of hospital-health alliances for greater service coverage; a business management strategy to ensure quality of care and safety,clinical pathways in place and optimize service processes; an administrative strategy to enhance cost control,strengthen information technology,and transform the management functions.
... HOUSING ACT AND OTHER AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS Construction § 242.47 Insured advances... only for components stored off-site in a quantity required to permit uninterrupted installation at the...
Chinese Nuclear Insurance Started with Daya Bay Nuclear Power Station, PICC issued the insurance policy. Nuclear insurance cooperation between Chinese and international pool's organizations was set up in 1989. In 1996, the Chinese Nuclear Insurance Pool was prepared. The Chinese Nuclear Insurance Pool was approved by The Chinese Insurance Regulatory Committee in May of 1999. The principal aim is to centralize maximum the insurance capacity for nuclear insurance from local individual insurers and to strengthen the reinsurance relations with international insurance pools so as to provide the high quality insurance service for Chinese nuclear industry. The Member Company of Chinese Nuclear Pool and its roles are introduced in this article
Hayhoe, Celia Ray; Smith, Mike, CPF
The purpose of disability income insurance is to partially replace your income if you are unable to work because of sickness or an accident. This guide reviews the types of disability insurance, important terms and concepts and employer provided benefits.
... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...
Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…
Debaets, M.; Springett, G.D.; Luotonen, K.; Virole, J.
When analysing the nuclear insurance market, three elements must be taken into account: the nuclear operator's liability is regulated by national laws and/or international Conventions, such operators pay large premiums to insure their nuclear installations against property damage and finally, the nuclear insurance market is made up of pools and is mainly a monopoly. This report describes the different types of insurance coverage, the system governing nuclear third party liability under the Paris Convention and the Brussels Supplementary Convention and several national laws in that field. The last part of the report deals with liability and insurance aspects of international transport of nuclear materials [fr
Landes, Xavier; Néron, Pierre-Yves
Heath (among other political theorists) considers that the principle of efficiency provides a better normative explanation and justification of public insurance than the egalitarian account. According to this view, the fact that the state is involved in the provision of specific insurance (primarily......Public insurance is commonly assimilated with redistributive tools mobilized by the welfare state in the pursuit of an egalitarian ideal. This view contains some truth, since the result of insurance, at a given moment, is the redistribution of resources from the lucky to unlucky. However, Joseph...... surrounding public insurance as a redistributive tool, advancing the idea that public insurance may be a relational egalitarian tool. It then presents a number of relational arguments in favor of the involvement of the state in the provision of specific forms of insurance, arguments that have been overlooked...
Bertoli, Paola; Grembi, Veronica
We assess the impact of the introduction of schedules of non-economic damages (i.e. tiered caps systems) on the behavior of insurers operating in the medical liability market for hospitals while controlling the performance of the judicial system, measured as court backlog. Using a difference......-in-differences strategy on Italian data, we find that the introduction of schedules increases the presence of insurers (i.e. medical liability market attractiveness) only in inefficient judicial districts. In the same way, court inefficiency is attractive to insurers for average values of schedules penetration...... of the market, with an increasing positive impact of inefficiency as the territorial coverage of schedules increases. Finally, no significant impact is registered on paid premiums. Our analysis sheds light on a complex set of elements affecting the decisions of insurers in malpractice markets. The analysis...
Konovalov, R.; Kumlander, Deniss
This paper proposes the idea to use Clinical Decision Support software in Health Insurance Company as a tool to reduce the expenses related to Medication Errors. As a prove that this class of software will help insurance companies reducing the expenses, the research was conducted in eight hospitals in United Arab Emirates to analyze the amount of preventable common Medication Errors in drug prescription.
Nuclear facilities operate under the constant risk that radioactive materials could be accidentally released off-site and cause injuries to people or damages to the property of others. Management of this nuclear risk, therefore, is very important to nuclear operators, financial stakeholders and the general public. Operators of these facilities normally retain a portion of this risk and transfer the remainder to others through an insurance mechanism. Since the nuclear loss exposure could be very high, insurers usually assess their risk first-hand by sending insurance engineers to conduct a nuclear insurance inspection. Because a serious fire can greatly increase the probability of an off-site release of radiation, fire safety should be included in the nuclear insurance inspection. This paper reviews essential elements of a facility's fire safety program as a key factor in underwriting nuclear third-party liability insurance. (author)
Darooneh, Amir H.
We consider the insurance company as a physical system which is immersed in its environment (the financial market). The insurer company interacts with the market by exchanging the money through the payments for loss claims and receiving the premium. Here, in the equilibrium state, we obtain the premium by using the canonical ensemble theory, and compare it with the Esscher principle, the well-known formula in actuary for premium calculation. We simulate the case of car insurance for quantitative comparison.
This short communication deals with compensation for nuclear damage and compensation for environmental pollution through industrial activities and compress both systems and their insurance coverage [fr
... contributed by: familydoctor.org editorial staff Categories: Healthcare Management, Insurance & Bills, Your Health ResourcesTags: brand name, co-pay, drug, formulary, generic, isurance, medicine, ...
Andersen, Z. J.; Lin, Chyongchiou J; Chang, Chung-Chou H
analyzed. Approximately 74 percent of uninsured Americans are nonelderly Americans. Among the nonelderly Americans, about 17 percent are uninsured. Our findings show that insurance status varies significantly by region, age, race, gender, marital status, income, education, employment status, and health......This study identified the underlying demographic and socioeconomic factors associated with insurance status among nonelderly Americans (age 19-64), as well as compared health care utilization between insured and uninsured. Data from the Community Tracking Study 1996-1997 Household Survey were...... status. Also, the insured nonelderly Americans were found to have better access to health care than the uninsured nonelderly....
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to § 5.235(d), in providing a medical, hospital, accident, or life insurance...
... Prohibited § 23.440 Health and insurance benefits and services. Subject to § 23.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and insurance...
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...
... 10 Energy 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 5.440 Section... Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to § 5.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...
... § 1317.440 Health and insurance benefits and services. Subject to § 1317.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Health and insurance...
... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Health and insurance benefits... Education Programs or Activities Prohibited § 19.440 Health and insurance benefits and services. Subject to § 19.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...
... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Health and insurance... insurance benefits and services. Subject to § 101-4.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits and... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...
... 49 Transportation 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 25.440... Basis of Sex in Education Programs or Activities Prohibited § 25.440 Health and insurance benefits and services. Subject to § 25.235(d), in providing a medical, hospital, accident, or life insurance benefit...
... 10 Energy 4 2010-01-01 2010-01-01 false Health and insurance benefits and services. 1042.440... in Education Programs or Activities Prohibited § 1042.440 Health and insurance benefits and services. Subject to § 1042.235(d), in providing a medical, hospital, accident, or life insurance benefit, service...
... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...
... 29 Labor 1 2010-07-01 2010-07-01 true Health and insurance benefits and services. 36.440 Section... Education Programs or Activities Prohibited § 36.440 Health and insurance benefits and services. Subject to § 36.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or...
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits and....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health and insurance benefits and services. 86.39... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...
... 7 Agriculture 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 15a.39... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...
... Administration (FHA) Mortgage Insurance Premiums for Multifamily Housing Programs, Health Care Facilities and... mortgage insurance premiums (MIPs) for FHA Multifamily Housing, Health Care Facilities, and Hospital... mortgage insurance regulation at 24 CFR 207.254 provides as follows: Notice of future premium changes will...
A brief account is given of the development of nuclear insurance. The subject is dealt with under the following headings: the need for nuclear insurance, nuclear insurance pools, international co-operation, nuclear installations which may be insured, international conventions relating to the liability of operators of nuclear installations, classes of nuclear insurance, nuclear reactor hazards and their assessment, future developments. (U.K.)
Gasto de hogares durante la hospitalización de menores derechohabientes, con diagnóstico de leucemia, en dos hospitales en México Out-of-pocket expenditures during hospitalization of young leukemia patients with state medical insurance in two Mexican hospitals
two hospitals of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social -IMSS-. MATERIAL AND METHODS: A cross-sectional study was conducted in Mexico City and Leon, Guanajato, Mexico in 1997. The study population consisted of the parents of 51 children under 15 years of age diagnosed with leukemia, who were hospitalized for the first time in two IMSS hospitals. A questionnaire was applied to participants to obtain direct and indirect expenditures during that period. Consumer price indexes (1997-2002 were used to estimate expenditure prices for 2002. Average expenditures and catastrophic expenditures were estimated. Factors associated with expenditures were analyzed using a linear regression model in which the dependent variable was the total household expenditures during hospitalization. RESULTS: The average household cost per hospitalization was 7 318 pesos, 86% of which corresponded to medical care and 14% to indirect costs. Catastrophic expenditures occurred in 14% of households. In 47% of household expenditures exceeded 100% of the total household income during the hospitalization period. Expenditures during hospitalization were associated with place of residence, income level, and type of medical insurance. CONCLUSIONS: Being an IMSS policyholder decreased out-of-pocket expenditures, but not complementary expenditures, which may still be unaffordable for a large segment of the population. For more than a half of the households studied, continuity of care was compromised, as expenditures during the first hospitalization entailed using up savings, going into debt, and/or selling household property.
This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...
It was the risk of contamination of ships from the Pacific atmospheric atomic bomb tests in the 1940's that seems first to have set insurers thinking that a limited amount of cover would be a practical possibility if not a commercially-attractive proposition. One Chapter of this book traces the early, hesitant steps towards the evolution of ''nuclear insurance'', as it is usually called; a term of convenience rather than exactitude because it seems to suggest an entirely new branch of insurance with a status of its own like that of Marine, Life or Motor insurance. Insurance in the field of nuclear energy is more correctly regarded as the application of the usual, well-established forms of cover to unusual kinds of industrial plant, materials and liabilities, characterised by the peculiar dangers of radioactivity which have no parallel among the common hazards of industry and commerce. It had, and still has, the feature that individual insurance underwriters are none too keen to look upon nuclear risks as a potential source of good business and profit. Only by joining together in Syndicates or Pools have the members of the national insurance markets been able to make proper provision for nuclear risks; only by close international collaboration among the national Pools have the insurers of the world been able to assemble adequate capacity - though still, even after thirty years, not sufficient to provide complete coverage for a large nuclear installation. (author)
International Labour Office. Geneva
This manual provides an overview of social health insurance schemes and looks at the development of health care policies and feasibility issues. It also examines the design of health insurance schemes, health care benefits, financing and costs and considers the operational and strategic information requirements.
This is an insurance industry guide for the independent power industry. The directory includes the insurance company's name, address, telephone and FAX numbers and a description of the company's area of expertise, products and services, and limitations. The directory is international in scope. Some of the companies specialize in independent power projects
Full Text Available Insurance industry has traditionally been oriented on sale of its products i.e. at the stage which from the aspect of marketing theory can be characterized as sales phase, phase which proceeds the marketing orientation. However, faced with numerous challenges of modern business environment such as globalization, deregulation and sophisticated information technology insurance companies must change their way of doing business. Competition is becoming fierce as insurance companies are faced with competition not only from insurance industry but also from other competitors, such as banks, that are in position to offer product substitutes for life insurance products. In this new environment information about customers and their education are becoming critical factors. Insurance companies must know their customers what influences their demand for life insurance, what is the amount of their income, what is inflation rate, their expenditures on other goods i.e. opportunity costs, etc. Those are factors that force insurance companies to concentrate more on present and potential buyers and their needs and force them to give their best to satisfy those needs in a way that will produce delighted customers.
Larsen, Birthe; Waisman, Gisela
This paper examines the impact of higher unemployment insurance on the fraction of the work force paying into an unemployment insurance fond, wage differences and therefore inquality and education letting worker initial wealth being important for the decisions and implied values. As usually higher...... educated workers receive a lower fraction of their wages as unemployment insurance, we consider how the impact on labour market performance and wage differences and thereby inequality differ dependent on whether educated or uneducated workers receive higher benefits. The model can help shed light...... on the the puzzle why only some workers, for given educational level, pay into an unemployment insurance fond, the lower wealth mobility than income mobility as well as the relative compressed wage structure in countries with generous social assistance as well as unemployment insurance for low income workers...
The French government has decided that, with effect from 1 June 2014, persons resident in France but working in Switzerland (hereinafter referred to as “frontaliers”) will no longer be entitled to opt for private French health insurance provision as their sole and principal health insurance. The right of choice, which was granted by the Bilateral Agreement on the Free Movement of Persons between Switzerland and the European Union and which came into force on 1 June 2002, exempts “frontaliers” from the obligation to become a member of Switzerland’s compulsory health insurance scheme (LAMal) if they can prove that they have equivalent coverage in France, provided by either the French social security system (CMU) or a private French insurance provider. As the latter option of private health insurance as an alternative to membership of LAMal will be revoked under the new French legislation that will come into force on 1 June 2014, current “...
.... Addressing this problem, Congress enacted the Terrorism Risk Insurance Act of 2002 (TRIA) to create a temporary program to share future insured terrorism losses with the property-casualty insurance industry and policyholders...
.... The request was prompted by action taken by the Florida Department of Insurance against two life insurance companies that had received large numbers of insurance allotments from Service members...
Daysal, N. Meltem
In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome -- the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999-2006). My...... results indicate that uninsured patients have an economically significant effect that increases the mortality rate of insured heart attack patients. I show that these results are not driven by alternative explanations, including reverse causality, patient composition effects, sample selection...... of care to insured heart attack patients in response to reduced revenues, the evidence I have suggests a modest increase in the quantity of cardiac services without a corresponding increase in hospital staff....
Alain Tosetti; Thomas Behar; Michel Fromenteau; Stéphane Ménart
We shall be examining the following topics: (i) basic frameworks for accounting and for statutory insurance rules; and (ii) actuarial principles of insurance; for both life and nonlife (i.e. casualty and property) insurance.Section 1 introduces insurance terminology, regarding what an operation must include in order to be an insurance operation (the legal, statistical, financial or economic aspects), and introduces the accounting and regulation frameworks and the two actuarial models of insur...
Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...
La Forgia, Ambar; Maeda, Jared Lane K; Banthin, Jessica S
As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these "vertically" integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.
Bradley, Cathy J.; Neumark, David; Motika, Meryl
Background Employment-contingent health insurance (ECHI) has been criticized for tying insurance to continued employment. Our research sheds light on two central issues regarding employment-contingent health insurance: whether such insurance “locks” people who experience a health shock into remaining at work; and whether it puts people at risk for insurance loss upon the onset of illness, because health shocks pose challenges to continued employment. Objective To determine how men’s dependence on their own employer for health insurance affects labor supply responses and health insurance coverage following a health shock. Data Sources We use the Health and Retirement Study (HRS) surveys from 1996 through 2008 to observe employment and health insurance status at interviews two years apart, and whether a health shock occurred in the intervening period between the interviews. Study Selection All employed married men with health insurance either through their own employer or their spouse’s employer, interviewed in at least two consecutive HRS waves with non-missing data on employment, insurance, health, demographic, and other variables, and under age 64 at the second interview. We limited the sample to men who were initially healthy. Data Extraction Our analytical sample consisted of 1,582 men of whom 1,379 had ECHI at the first interview, while 203 were covered by their spouse’s employer. Hospitalization affected 209 men with ECHI and 36 men with spouse insurance. A new disease diagnosis was reported by 103 men with ECHI and 22 men with other insurance. There were 171 men with ECHI and 25 men with spouse employer insurance who had a self-reported health decline. Data Synthesis Labor supply response differences associated with ECHI – with men with health shocks and ECHI more likely to continue working – appear to be driven by specific types of health shocks associated with future higher health care costs but not with immediate increases in morbidity that
Meltem Daysal, N.
Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California
Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...
Until 2001 losses caused by terrorist attacks have been covered under fire policies worldwide with two exceptions: Spain and UK where major and multiple losses caused by ETA and IRA had led to specific insurance solutions. The September 11, 2001 attacks on the World Trade Centre have changed the world in many aspects. This includes the insurance industry, which was compelled to exclude terrorism from coverage and to offer special solutions for extra premium. Nuclear power plants have been repeatedly called targets for terrorists as their destruction could cause a large catastrophe and more victims than the September 2001 attacks. How does the insurance industry respond? (author)
Full Text Available In August 2003, the Ghanaian Government made history by implementing the first National Health Insurance System (NHIS in Sub-Saharan Africa. Within three years, over half of the country’s population had voluntarily enrolled into the National Health Insurance Scheme. This study had three objectives: 1 To estimate the risk factors that influences the Ghana national health insurance claims. 2 To estimate the magnitude of each of the risk factors in relation to the Ghana national health insurance claims. In this work, data was collected from the policyholders of the Ghana National Health Insurance Scheme with the help of the National Health Insurance database and the patients’ attendance register of the Koforidua Regional Hospital, from 1st January to 31st December 2011. Quantitative analysis was done using the generalized linear regression (GLR models. The results indicate that risk factors such as sex, age, marital status, distance and length of stay at the hospital were important predictors of health insurance claims. However, it was found that the risk factors; health status, billed charges and income level are not good predictors of national health insurance claim. The outcome of the study shows that sex, age, marital status, distance and length of stay at the hospital are statistically significant in the determination of the Ghana National health insurance premiums since they considerably influence claims. We recommended, among other things that, the National Health Insurance Authority should facilitate the institutionalization of the collection of appropriate data on a continuous basis to help in the determination of future premiums.
This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.
Full Text Available Personal insurance represents one of the sources of personal social security as a category of personal property. How to get a proper life insurance is a frequently asked question. When insuring material objects (car, house..., the problem is usually not in the amount of the taken insurance. With life insurance (abstract goods, problems as such occur. In this paper, we wish to present a model that, according to the financial situation and the anticipated future, makes it possible to calculate the optimum insurance sum in life insurance.
The CERN Administration wishes to inform staff members and fellows having taken out optional life insurance under the group contract signed by CERN that the following changes to the rules and regulations entered into force on 1 January 2013: The maximum age for an active member has been extended from 65 to 67 years. The beneficiary clause now allows insured persons to designate one or more persons of their choice to be their beneficiary(-ies), either at the time of taking out the insurance or at a later date, in which case the membership/modification form must be updated accordingly. Beneficiaries must be clearly identified (name, first name, date of birth, address). The membership/modification form is available on the FP website: http://fp.web.cern.ch/helvetia-life-insurance For further information, please contact: Valentina Clavel (Tel. 73904) Peggy Pithioud (Tel. 72736)
Pauly, Mark V
This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines) in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs) but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage). It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.
Mark V. Pauly
Full Text Available This paper explores the relationship between the research for and development of vaccines against global pandemics and insurance. It shows that development in advance of pandemics of a portfolio of effective and government-approved vaccines does have some insurance properties: it requires incurring costs that are certain (the costs of discovering, developing, and testing vaccines in return for protection against large losses (if a pandemic treatable with one of the vaccines occurs but also with the possibility of no benefit (from a vaccine against a disease that never reaches the pandemic stage. It then argues that insurance against the latter event might usefully be offered to organizations developing vaccines, and explores the benefits of insurance payments to or on behalf of countries who suffer from unpredictable pandemics. These ideas are then related to recent government, industry, and philanthropic efforts to develop better policies to make vaccines against pandemics available on a timely basis.
Nuclear insurance and some of the features associated with it, such as the International Conventions and the operation of Atomic Risk Pools, are discussed both in general and with specific reference to the USA, Canada and the United Kingdom
Freese, William C.
Insurance coverage of school buildings and contents is becoming increasingly difficult to obtain, and increases of 50 percent or more in the premium are not uncommon. Methods of reducing premium increases are outlined in this speech. (MLF)
Dimitriyadis, I.; Öney, Ü. N.
This study is an extension to a simulation study that has been developed to determine ruin probabilities in health insurance. The study concentrates on inpatient and outpatient benefits for customers of varying age bands. Loss distributions are modelled through the Allianz tool pack for different classes of insureds. Premiums at different levels of deductibles are derived in the simulation and ruin probabilities are computed assuming a linear loading on the premium. The increase in the probability of ruin at high levels of the deductible clearly shows the insufficiency of proportional loading in deductible premiums. The PH-transform pricing rule developed by Wang is analyzed as an alternative pricing rule. A simple case, where an insured is assumed to be an exponential utility decision maker while the insurer's pricing rule is a PH-transform is also treated.
Marie-Cécile FAGART; Bidénam KAMBIA-CHOPIN
This paper considers a competitive insurance market under moral hazard and adverse selection, in which preventive efforts and self-protection costs are unobservable by insurance companies. Under reasonable assumptions, the conclusions of Rothschild and Stiglitz (1976) are preserved in our context even if it involves moral hazard. The riskier agents in equilibrium, who would also be the riskier agents under perfect information, receive their moral hazard contract. For other agents, adverse sel...
Full Text Available The paper analyses the notion of consumer in the European Union law, and, in particular, the notion of consumer in insurance law. The author highligts the differences between the notion of consumer is in aquis communautaire and in insurance law, discussing whether the consumer can be defined in both field in the same way, concerning that insurance services differ a lot from other kind of services. Having regarded unequal position of contracting parties and information and technical disadvantages of a weaker party, author pleads for broad definition of consumer in insurance law. In Serbian law, the consumer is not defined in consistent way. That applies on Serbian insurance law as well. Therefore, the necessity of precise and broad definition of consumes is underlined, in order to delimit the circle of subject who are in need for protection. The author holds that the issue of determination of the circle of persons entitled to extended protection as consumers is of vital importance for further development of insurance market in Serbia.
Kerssens, Jan J; Groenewegen, Peter P
Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans which differed in 12 characteristics (premium, deductibles, no-claim discount, extension of insurance and financial services, red tape involved, medical help-desk, choice of family physicians and hospitals, dental benefits, physical therapy benefits, benefits for prescription drugs and homeopathy). In 90% the health plan with the most attractive characteristics was preferred, indicating a predominantly rational kind of choice. The most decisive characteristics for preference were: complete dental benefits, followed by zero deductibles, and free choice of hospitals.
Jacobs, M Orry; Eggbeer, Bill
The introduction of the state health insurance exchanges, as provided for in the Affordable Care Act, has many strategic implications for healthcare providers: Unprecedented transparency; The "Walmart Effect", with patients playing a greater role as healthcare consumers; A rise in narrow networks spurred by low prices and narrow geographies; The potential end of the cross subsidy of Medicare and Medicaid by commercial plans; The possible end of not-for-profit status for hospitals
Should Governments engage health insurance intermediaries? A comparison of benefits with and without insurance intermediary in a large tax funded community health insurance scheme in the Indian state of Andhra Pradesh.
Nagulapalli, Srikant; Rokkam, Sudarsana Rao
A peculiar phenomenon of engaging insurance intermediaries for government funded health insurance schemes for the poor, not usually found globally, is gaining ground in India. Rajiv Aarogyasri Scheme launched in the Indian state of Andhra Pradesh, is first largest tax funded community health insurance scheme in the country covering more than 20 million poor families. Aarogyasri Health Care Trust (trust), the scheme administrator, transfers funds to hospitals through two routes one, directly and the other through an insurance intermediary. The objective of this paper is to find out if engaging an insurance intermediary has any effect on cost efficiency of the insurance scheme. We used payment data of RAS for the period 2007-12, to find out the influence of insurance intermediary on the two variables, benefit cost ratio defined as benefit payment divided by premium payment, and claim denial ratio defined as benefit payment divided by treatment cost. Relationship between scheme expenditure and number of beds empanelled under the scheme is examined. OLS regression is used to perform all analyses. We found that adding an additional layer of insurance intermediary between the trust and hospitals reduced the benefit cost ratio under the scheme by 12.2% (p-value = 0.06). Every addition of 100 beds under the scheme increases the scheme payments by US$ 0.75 million (p-value insurance and trust modes narrowed down from 2.84% in government hospitals to 0.41% in private hospitals (p-value insurance intermediary has the twin effects of reduction in benefit payments to beneficiaries, and chocking fund flow to government hospitals. The idea of engaging insurance intermediary should be abandoned.
LAYTON, TIMOTHY J.; MCGUIRE, THOMAS G.; SINAIKO, ANNA D.
In order to encourage entry and lower prices, most regulated markets for health insurance include policies that seek to reduce the uncertainty faced by insurers. In addition to risk adjustment of premiums paid to plans, the Health Insurance Marketplaces established by the Affordable Care Act implement reinsurance and risk corridors. Reinsurance limits insurer costs associated with specific individuals, while risk corridors protect against aggregate losses. Both tighten the insurer's distribut...
Scheffler, Richard M; Arnold, Daniel R
Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration-as measured by the Herfindahl-Hirschman Index (HHI)-interact and are correlated with prices. We found evidence that in the range of the Department of Justice's and Federal Trade Commission's definition of a moderately concentrated market (HHI of 1,500-2,500), insurers have the bargaining power to reduce provider prices in highly concentrated provider markets. In particular, hospital admission prices were 5 percent lower and cardiologist, radiologist, and hematologist/oncologist visit prices were 4 percent, 7 percent, and 19 percent lower, respectively, in markets with high provider concentration and insurer HHI above 2,000, compared to such markets with insurer HHI below 2,000. We did not find evidence that high insurer concentration reduced visit prices for primary care physicians or orthopedists, however. The policy dilemma that arises from our findings is that there are no insurer market mechanisms that will pass a portion of these price reductions on to consumers in the form of lower premiums. Large purchasers of health insurance such as state and federal governments, as well as the use of regulatory approaches, could provide a solution. Project HOPE—The People-to-People Health Foundation, Inc.
Full Text Available The aim of the paper that treats the actuarial model of insurance in case of survival or early death is to show the actuarial methods and methodology for creating a model and an appropriate number of sub-models of the most popular form of life insurance in the world. The paper applies the scientific methodology of the deductive character based on scientific, theoretical knowledge and practical realities. Following the basic theoretical model’s determinants, which are at the beginning of the paper, the basic difference between models further in this paper was carried out according to the character of the premium to be paid. Finally, the financial repercussions of some models are presented at examples in insurance companies. The result of this paper is to show the spectrum of possible forms of capital endowment insurance which can be, without major problems, depending on the financial policy of the company, applied in actual practice. The conclusion of this paper shows the theoretical and the practical reality of this model, life insurance, and its quantitative and qualitative guidelines.
The CERN Administration would like to remind you that staff members and fellows have the possibility to take out a life insurance contract on favourable terms through a Group Life Insurance. This insurance is provided by the company Helvetia and is available to you on a voluntary basis. The premium, which varies depending on the age and gender of the person insured, is calculated on the basis of the amount of the death benefit chosen by the staff member/fellow and can be purchased in slices of 10,000 CHF. The contract normally ends at the retirement age (65/67 years) or when the staff member/fellow leaves the Organization. The premium is deducted monthly from the payroll. Upon retirement, the staff member can opt to maintain his membership under certain conditions. More information about Group Life Insurance can be found at: Regulations (in French) Table of premiums The Pension Fund Benefit Service &...
Obadović Mirjana M.
Full Text Available Every day insurance companies face a number of risks arising from the insurance industry itself, as well as risks arising from insurance company operations. In this constant fight against risks insurance companies use different models and methods that help them better understand, have a more comprehensive view of, and develop greater tolerance towards risks, in order to reduce their exposure to these risks. The model presented in this paper has been developed for implementation in insurance risk management directly related to insurance company risk, i.e. it is a model that can reliably determine the manner and intensity with which deviations in the initial insurance risk assessment affect insurance company operations, in the form of changes in operational risks and consequently in insurance companies’ business strategies. Additionally we present the implementation of the model in the Serbian market for the period 2005-2010.
Ravi SS Toor
Full Text Available Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI bill which was put forward in the winter session of the Lok Sabha (2008 focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.
Madalina Giorgiana MANGRA
Full Text Available The offer of insurance products is about the requirements and needs of the consumer who must always have information regarding: the type of insurance risk covered and the excluded risks, the sum insured, the payment of premiums and their duration. The accurate information of customer requires, from the commencement of contract and throughout its duration, that he or she is aware of the obligations throughout the contractual period. Most of the Romanians are turning their attention to one of the insurance companies found in the top 10 in 2016, supervised by F.S.A. (Financial Supervision Authority, preferring to have a policy of mandatory household and goods insurance, auto liability or life insurance, but are also interested in travel health insurance when going abroad, private health insurance or private pension insurance. Romanians' reluctance regarding the conclusion of an insurance comes from their distrust in insurance companies (see the situations of companies like Astra Insurance, Carpatica Insurance etc., their personal financial situation and the fear that they will not receive protection if the risk is covered but the insured sum is insufficient
Virtually any type of nuclear risk is insurable in principle, providing, of course, that the necessary standards of safety and control are met. Some of the risks are of a relatively minor character and no more hazardous than a simple conventional risk. But insurers would not consider as a minor risk anything which involves the use of nuclear fuel or other nuclear materials which are in a critical state or capable of releasing dangerous levels of radioactivity. These would include nuclear reactors or, indeed, any type of assembly which can not be regarded as subcritical. Most insurers would also regard installations involved in the manufacturing, processing and enriching of nuclear fuel, and certainly those concerned with the reprocessing of irradiated fuel and plutonium extraction, as major risks. (HP) [de
A brief account is given of insurance protection in the nuclear industry, and the legislation involved. Aspects discussed are: third part liability and the role of government in setting the maximum amount of compensation; the development and concept of channelling the liability exclusively to the operator; the development of nuclear insurance facilities in Europe and the USA; and the emergence in Europe of international agreements on third party liability for protection of neighbouring countries in the event of a major accident. The development of liability law in the USA from the time of the Price Anderson Act of 1957 through subsequent legislation is described. (U.K.)
Nuclear liability insurance covers liability for damages directly caused by the nuclear energy hazard. This coverage includes offsite bodily injury and property damage sustained by members of the general public, and bodily injury to onsite third party personnel. Recent nuclear liability claims allege bodily injury and property damage resulting from releases or radioactive materials to the environmental and occupational radiation worker exposures. Routine reactor operations involving radioactive waste have the potential to result in such claims. The nuclear insurance Pools believe that one way such claims can be minimized is through the implementation of an effective radioactive waste management program
Insurance has become a necessary aspect of modern society. The mathematical basis of insurance modeling is best expressed in terms of continuous time stochastic processes. This introductory text on actuarial risk theory deals with the Cramer-Lundberg model and the renewal risk model. Their basic structure and properties, including the renewal theorems as well as the corresponding ruin problems, are studied. There is a detailed discussion of heavy tailed distributions, which have become increasingly relevant. The Lundberg risk process with investment in risky asset is also considered. This book will be useful to practitioners in the field and to graduate students interested in this important branch of applied probability.
Fulton, Wallace C.
Article discusses the feasibility of marriage counseling as an insurance benefit in the future. It is suggested that the physician be used as a marriage counselor in that insurance companies will pay for medical services. (EK)
Nicole Maestas; Kathleen J. Mullen; Alexander Strand
As health insurance becomes available outside of the employment relationship as a result of the Affordable Care Act (ACA), the cost of applying for Social Security Disability Insurance (SSDI)–potentially going without health insurance coverage during a waiting period totaling 29 months from disability onset–will decline for many people with employer-sponsored health insurance. At the same time, the value of SSDI and Supplemental Security Income (SSI) participation will decline for individuals...
Sanja Coric; Danijel Bara
Selling insurance products in conditions of today’s modern technological solutions is faced with numerous challenges. Business processes in insurance as well as the results of these business processes are the real interface to policyholders. Modeling and analysis of business process in insurance ensure organizations to focus on the customer and increase the efficiency and quality of work. Managing critical business processes in every single organization, likewise in insurance is a key factor ...
Brown, Timothy T; Robinson, James C
Reference pricing (RP) theories predict different outcomes when reference prices are fixed (exogenous) versus being a function of market prices (MPs) (endogenous). Exogenous RP results in MPs at both high-price and low-price firms converging towards the reference price from above and below, respectively. Endogenous RP results in MPs at both high-price and low-price firms decreasing, with low-price firms acting strategically to decrease the reference price in order to gain market share. We extend these models to a hospital context focusing on insurer and consumer payments. Under exogenous RP, insurer and consumer payments to low-price hospitals increase, and insurer payments to high-price hospitals decrease, but predictions regarding consumer payments are ambiguous for high-price hospitals. Under endogenous RP, insurer payments to high-price and low-price hospitals decrease, and consumer payments to low-price hospitals decrease, but predictions regarding consumer payments are ambiguous for high-price hospitals. We test these predictions with difference-in-differences specifications using 2008-2013 data on patients undergoing joint replacement. For 2 years following RP implementation, insurer payments to high-price and low-price hospitals moved downward, consistent with endogenous RP. However, when the reference price was not reset to account for changes in MPs, insurer payments to low-price hospitals reverted to pre-implementation levels, consistent with exogenous RP. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
... as a potential global deposit insurer, preserve confidence in the FDIC deposit insurance system, and... the United States.\\2\\ The FDIC generally pays out deposit insurance on the next business day after a... since 2001 and total approximately $1 trillion today. In many cases, these branches do not engage in...
O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene
Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...
This article addresses steps to take to improve the economics and risk profiles for independent power projects. The topics discussed in the article include the results of competition in the power industry, custom packages and the lack of competition among insurers in the power industry, mitigating risk through providing technical information, and developing programs
Austin, Laurel; Fischhoff, Baruch
Using interviews with 74 drivers, we elicit and analyse how people think about collision coverage and, more generally, about insurance decisions. We compare the judgments and behaviours of these decision makers to the predictions of a range of theoretical models: (a) A model developed by Lee (200...
Full Text Available This article deals with a topical for our country problem which is related to the State Social Insurance. It provides a review of the factors having an adverse effect onto the financial state of the Bulgarian pension system. Discussed are the basic parameters related to the economic incentives in connection with the optimal functioning of the pension system
FLOREA IANC MARIA MIRABELA
Full Text Available Last few years have shown that Romania is not protected from the consequences of climate change. It is clear that type flood events may cause social problems and losses is difficult financing from public resources, especially in the context of the existence of budget constraints. The only viable system to cope with such disasters is insurance system that has the ability to spread risks by reinsurance Natural disasters - earthquakes, floods, landslides - are just some of the risks that may threaten your home. And if natural disasters can seem distant danger, think as fires, floods caused by broken pipes or theft of household goods are trouble can happen anytime to anyone. To protect yourself in such unpleasant situations, whose frequency is unfortunately on the rise, it is necessary to be assured. Thus, you will be able to recover losses in the event that they occur. The house is undoubtedly one of the most important assets we own. Therefore, the Romans began to pay increasingly more attention to domestic insurance products. Since 2011, voluntary home insurance, life insurance with, were the most dynamic segments of the market.
The current state and future trends for the world and domestic insurance markets are analyzed. The description of business intelligence methodology, tools and their practical implication for insurance companies are provided.
Full Text Available The current state and future trends for the world and domestic insurance markets are analyzed. The description of business intelligence methodology, tools and their practical implication for insurance companies are provided.
Full Text Available The paper presents the techniques and the formulas used on international practice for establishing the premiums for a life policy. The formulas are generally based on a series of indicators named mortality indicators which mainly point out the insured survival probability, the death probability and life expectancy at certain age. I determined, using a case study, the unique net premium, the annual net premium for a survival insurance, whole life insurance and mixed life insurance.
After democratic changes in 1990 and the declaration of independence in 1991, Croatia inherited an archaic system of economy, similar to all the other post-communist countries, which had especially negative effects on the health system. Health services were divided into 113 independent offices with their own local rules; they could not truly support the health care system, which gradually stagnated, both organizationally and technologically. Such an administrative system devoured 17.5% of the total funds, and primary care used only 10.3% of this. Despite the costly hospital medicine the entire system was financed with US$300 per citizen. The system was functioning only because of professionalism and enthusiasm of well-educated medical personnel. Such health policy had a negative effect on all levels of the system, with long-term consequences. The new health insurance system instituted a standard of 1,700 insureds per family medicine team, reducing hospital capacities to 3.8 beds per 1,000 citizens for acute illnesses. Computerization of the system makes possible the transparency of accounting income and expenses. In a relatively short period, in spite of the war, and in a complex, socially and ethically delicate area, Croatian Health Insurance Institute has successfully carried out the rationalization and control of spending, without lowering the level of health care or negatively influencing the vital statistics data.
Nkoy, Flory L; Stone, Bryan L; Knighton, Andrew J; Fassl, Bernhard A; Johnson, Joseph M; Maloney, Christopher G; Savitz, Lucy A
Collecting social determinants data is challenging. We assigned patients a neighborhood-level social determinant measure, the area of deprivation index (ADI), by using census data. We then assessed the association between neighborhood deprivation and asthma hospitalization outcomes and tested the influence of insurance coverage. A retrospective cohort study of children 2 to 17 years old admitted for asthma at 8 hospitals. An administrative database was used to collect patient data, including hospitalization outcomes and neighborhood deprivation status (ADI scores), which were grouped into quintiles (ADI 1, the least deprived neighborhoods; ADI 5, the most deprived neighborhoods). We used multivariable models, adjusting for covariates, to assess the associations and added a neighborhood deprivation status and insurance coverage interaction term. A total of 2270 children (median age 5 years; 40.6% girls) were admitted for asthma. We noted that higher ADI quintiles were associated with greater length of stay, higher cost, and more asthma readmissions ( P < .05 for most quintiles). Having public insurance was independently associated with greater length of stay (β: 1.171; 95% confidence interval [CI]: 1.117-1.228; P < .001), higher cost (β: 1.147; 95% CI: 1.093-1.203; P < .001), and higher readmission odds (odds ratio: 1.81; 95% CI: 1.46-2.24; P < .001). There was a significant deprivation-insurance effect modification, with public insurance associated with worse outcomes and private insurance with better outcomes across ADI quintiles ( P < .05 for most combinations). Neighborhood-level ADI measure is associated with asthma hospitalization outcomes. However, insurance coverage modifies this relationship and needs to be considered when using the ADI to identify and address health care disparities. Copyright © 2018 by the American Academy of Pediatrics.
This paper opens with some brief information about the Piper Alpha loss, how the loss was handled and its final cost. More importantly, it discusses the effect of the Piper Alpha loss on the world insurance market including the oil insurance captives such as O.I.L Limited. Finally, the insurance market current status and prognosis for the future are considered. (Author)
Fouladvand, M. Ebrahim; Darooneh, Amir H.
We present an analytical study of an insurance company. We model the company's performance on a statistical basis and evaluate the predicted annual income of the company in terms of insurance parameters namely the premium, total number of the insured, average loss claims etc. We restrict ourselves to a single insurance class the so-called automobile insurance. We show the existence a crossover premium p_c below which the company is loss-making. Above p_c, we also give detailed statistical ana...
Full Text Available Providing insurance contract with “deductible” is beneficial for both insurer and insured. In this paper, we provide a utility modeling approach to handle insurance pricing and evaluate the tradeoff between discount benefit and deductible level. We analyze four different pricing problems of no insurance, full insurance coverage, insurance with β% deductible and insurance with D-dollar deductible based on a given utility function. A numerical example is also used to illustrate some interesting results.
Dranove, D; White, W D; Wu, L
This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice.
... total amount of war risk insurance obtainable from companies authorized to do an insurance business in a... MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Builder's Risk Insurance § 308.403 Insured amounts. (a) Prelaunching period. The amount insured during...
Boone, Jan; Schottmüller, Christoph
Standard insurance models predict that people with high risks have high insurance coverage. It is empirically documented that people with high income have lower health risks and are better insured. We show that income differences between risk types lead to a violation of single crossing...... in an insurance model where people choose treatment intensity. We analyse different market structures and show the following: If insurers have market power, the violation of single crossing caused by income differences and endogenous treatment choice can explain the empirically observed outcome. Our results do...
Full Text Available Background: Little research has focused on the economic hardship among the insured with severe illnesses and high treatment costs, in particular, the consequence of poorer insurance coverage for high-cost illnesses. Therefore, we presented the case for identifying the experiences of insured patients with severe chronic and acute illnesses. This study identified a qualitative understanding of the economic impact of severe chronic and acute illnesses and household strategies to deal with high treatment costs. Design: Interviews were conducted with 19 insured households of three different health insurance programs with a family member that had been hospitalized for severe chronic or acute illnesses in either Banyumas or Margono Sukarjo hospitals in Banyumas, Central Java, Indonesia. A thematic analysis was applied to guide the interpretation of the data. Results: Insured households with a family member that had been hospitalized for severe chronic and acute illnesses were greatly affected by the high treatment costs. Four major issues emerged from this qualitative study: insured patients are still burdened with high out-of-pocket payments, households adopt various strategies to cope with the high cost of treatments, households experience financial hardships, and positive and negative perceptions of the insured regarding their health insurance coverage for acute and chronic illnesses. Conclusions: Askes and Jamsostek patients faced financial burdens from high cost sharing for hospital amenities, non-covered drugs, and treatments and other indirect costs. Meanwhile, Jamkesmas beneficiaries faced no financial burden for related medical services but were rather burdened with indirect costs for the carers. Households relied on internal resources to cover hospital bills as the first strategy, which included the mobilization of savings, sale of assets, and borrowing of money. External support was tapped secondarily and included financial support from
Hung, Hung-Chih; Hung, Jia-Yi
1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability
This book is a compilation of 21 papers presented at the International Cramér Symposium on Insurance Mathematics (ICSIM) held at Stockholm University in June, 2013. The book comprises selected contributions from several large research communities in modern insurance mathematics and its applications. The main topics represented in the book are modern risk theory and its applications, stochastic modelling of insurance business, new mathematical problems in life and non-life insurance, and related topics in applied and financial mathematics. The book is an original and useful source of inspiration and essential reference for a broad spectrum of theoretical and applied researchers, research students and experts from the insurance business. In this way, Modern Problems in Insurance Mathematics will contribute to the development of research and academy–industry co-operation in the area of insurance mathematics and its applications.
The author analyses the papers presented at the Paris Conference on the maturity of nuclear energy. It is evident that financing possibilities will be a determinant factor in the rate of development of nuclear power during the years to come. After having evaluated the capital requirements necessitated for the development of nuclear programmes, the parties intervening have examined the means at the disposal of electricity manufacturers to meet these needs (self-financing, recourse to external financing, regrouping, on an international scale of the electricity manufacturers of the setting up of high capacity plants). As concerns the insurance problems, they are becoming more and more involved as nuclear applications, are further diversified and intensified. The parties intervening have discussed new tarification techniques likely to be applied and pointed out the possibilities offered by regrouping or pooling of insurers (Market Pool) which allow for a maximum of risks to be covered without exceeding the means proper to each company concerned [fr
It examines the technical, scientific and legal issues relating to the peaceful use of atomic energy in Turkey. The first fifteen chapters give a general overview of the atom and radioactivity; the chapters which follow this section are more technical and deal with the causes of nuclear accidents in reactors.A number of chapters cover legal issues, for example the conditions and procedures involved in the insurance market and the risks linked to operation of a nuclear power plant.The following subjects are examined in relation to nuclear insurance: risks during construction; fire during operation of the plants and other causes of accidents; risks due to the transport of radioactive materials and waste etc. The final chapters reproduce the principle legislative texts in force in Turkey in the field of nuclear energy, and also certain regulations which establish competent regulatory bodies
Gerber, Hans U
This concise introduction to life contingencies, the theory behind the actuarial work around life insurance and pension funds, will appeal to the reader who likes applied mathematics. In addition to model of life contingencies, the theory of compound interest is explained and it is shown how mortality and other rates can be estimated from observations. The probabilistic model is used consistently throughout the book. Numerous exercises (with answers and solutions) have been added, and for this third edition several misprints have been corrected.
W.P.M.M. van de Ven (Wynand); F.T. Schut (Erik)
textabstractIn 1988 the Dutch government launched a proposal for a national health insurance based on regulated competition. The mandatory benefits package should be offered by competing insurers and should cover both non-catastrophic risks (like hospital care, physician services and drugs) and
Full Text Available Under L-type economy, remodelling the growth power in the medium and long term is essential. The insurance industry during the 13th Five-year Plan period has been given a heavy expectation on promoting economic quality and upgrading economic efficiency, so it will try to accelerate its innovation and development process which serves national needs, market demand and people's requirements. Referring to the previous researches of Solow and Zhang and measuring Capital Stock and Total Factor Productivity independently, the paper analyses the inherent correlation between insurance (including life insurance and non-life insurance and economic growth, reveals the contribution law of the insurance development in economic growth in the short and long term from both economic scale and quality respectively. It also shows enlightenments on policy decision for insurance industry, thus helps economic stability under the downturn periods.
Electrical utility companies have invested large sums in the establishment of nuclear facilities. For this reason it is normal for these companies to attempt to protect their investments as much as possible. One of the methods of protection is recourse to insurance. For a variety of reasons traditional insurance markets are unable to function normally for a number of reasons including, the insufficient number of risks, an absence of meaningful accident statistics, the enormous sums involved and a lack of familiarity with nuclear risks on the part of insurers, resulting in a reluctance or even refusal to accept such risks. Insurers have, in response to requests for coverage from nuclear power station operators, established an alternative system of coverage - insurance through a system of insurance pools. Insurers in every country unite in a pool, providing a net capacity for every risk which is a capacity covered by their own funds, and consequently without reinsurance. All pools exchange capacity. The inconvenience of this system, for the operators in particular, is that it involves a monopolistic system in which there are consequently few possibilities for the negotiation of premiums and conditions of coverage. The system does not permit the establishment of reserves which could, over time, reduce the need for insurance on the part of nuclear power station operators. Thus the cost of nuclear insurance remains high. Alternatives to the poor system of insurance are explored in this article. (author)
We analyze dynamic interactions between market insurance, the stock of insurable assets and liquid wealth accumulation in a model with non-durable and durable consumption. The stock of the durable is exposed to risk against which households can insure. Since the model does not have a closed form solution we first provide an analytical approximation for the case in which households own abundant liquid wealth. It turns out that precautionary motives still matter because of fluctuations of the p...
Becker, Edmund R.; Steinwald, Bruce
Using the Commission on Professional and Hospital Activities' Resource Need Index as a measure of casemix complexity, this paper examines the relative contributions of teaching commitment and other hospital characteristics, hospital service and insurer distributions, and area characteristics to variations in casemix complexity. The empirical estimates indicate that all three types of independent variables have a substantial influence. These results are discussed in light of recent casemix research as well as current policy implications. PMID:6799430
... (PQRS), the Children's Health Insurance Program (CHIP), and the Pioneer Accountable Care Organization... No. 93.773, Medicare--Hospital Insurance; and Program No. 93.774, Medicare-- Supplementary Medical...
Polyakova, Maria; Bundorf, M Kate; Kessler, Daniel P; Baker, Laurence C
To examine the association between annual premiums for health plans available in Federally Facilitated Marketplaces (FFMs) and the extent of competition and integration among physicians and hospitals, as well as the number of insurers. We used observational data from the Center for Consumer Information and Insurance Oversight on the annual premiums and other characteristics of plans, matched to measures of physician, hospital, and insurer market competitiveness and other characteristics of 411 rating areas in the 37 FFMs. We estimated multivariate models of the relationship between annual premiums and Herfindahl-Hirschman indices of hospitals and physician practices, controlling for the number of insurers, the extent of physician-hospital integration, and other plan and rating area characteristics. Premiums for Marketplace plans were higher in rating areas in which physician, hospital, and insurance markets were less competitive. An increase from the 10th to the 90th percentile of physician concentration and hospital concentration was associated with increases of $393 and $189, respectively, in annual premiums for the Silver plan with the second lowest cost. A similar increase in the number of insurers was associated with a $421 decrease in premiums. Physician-hospital integration was not significantly associated with premiums. Premiums for FFM plans were higher in markets with greater concentrations of hospitals and physicians but fewer insurers. Higher premiums make health insurance less affordable for people purchasing unsubsidized coverage and raise the cost of Marketplace premium tax credits to the government.
on the theme, originally proposed by Fischer Black. In CPPI, a financial institution guarantees a floor value for the “insured” portfolio and adjusts the stock/bond mix to produce a leveraged exposure to the risky assets, which depends on how far the portfolio value is above the floor. Plain-vanilla portfolio...... insurance largely died with the crash of 1987, but CPPI is still going strong. In the frictionless markets of finance theory, the issuer’s strategy to hedge its liability under the contract is clear, but in the real world with transactions costs and stochastic jump risk, the optimal strategy is less obvious...
The present paper debates the main aspects related to ethics, into an industry that recorded exponential growth in Romania insurance field. A very important role for a good business is enhanced by the ethics. The specialists appreciate that ethics represent a key factor for business success. Obviously, the insurance field into a competition market must follow all the aspects related to ethics. The ethics should be an essential element of every insurance company management. If we talk about et...
Jha, Saurabh; Baker, Tom
Insurance plays an important role in the United States, most importantly in but not limited to medical care. The authors introduce basic economic concepts that make medical care and health insurance different from other goods and services traded in the market. They emphasize that competitive pricing in the marketplace for insurance leads, quite rationally, to risk classification, market segmentation, and market failure. The article serves as a springboard for understanding the basis of the reforms that regulate the health insurance market in the Patient Protection and Affordable Care Act. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.
... mutual), mutual marine insurance companies, and mutual fire insurance companies issuing perpetual... companies (other than life or mutual), mutual marine insurance companies, and mutual fire insurance... insurance companies and mutual fire insurance companies exclusively issuing either perpetual policies, or...
This article discusses how a special library can meet the needs of a specific industry. The author focuses on India's National Insurance Academy (NIA) Library, which serves the insurance industry of India and some neighboring countries. It is where the author serves as the chief librarian.
Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa
States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.
...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 85 (as of June 2013) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...
...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 82 (as of April, 2012) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...
... to know what your insurance company is paying…Health Insurance: Understanding What It CoversRead Article >>Insurance & BillsHealth Insurance: Understanding What It CoversYour insurance policy lists a package of medical benefits such as tests, drugs, and treatment services. These ...
Rosen, Anita; Lynch, Margaret E.
This booklet is intended to help students gain a broad understanding of the meaning, characteristics, organization, products, and functions of the insurance industry. The following topics are discussed: the concept of and need for insurance; basic principles of insurance (risk assessment, insurability and insurable interest, determination of…
Full Text Available The researchers analyzed how different regions in the USA, family structure, ethnicity, and family income levels influenced the selection and utilization of medical care programs and services by American children. To prevent any possible bias in the analysis and to produce reliable results, an endogenous switching model was utilized in the study. The researchers found no statistically significant differences in the number of doctor visits and hospital stays between children with insurance and children without insurance. However, significant differences were determined regarding family structure, family income, geographic regions, and ethnicity. Children from single-parent families with insurance coverage (private, Medicaid, or SCHIP had statistically higher rates of doctor visits and hospital stays than children from two-parent families with insurance coverage. Family income, region, and ethnicity variables all had significant impacts on the type of health insurance coverage that was reported for children.
Li, Yiting; Miranda, Mario J.
Conventional agricultural index insurance indemnifies based on the observed value of a specified variable, such as rainfall, that is correlated with agricultural production losses. Typically, indemnities are paid to the policyholder after the losses have been experienced. This paper explores alternate timing for index insurance payouts. In particular, we explore the potential benefits of what we call “mitigation index insurance” in which the payouts of the insurance contract arrive before los...
Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue
evaluated the effects of strategies on increasing health insurance coverage for vulnerable populations. We defined strategies as measures to improve the enrolment of vulnerable populations into health insurance schemes. Two categories and six specified strategies were identified as the interventions. At least two review authors independently extracted data and assessed the risk of bias. We undertook a structured synthesis. We included two studies, both from the United States. People offered health insurance information and application support by community-based case managers were probably more likely to enrol their children into health insurance programmes (risk ratio (RR) 1.68, 95% confidence interval (CI) 1.44 to 1.96, moderate quality evidence) and were probably more likely to continue insuring their children (RR 2.59, 95% CI 1.95 to 3.44, moderate quality evidence). Of all the children that were insured, those in the intervention group may have been insured quicker (47.3 fewer days, 95% CI 20.6 to 74.0 fewer days, low quality evidence) and parents may have been more satisfied on average (satisfaction score average difference 1.07, 95% CI 0.72 to 1.42, low quality evidence).In the second study applications were handed out in emergency departments at hospitals, compared to not handing out applications, and may have had an effect on enrolment (RR 1.5, 95% CI 1.03 to 2.18, low quality evidence). Community-based case managers who provide health insurance information, application support, and negotiate with the insurer probably increase enrolment of children in health insurance schemes. However, the transferability of this intervention to other populations or other settings is uncertain. Handing out insurance application materials in hospital emergency departments may help increase the enrolment of children in health insurance schemes. Further studies evaluating the effectiveness of different strategies for expanding health insurance coverage in vulnerable population are
Kim, Hye Yeong; Lee, Jinhyung
The widespread adoption of health information technology (IT) will help contain health care costs by decreasing inefficiencies in healthcare delivery. Theoretically, health IT could lower hospitals' malpractice insurance premiums (MIPs) and improve the quality of care by reducing the number and size of malpractice. This study examines the relationship between health IT investment and MIP using California hospital data from 2006 to 2007. To examine the effect of hospital IT on malpractice insurance expense, a generalized estimating equation (GEE) was employed. It was found that health IT investment was not negatively associated with MIP. Health IT was reported to reduce medical error and improve efficiency. Thus, it may reduce malpractice claims from patients, which will reduce malpractice insurance expenses for hospitals. However, health IT adoption could lead to increases in MIPs. For example, we expect increases in MIPs of about 1.2% and 1.5%, respectively, when health IT and labor increase by 10%. This study examined the effect of health IT investment on MIPs controlling other hospital and market, and volume characteristics. Against our expectation, we found that health IT investment was not negatively associated with MIP. There may be some possible reasons that the real effect of health IT on MIPs was not observed; barriers including communication problems among health ITs, shorter sample period, lower IT investment, and lack of a quality of care measure as a moderating variable.
Jentzsch, Thorsten; Neuhaus, Valentin; Seifert, Burkhardt; Osterhoff, Georg; Simmen, Hans-Peter; Werner, Clément M L; Moos, Rudolf
The socioeconomic status has been associated with disparities in the incidence and mortality of traumatic injuries. However, there is a lack of studies on the level of health insurance with regard to various epidemiologic data of traumatic injuries, which this study opted to clarify. All consecutive 6595 patients admitted to a level one trauma center in 2012 and 2013 were included in this retrospective cohort study. Patients were grouped according to their health insurance status (public versus private extended health care insurance) and compared with regard to several epidemiologic variables, that is, the type of injuries, inhospital outcome, and surgical procedures. Public insurance coverage was significantly more common than private insurance (75% versus 25%). Public insurance was associated with younger age, male sex, transfers to another hospital or mental institution, head concussions, head fractures, and increased mortality. Contrarily, patients with private insurance were more often associated with longer hospital stay, discharge to a rehabilitation clinic, fractures of the proximal humerus, and shoulder dislocations. However, there were no significant differences for the remaining majority of studied variables. In a trauma setting, the level of insurance does not seem to play a crucial role in most types of injuries and surgical procedures in a country with a high level of obligatory health care coverage. Nonetheless, it appears that publicly insured patients are more commonly younger, males, transferred to another hospital more often, more prone to head trauma, and subject to increased mortality, whereas privately insured patients show longer hospital stays, increased transfers to rehabilitation clinics, and more fractures of the proximal humerus. Copyright © 2016 Elsevier Inc. All rights reserved.
... insurance industry traces its roots back to England, where, in 1696, the first mutual fire insurer was... FEDERAL DEPOSIT INSURANCE CORPORATION 12 CFR Part 380 RIN 3064-AD89 Mutual Insurance Holding Company Treated as Insurance Company AGENCY: Federal Deposit Insurance Corporation (FDIC). ACTION: Notice...
Plantinga, A; Huijgen, C
In this article, the authors develop an attribution framework for evaluating the investment performance of institutional investors such as insurance companies. The model is useful in identifying the investment skills of insurance companies. This is accomplished by developing a dual benchmark for the
Baran, Nancy H., Ed.
This booklet provides some practical guidelines for determining total insurance needs, examining options, and comparing costs. It discusses how to fit insurance costs into an overall financial plan, the necessity of adequate liability coverage, and the importance of keeping policies up to date. The next four sections highlight the basic types of…
Skold, Melvin D.; Davis, Robert M.
The incidence of benefits and costs from controlling rangeland grasshoppers on public grazing lands poses problems of economic efficiency and distributional equity. Public grasshopper control programs operate like public disaster assistance. However, grasshopper infestations are an insurable risk. This article proposes a rangeland grasshopper insurance program which reduces the economic inefficiencies and distributional inequities of the existing program.
Andersen, Torben M.; Svarer, Michael
The consequences of business cycle contingencies in unemployment insurance systems are considered in a search-matching model allowing for shifts between "good" and "bad" states of nature. We show that not only is there an insurance argument for such contingencies, but there may also be an incentive...
The paper examines Russian banks’ household deposit interest rates for the transition period of setting up the deposit insurance system. Monthly observations of Russian banks’ interest rates and balance sheets are used in a fixed effects panel data model. It is shown market discipline has been significantly diminished after switching to the deposit insurance.
... REPAIRS UNDER NATIONAL SHIPPING AUTHORITY MASTER LUMP SUM REPAIR CONTRACT-NSA-LUMPSUMREP Sec. 13 Insurance. Article 9 of the NSA-LUMPSUMREP Contract sets forth the Contractor's liabilities and obligations with... 46 Shipping 8 2010-10-01 2010-10-01 false Insurance. Sec. 13 Section 13 Shipping MARITIME...
... recipient. Federally-owned property need not be insured unless required by the terms and conditions of the... Standards § 3019.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance...
... recipient. Federally-owned property need not be insured unless required by the terms and conditions of the... § 95.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage...
... Student Health Insurance Coverage AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION... health insurance coverage under the Public Health Service Act and the Affordable Care Act. The proposed rule would define ``student health insurance [[Page 7768
...-economic circumstances and drug needs. Volume two presents an analysis of the un-insured and under-insured by measuring the extent to which Canadians have access to insurance for prescription drug expenses and the quality of that coverage...
The Price-Anderson Act is discussed, which establishes procedures for insuring nuclear facilities (including nuclear power plants). The act was enacted with the dual purpose of protecting the public and encouraging the development of a private nuclear energy industry. Criticisms that can generally be grouped into four categories regarding the Act are presented, the most controversial aspect being that should an accident occur, the aggregate liability of the reactor operator, the NRC, or any others who might be at fault is limited to $560 million. Lawsuits for amounts in excess of $560 million are prohibited. The 1975 renewal of the Price-Anderson Act does provide that damages in excess of the $560 million prompt Congress to review the particular incident and take action to protect the public from the consequences of a disaster of such magnitude
David M Dror
Full Text Available Background & objectives: The evidence-base of the impact of community-based health insurance (CBHI on access to healthcare and financial protection in India is weak. We investigated the impact of CBHI in rural Uttar Pradesh and Bihar s0 tates of India on insured households′ self-medication and financial position. Methods: Data originated from (i household surveys, and (ii the Management Information System of each CBHI. Study design was "staggered implementation" cluster randomized controlled trial with enrollment of one-third of the treatment group in each of the years 2011, 2012 and 2013. Around 40-50 per cent of the households that were offered to enroll joined. The benefits-packages covered outpatient care in all three locations and in-patient care in two locations. To overcome self-selection enrollment bias, we constructed comparable control and treatment groups using Kernel Propensity Score Matching (K-PSM. To quantify impact, both difference-in-difference (DiD, and conditional-DiD (combined K-PSM with DiD were used to assess robustness of results. Results: Post-intervention (2013, self-medication was less practiced by insured HHs. Fewer insured households than uninsured households reported borrowing to finance care for non-hospitalization events. Being insured for two years also improved the HH′s location along the income distribution, namely insured HHs were more likely to experience income quintile-upgrade in one location, and less likely to experience a quintile-downgrade in two locations. Interpretation & conclusions: The realized benefits of insurance included better access to healthcare, reduced financial risks and improved economic mobility, suggesting that in our context health insurance creates welfare gains. These findings have implications for theoretical, ethical, policy and practice considerations.
This paper considers a housing insurance market in which buildings have different damage probabilities. Insurers use imperfect tests to find out about buildings’ damage types. The insurance market is a natural monopoly. If more than one insurer is active, high risk house owners continue to apply to insurers until they are eventually assigned to a low-risk class. First we show that the natural insurance monopoly need not be sustainable. Then we show that in the equilibrium industry structure t...
Full Text Available This article provides a case study that analyzes national macroprudential insurance regulation in Switzerland. We consider an insurance market that is based on data from the Swiss private insurance industry. We stress this market with several scenarios related to financial and insurance risks, and we analyze the resulting risk capitals of the insurance companies. This stress-test analysis provides insights into the vulnerability of the Swiss private insurance sector to different risks and shocks.
Philippe Deprez; Mario V. Wüthrich
This article provides a case study that analyzes national macroprudential insurance regulation in Switzerland. We consider an insurance market that is based on data from the Swiss private insurance industry. We stress this market with several scenarios related to financial and insurance risks, and we analyze the resulting risk capitals of the insurance companies. This stress-test analysis provides insights into the vulnerability of the Swiss private insurance sector to different risks and sho...
ME Le Roux
Full Text Available Insurance provided by captive insurers is one of various forms of risk financing. The nature and main types of captive insurance companies are discussed. This is followed by the results of an empirical study that focused on South African onshore captive insurance companies. The objectives in establishing and operating a captive insurer, the factors which determine the decision of the parent company to establish and operate a captive insurer and the future and usefulness of insurance provided by captive insurers are some of the aspects that are addressed.
The United Nations Environment Programme assesses that the cost of adaptation to climate change could reach 150 billions dollars per year by 2025-2030 and 500 billions dollars by 2050. This raises the issues of financing of adaptation measures, and of compensations in case of natural disaster, and insurance companies here seem to have a major role to play. However, the modification of the climatic risk puts the viability of conventional insurance mechanisms into question again. While discussing these issues, the author outlines that a sustainable insurance against these evolving risks may threaten insurance companies to go to bankrupt, but also all their policyholders who are, for most of them, unable to cope by themselves with the consequences of an extreme climatic event. The author also discusses related aspects such as risk modelling, risk mutualization, a securing of insurance companies based on the financial market, the implementation of public-private partnership, and ways to insure climate anomalies. She also comments the commitment of the insurance sector in adaptation and mitigation policies
Protocol for the management of rheumatic diseases in the insured population of the CCSS, attached to the Hospital Mexico, presentation of a proposal for the management and monitoring of the most prevalent rheumatic diseases: rheumatoid arthritis
Molina Guevara, Erick
The protocols for the care of rheumatic diseases are designed to disseminate guidelines for early diagnosis and timely referral, for application in networks and for patient access to early treatment. A protocol of clinical practice is presented following the institutional guidelines, based on bibliography that could be implemented in the Costa Rican social security, these documents were discussed and validated locally by the Rheumatology service of the Hospital Mexico allowing protocolarizing the attention of the Rheumatoid Arthritis. For the construction of a clinical care protocol, the methodological manual of the DDSS code M.GM.DDSS.007 Version 01 CCSS, 2013 was used. The evidence was searched and selected from the following places: Medline, Tripdatabase, GIN network; This selection was made based on critical reading under the methodology of the Caspe Group, and the best available evidence was used, after discussing it in the sessions of the rheumatology service [es
Bovenberg, Lans; Sørensen, Peter Birch
We study optimal social insurance aimed at insuring disability risk in the presence of linear income taxation. Optimal disability insurance benefits rise with previous earnings. Optimal insurance is incomplete even though disability risks are exogenous and verifiable so that moral hazard in disab...... in disability insurance is absent. Imperfect insurance is optimal because it encourages workers to insure themselves against disability by working and saving more, thereby alleviating the distortionary impact of the redistributive income tax on labor supply and savings.......We study optimal social insurance aimed at insuring disability risk in the presence of linear income taxation. Optimal disability insurance benefits rise with previous earnings. Optimal insurance is incomplete even though disability risks are exogenous and verifiable so that moral hazard...
Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue
) studies and Interrupted time series (ITS) studies that evaluated the effects of strategies on increasing health insurance coverage for vulnerable populations. We defined strategies as measures to improve the enrolment of vulnerable populations into health insurance schemes. Two categories and six specified strategies were identified as the interventions. Data collection and analysis At least two review authors independently extracted data and assessed the risk of bias. We undertook a structured synthesis. Main results We included two studies, both from the United States. People offered health insurance information and application support by community-based case managers were probably more likely to enrol their children into health insurance programmes (risk ratio (RR) 1.68, 95% confidence interval (CI) 1.44 to 1.96, moderate quality evidence) and were probably more likely to continue insuring their children (RR 2.59, 95% CI 1.95 to 3.44, moderate quality evidence). Of all the children that were insured, those in the intervention group may have been insured quicker (47.3 fewer days, 95% CI 20.6 to 74.0 fewer days, low quality evidence) and parents may have been more satisfied on average (satisfaction score average difference 1.07, 95% CI 0.72 to 1.42, low quality evidence). In the second study applications were handed out in emergency departments at hospitals, compared to not handing out applications, and may have had an effect on enrolment (RR 1.5, 95% CI 1.03 to 2.18, low quality evidence). Authors' conclusions Community-based case managers who provide health insurance information, application support, and negotiate with the insurer probably increase enrolment of children in health insurance schemes. However, the transferability of this intervention to other populations or other settings is uncertain. Handing out insurance application materials in hospital emergency departments may help increase the enrolment of children in health insurance schemes. Further studies
Fragnelli, Vito; Marina, Maria Erminia
We consider environmental risks that are evaluated too much heavy for a single insurance company, but they can be insured by n companies which a premium is assigned to.This is precisely the Italian scenario where a pool of companies co-insures these risks.Under a game theoretic approach we start by analyzing how they should split the risk and the premium in order to be better off. Under suitable hypotheses, there exists an optimal decomposition of the risk, that allow us to define a cooperati...
Full Text Available Many developing countries promote social health insurance as a means to eliminate unmet health needs. However, this strategy may be ineffective if there are barriers to fully utilizing insurance.We analyzed the utilization of social health insurance in 30 hospital districts in the central regions of the Philippines between 2003 and 2007. Data for the study came from the Quality Improvement Demonstration Study (QIDS and included detailed patient information from exit interviews of children under 5 years of age conducted in seven waves among public hospital districts located in the four central regions of the Philippines. These data were used to estimate and identify predictors of underutilization of insurance benefits--defined as the likelihood of not filing claims despite having legitimate insurance coverage--using logistic regression.Multivariate analyses using QIDS data from 2004 to 2007 reveal that underutilization averaged about 15% throughout the study period. Underutilization, however, declined over time. Among insured hospitalized children, increasing length of stay in the hospital and mother's education, were associated with less underutilization. Being in a QIDS intervention site was also associated with less underutilization and partially accounts for the downward trend in underutilization over time.The surprisingly high level of insurance underutilization by insured patients in the QIDS sites undermines the potentially positive impact of social health insurance on the health of the marginalized. In the Philippines, where the largest burden of health care spending falls on households, underutilization suggests ineffective distribution of public funds, failing to reach a significant proportion of households which are by and large poor. Interventions that improve benefit awareness may combat the problem of underutilization and should be the focus of further research in this area.
Full Text Available Insurance is a contract made by a company or society, or by the state, to provide a guarantee for loss, damage, illness, death etc in return for regular payments. In other words it is a means by which one pays a relatively small known cost for protection against an uncertain and much larger cost. Still, this contract (insurance policy makes it possible for the insured to cover only losses that are measurable in terms of money and caused strictly by hazardous events, independent from own doing. If no such events should happen, the benefits won’t exist in a tangible, material form, but will take the shape of security against ruin. Since the insurance industry has developed more during the last decade due to the powerful players that have entered the market, the services provided by the insurance companies, and not only their products have evolved a lot in order to meet the requirements of the consumers, and to make them familiar with this type of investments. Therefore all the means of advertising became essential in this process of implementation and familiarization with this area of activity: mass-media advertising, insurance brokerage companies, the internet are all parts of this process.
Manne, A.S.; Richels, R.G.
A growing concern that the increasing accumulation of greenhouse gases will lead to undesirable changes in global climate has resulted in proposals, both in the United States and internationally, to set physical targets for reducing greenhouse gas emissions. But what will these proposals cost? This book outlines a way to think about greenhouse-effect decisions under uncertainty. It describes an insightful model for determining the economic costs of limiting CO 2 emissions produced by burning fossil fuels and provides a solid analytical base for rethinking public policy on the far-reaching issue of global warming. It presents region-by-region estimates of the costs that would underlie an international agreement. Using a computer model known as Global 2100, they analyze the economic impacts of limiting CO 2 emissions under alternative supply and conservation scenarios. The results clearly indicate that a reduction in emissions is not the sole policy response to potential climate change. Following a summary of the greenhouse effect, its likely causes, and possible consequences, this book takes up issues that concern the public at large. They provide an overview of Global 2100, look at how the U.S. energy sector is likely to evolve under business-as-usual conditions and under carbon constraints, and describe the concept of greenhouse insurance. They consider possible global agreements, including an estimate of benefits that might result from trading in an international market in emission rights. They conclude with a technical description directed toward modeling specialists
Napier, Rebecca H; Bruelheide, Lori S; Demann, Eric T K; Haug, Richard H
The purpose of this article is to highlight the importance of understanding various numeric and alpha-numeric codes for accurately billing dental and medically related services to private pay or third-party insurance carriers. In the United States, common dental terminology (CDT) codes are most commonly used by dentists to submit claims, whereas current procedural terminology (CPT) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD.9.CM) codes are more commonly used by physicians to bill for their services. The CPT and ICD.9.CM coding systems complement each other in that CPT codes provide the procedure and service information and ICD.9.CM codes provide the reason or rationale for a particular procedure or service. These codes are more commonly used for "medical necessity" determinations, and general dentists and specialists who routinely perform care, including trauma-related care, biopsies, and dental treatment as a result of or in anticipation of a cancer-related treatment, are likely to use these codes. Claim submissions for care provided can be completed electronically or by means of paper forms.
...) Windstorm Coverage. (ii) Earthquake Coverage. (iii) Sinkhole Insurance or Mine Subsidence Insurance. (3) For... the coverage amount. (v) Sinkhole Insurance or Mine Subsidence Insurance. The deductible for sinkhole.... (10) Deductible amounts (excluding flood, windstorm, earthquake and sinkhole insurance or mine...
Meltem Daysal, N.
In this paper, I examine the impact of uninsured patients on the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999–2006). My results indicate that uninsured patients have an economically
Bose, Indranil; Liu, Han; Ye, Alex
The patients receiving treatment from a hospital need to interact with multiple entities when claiming reimbursements. The complexities of the medical service supply chain can be simplified with an electronic clearance management system that allows hospitals, medical insurance bureau, bank, and patients to interact in a seamless and cashless…
Rykova Valentina V.
he article describes information resources to support research on the issue of environmental insurance. It represents a brief analysis of a documentary flow, traces its dynamics and typical-thematic structures, shows the most productive journals
Kansas Data Access and Support Center — This digital data set provides an inventory of Federal Emergency Management Agency (FEMA) Flood Insurance Studies (FIS) that have been conducted for communities and...
Che Mohd Imran Che Taib
Full Text Available The aim of this paper is to study pricing of weather insurance contracts based on temperature indices. Three different pricing methods are analysed: the classical burn approach, index modelling and temperature modelling. We take the data from Malaysia as our empirical case. Our results show that there is a significant difference between the burn and index pricing approaches on one hand, and the temperature modelling method on the other. The latter approach is pricing the insurance contract using a seasonal autoregressive time series model for daily temperature variations, and thus provides a precise probabilistic model for the fine structure of temperature evolution. We complement our pricing analysis by an investigation of the profit/loss distribution from the contract, in the perspective of both the insured and the insurer.
Department of Housing and Urban Development — The FHA insured Multifamily Housing portfolio consist primarily of rental housing properties with five or more dwelling units such as apartments or town houses, but...
Gomez del Campo, Julian.
The purpose of this paper is to study the problems raised in Spain by third party liability insurance for nuclear damage. National law in this field is based on the Paris Convention on nuclear third party liability and defines the conditions of liability of operators of nuclear installations. The insurance contract requirements must comply with the regulations on cover for nuclear risks, under the control of the Finance Ministry's competent services. Certain exceptional nuclear risks which cannot be covered entirely by ordinary insurance policies, are taken over by the Consorcio de Compensacion de Seguros which belongs to this Ministry. From the insurance viewpoint, the regulations make a distinction between nuclear and radioactive installations and nuclear transport. (NEA) [fr
.... The final regulations clarify that these benefits constitute health insurance when they are offered by... insurance. Limited Scope Dental and Vision Benefits The proposed regulations defined health insurance to... revising the definition of health insurance to exclude limited scope dental and vision benefits (sometimes...
From the commencement of building to the time of decommissioning of nuclear power plants, the insurances provide continuous coverage, i.e. for construction, nuclear liability, nuclear energy hazards insurance, fire insurance, machinery insurance. The respective financial security is quantified. (DG) [de
Full Text Available Insurance companies carry out risk spreading through the co-insurance and reinsurance mechanism, consisting of the participation of more companies in the provision of high-value assets. Reinsurance is a form of insurance whereby an insurance organization can transfer to another reinsurer, partly or fully, its payment obligations arising from the insurance contracts that it has concluded. In the reinsurance ratios, the insurance companies appear in a double position - giving other insurance companies some of the risks assumed under direct insurance, being reinsured, but receiving different risks to reinsurance, acquiring the quality of reinsurers. Reinsurance intends to satisfy some multiple needs of the direct insurer and can provide means to counteract the risks associated with the fluctuations in compensation costs, the reinsurer will contribute to the payment of compensations on behalf of the reinsurer. Life insurance has characteristics that influence reinsurance: the average life of the insurance, the insurance is concluded for a fixed amount insured, the capital accumulation. In life reinsurance, almost all reinsurance arrangements are proportional agreements, and the largest share have the "surplus" agreements. Reinsurance plays an important role because it fulfills the following functions: it confers capacity, creates stability, helps to consolidate financial strength. The adjustment of the client portfolio in terms of the changes of reinsurance agreement, required by the reinsurer, can only be done by concluding the insurance contracts. In life insurance, reinsurance contracts contain provisions that meet the need of the insurer to have long-term protection.
... NHTSA's regulation requiring motor vehicle insurers to submit information on the number of thefts and recoveries of insured vehicles and actions taken by the insurer to deter or reduce motor vehicle theft. NHTSA..., which requires insurers to submit information about the make, model, and year of all vehicle thefts, the...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance endorsement. 266.612... Rights and Obligations Insurance Endorsement § 266.612 Insurance endorsement. (a) Initial endorsement. The Commissioner shall indicate his or her insurance of the mortgage by endorsing the original credit...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance benefits. 207.259 Section... Contract of Insurance § 207.259 Insurance benefits. (a) Method of payment. Upon either an assignment of the... of mortgage. If the mortgage is assigned to the Commissioner, the insurance benefits shall be paid in...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance premiums. 241.805 Section... Without a HUD-Insured or HUD-Held Mortgage Premiums § 241.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium. The...
... 34 Education 3 2010-07-01 2010-07-01 false Insurance premium. 682.505 Section 682.505 Education... § 682.505 Insurance premium. (a) General. The Secretary charges the lender an insurance premium for each Federal GSL Program loan that is guaranteed, except that no insurance premium is charged on a Federal...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance premiums. 220.804 Section... and Obligations-Projects Insured Project Improvement Loans § 220.804 Insurance premiums. (a) First premium. The lender, upon the initial endorsement of the loan for insurance, shall pay to the Commissioner...
Roemer, M I
Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.
By the declared will of the legislative bodies to give effect to the polluter pays principle on all levels those have to pay the costs of removing impairments of environmental media that are responsible for its occurence. Thus environmental pollution becomes a considerable financial risk for the polluter. Against this risk they try to protect themselves by the corresponding precautionary measures, e.g. by insurance. The insurance industry is consequently requested to meet this new demand. The legal bases are followed by the description of the insurance relationship under the aspect of the theory of risks, which follows, based on the basic model of decision theory, the objective of a quantitative representation of the situation of the decision. In the last chapter the author deals with the financial security for the risks of a third party liability insurance of environmental pollution as it is offered today in the Federal Republic of Germany. The elaboration of the existing financial security is then compared with the legal conditions of liability. In doing this the author describes cases not covered by financial security and its definition by comparison with findings of risk theory. As a result it becomes obvious that numerous exclusions of risks could quite good be included in the financial security and that the argument of the impossibility to insure often put forward by the insurers to justify the exclusion of risks can neither theoretically nor practically be uphold. (orig./HSCH) [de
Private insurance companies developed means to provide first-tier nuclear coverage to operators of power plants and other nuclear facilities; US Government initially provided second tier. US insurance companies chose 'pooling' technique as means to provide large amounts of insurance capacity by spreading the risk over a number of insurance companies. Classic example of nuclear risk that presents low frequency, high severity loss potential. Insurers usually spread their risk over a large, fairly stable premium base, as with automobile insurance. The American Nuclear Insurers (ANI) and its roles are introduced in this article
Ahlin, Tanja; Nichter, Mark; Pillai, Gopukrishnan
The percentage of India's national budget allocated to the health sector remains one of the lowest in the world, and healthcare expenditures are largely out-of-pocket (OOP). Currently, efforts are being made to expand health insurance coverage as one means of addressing health disparity and reducing catastrophic health costs. In this review, we document reasons for rising interest in health insurance and summarize the country's history of insurance projects to date. We note that most of these projects focus on in-patient hospital costs, not the larger burden of out-patient costs. We briefly highlight some of the more popular forms that government, private, and community-based insurance schemes have taken and the results of quantitative research conducted to assess their reach and cost-effectiveness. We argue that ethnographic case studies could add much to existing health service and policy research, and provide a better understanding of the life cycle and impact of insurance programs on both insurance holders and healthcare providers. Drawing on preliminary fieldwork in South India and recognizing the need for a broad-based implementation science perspective (studying up, down and sideways), we identify six key topics demanding more in-depth research, among others: (1) public awareness and understanding of insurance; (2) misunderstanding of insurance and how this influences health care utilization; (3) differences in behavior patterns in cash and cashless insurance systems; (4) impact of insurance on quality of care and doctor-patient relations; (5) (mis)trust in health insurance schemes; and (6) health insurance coverage of chronic illnesses, rehabilitation and OOP expenses.
Although transport of nuclear substances represents only a very small part of the global transport of dangerous goods, it takes place every day all over the world and it is part of our daily life. Transport of nuclear material takes also place at every stage of the nuclear fuel cycle; radioactive materials are carried out all over the world by all major modes of transport: sea, air, road and rail. Despite the large number of nuclear transports, they are not considered as posing a serious risk. A major nuclear incident is almost always associated with the operating of fixed installations such as nuclear power plants; just think about Three Mile Island and Chernobyl. This perception is strengthened by the absence so far of serious accidents in the nuclear transport sector and this finding is in fact proof of the very safe conditions of nuclear transport. But accidents can never be excluded entirely and in some cases damages could be as large as those caused by fixed installations. This means that protection of the interests of possible victims should also be covered in a correct way. That is why the special nuclear liability regime has also been developed to cover damage caused by a nuclear transport accident. As stated by Patrick Reyners, the prime motivation for originally adopting a special nuclear regime was the harmonisation of national legislation and that nowhere more than in the field of international transport operations is such harmonisation felt desirable . The international legal regime has been developed along two tracks, one based on the mode of transport and the other based on the notion of dangerous goods. The linkage between those two tracks is of permanent concern and the mode of transport is the key element to determine which international instrument should be applicable. The purpose of this paper is to briefly introduce the financial security provided by the insurance industry to cover the international nuclear liability regime for nuclear
...-0008] RIN 0563-AC35 Common Crop Insurance Regulations; Pecan Revenue Crop Insurance Provisions AGENCY... Corporation (FCIC) proposes to amend the Common Crop Insurance Regulations, Pecan Revenue Crop Insurance... Regulations (7 CFR part 457) by revising Sec. 457.167 Pecan Revenue Crop Insurance Provisions, to be effective...
... to: (1) Theft; or (2) Inability to market the avocados for any reason other than actual physical... Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions AGENCY: Federal Crop Insurance... Common Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions to convert the Florida...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...
The industrial revolution led to the birth of different types of insurance systems. Insurance business emerged and developed in Eritrea during the Italian period. The insurance industry in Eritrea has been huge profits from its inception in 1992. In spite of the consistent profits by the insurance, the Government privatised it recently due the policy and revenue requirements. An attempt is made in this paper to discuss the background of the insurance and it evolution and development. This pap...
Abdullah Ibrahim Nazal
This study is one of very few studies which have investigated Islamic Insurance Companies as solution. It explained its operations also comparing with Traditional Insurance Companies and theoretical Islamic insurance models. As result to this study Islamic Insurance companies are profit organization. It helps Islamic banks but it costs customer to face expect risk. Islamic Insurance companies have many ways to get profits and consider all customers installments grants. Its operation gap comes...
Nearly half of the Irish population is covered by private health insurance. In recent years, premium inflation has been significantly ahead of overall inflation and has been accelerating. This has contributing to a drop in the numbers insured since the peak in 2008. The fall in the numbers with private health insurance also has implications for the public health system. Factors behind this premium inflation include rising charges for beds in public hospitals, increasing volume of treatments and increasing quality of service and cover. While some progress has been made by insurers on reducing fees paid to consultants and private hospitals, unless the quantity or quality of care are addressed then premium inflation is unlikely to abate.
In this paper there are showed and debated some situation in which psychological effects like loss aversion, reference point, status-quo and framming effects can influence the deccision of the consumer and are not consistent with the standard economic model.In addition to this aspects, Cumulative Prspect Theory enhance the fact that decision makers overestimate low peobabilities and underestimate high probabilities,thus buying inadequate insurance in many situation.in thiss sense, in order to support this idea I tried to make a qualitative presentation of the model used on the insurance market using Prelec function which is the function related with the Cumulative Prospect Theory which can be used in the insurance context.The weak points of the theory of expected utility are explained through this new perspectives and nevertheless aspects like insensivity to bad news concerning incomes,elasticity of price,displacements of status-quo and default,disposition effect and equity premium are taken into consideration.As example,I chose a Kunreuther experiment about insurance decision in with is underlyined the fact that for moderate risk people buy insurance with premiums that exceed the expected loss.There are demands for low deductibles in the the markets for extended guarantees and insurances for mobile phones where was observed that the insurance underwriting rate increases with the probability of loss keeping the expected loss constant.It is better to mention that the theory and the model that are presented here comes as complementary to the economic standard theory not as a substitute.
Glied, Sherry A; Altman, Stuart H
The United States relies on competition to balance costs and quality in the health care system. But concentration is increasing throughout the hospital, physician, and insurer markets. Midsize community hospitals face declining demand and growing competition from both larger hospitals and smaller freestanding diagnostic and surgical centers, leaving the midsize hospitals vulnerable to closure or merger with other facilities. Competition among insurers has been limited by the development of hospital systems that extend the bargaining power of "must-have" hospitals (those perceived to provide the best care for complex and less common conditions) across local health care markets. Government antitrust enforcement could play an important role in maintaining competition in both the hospital and insurer markets, but in many markets, the impact of that enforcement has been limited to date. Policy makers should consider supplementing antitrust activities with strategies that combine competition and regulation-for example, by regulating selected prices and structuring competition to cover entire insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.
Doncho M. Donev
Full Text Available This article gives an insight to the current health insurance system in the Republic of Macedonia. Special emphasis is given to the specificities and practice of both obligatory and voluntary health insurance, to the scope of the insured persons and their benefits and obligations, the way of calculating and payment of the contributions and the other sources of revenues for health insurance, user participation in health care expenses, payment to the health care providers and some other aspects of realization of health insurance in practice. According to the Health Insurance Law, which was adopted in March 2000, a person can become an insured to the Health Insurance Fund on various modalities. More than 90% of the citizens are eligible to the obligatory health insurance, which provides a broad scope of basic health care benefits. Till end of 2008 payroll contributions were equal to 9.2%, and from January 1st, 2009 are equal to 7.5% of gross earned wages and almost 60% of health sector revenues are derived from them. Within the autonomy and scope of activities of the Health Insurance Fund the structures of the revenues and expenditures are presented. Health financing and reform of the payment to health care providers are of high importance within the ongoing health care reform in Macedonia. It is expected that the newly introduced methods of payments at the primary health care level (capitation and at the hospital sector (global budgeting, DRGs will lead to increased equity, efficiency and quality of health care in hospitals and overall system
Mardiana, Ria; Djabir Hamzah; Syamsul Bahri
Aims: The aims of this study is to confirm the direct and indirect influence of employee ability, perceived of hospital???s ethic and leadership to the satisfaction of customer through employee commitment. Sample are hospital???s stakeholders that consist of paramedics (frontliners, doctors, and nurses) and inpatient of healthcare insurance. Study design: A survey instrument comprising a construct of employee ability, perceived hospital ethic, lead...
Full Text Available Loss ratio is one of the most important indicator that has many strategic decisions applications, such as pricing, underwriting, investment, reinsurance and reserving decisions. It serves as an early warning of financial solvency of insurance companies and it can be judged on the strength of the financial position of these companies. The aim of this study is to identify the reliable time series-forecasting model to forecast loss ratio estimates of fire segment in Misr insurance company. Box-Jenkins Analysis is applied on actual reported loss ratios data for Misr insurance company for the period 1980/1981– 2013/2014. The study concludes that the best forecasting model is ARMA(1,1.
Following a long series of discussions with the Administration of the La Tour Hospital, a tariff agreement has been concluded between the Hospital and the CERN Health Insurance Scheme. In the case of hospitalisations, this new agreement will apply to admissions on or after 1st September 2004 and will result, in particular, in the reintroduction of the third-party payer system. In the case of out-patient treatment, billing will be according to the Swiss medical tariff system TARMED and Uniqa will act as third-party guarantor. Further details will be published in the next issue of the CHISBull'. Tel.74484
..., the first mutual fire insurer was established. The first American mutual insurance company, the Philadelphia Contributionship for the Insurance of Houses from Loss by Fire, was founded in 1752.\\3\\ \\3\\ The...
... DEPARTMENT OF THE TREASURY Terrorism Risk Insurance Program; Recordkeeping Requirements for... Budget. The Terrorism Risk Insurance Program Office within the Department of the Treasury is soliciting... original and two copies) to: Terrorism Risk Insurance Program, Public Comment Record, Suite 2100...
...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of... Financial Assistance/Subsidy Arrangement (Arrangement), (90 as of June 1, 2010) private sector property... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...
...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of... Financial Assistance/Subsidy Arrangement (Arrangement), 87 (as of July 1, 2011) private sector property... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...
...-0008] RIN 0563-AC35 Common Crop Insurance Regulations; Pecan Crop Insurance Provisions; Correction... FR 13454-13460). The regulation pertains to the insurance of Pecans. DATES: Effective Date: June 5...: [[Page 33691
The relationship between the State and the health insurance passes through an institutional and financial crisis, leading the government to decide a new governance of the health care system and of the health insurance. The onset of the institutional crisis is the consequence of the confusion of the roles played by the State and the social partners. The social democracy installed by the French plan in 1945 and the autonomy of management of the health insurance established by the 1967 ordinances have failed. The administration parity (union and MEDEF) flew into pieces. The State had to step in by failing. The light is put on the financial crisis by the evolution of ONDAM (National Objective of the Health Insurance Expenses) which appears in the yearly law financing Social Security. The drift of the real expenses as compared to the passed ONDAM bill is constant and worsening. The question of reform includes the link between social democracy to be restored (social partners) and political democracy (Parliament and Government) to establish a contractual democracy. The Government made the announcement of an ONDAM sincere and medically oriented, based on tools agreed upon by all parties. The region could become a regulating step involving a regional health council. An accounting magistrate would be needed to consider not only the legal aspect but to include economic fallouts of health insurance. The role and the missions of the Social Security Accounting Committee should be reinforced.
Lu-Ming Tseng; Wen-Pin Su
Insurance researchers believe that the increase in insurance fraud may be associated with the unethical decisions made by some insurance salespeople. However, to date, research that has empirically investigated the link between insurance salespeople and collusion is scant. Using the car insurance industry in Taiwan as an example, this paper explores the impact of the opportunity to obtain the fraudulent claim and that of the size of actual loss on car insurance salespeople's attitudes towards...
Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang
Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (pinsured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.
Stowe, J D
As Hawn (2) says, "insurance is about risk and peace of mind." She reports that the American Humane Society supports pet insurance because companion animals are able to be treated for disease or accidents that are life-threatening where, otherwise, they would have been euthanized. For veterinarians, she suggests that pet insurance allows them to practice veterinary medicine "as if it were free." It is inevitable that pet insurance will grow as a recourse for veterinary fees. This may be a savior to some families whose budget is stretched to the limit at a critical moment in the health care of their cherished pet. We in the veterinary profession have an advantage over other professions. We have seen the good, the bad, and the ugly of insurance, as it applies to human health and dental care. If we work hand-in-hand with our own industries, collectively we may be able to develop a system that wins for everyone, with fees that allow practice to thrive and growth strategies that accommodate new treatment and diagnostic modalities, as well as consistent and exemplary customer service. The path ahead is always fraught with bumps and potholes. We can be a passive passenger and become a victim of the times or an active driver to steer the profession to a clearer route. Pet insurance is but one of the solutions for the profession; the others are a careful assessment of our fees--charging what we are worth, not what we think the client will pay; business management; customer service; leadership of our health care team; lifelong learning; and more efficient delivery systems. Let us stop being a victim, stop shooting ourselves in the professional foot, and seize the day!
A Pennsylvania task force recommended that nuclear utilities insure their plants with a mandatory national property insurance program. The proposed Nuclear Powerplant Property Damage Insurance Act of 1981 will cover the cleanup costs of onsite damage in excess of $350 million for a single accident ($50 million when private insurance is added on) and a ceiling of two billion dollars. Participation in the insurance pool would be in conjunction with licensing and would permit no grandfathering. Total payout for Three Mile Island-2 would cover 75% of the cleanup costs, the remainder to be apportioned among other parties. The insurance pool will have a $750 million goal supported by utility premiums
Røed, Knut; Jensen, Peter; Thoursie, Anna
Based on pooled register data from Norway and Sweden, we find that differences in unemployment duration patterns reflect dissimilarities in unemployment insurance (UI) systems in a way that convincingly establishes the link between economic incentives and job search behaviour. Specifically, UI...... benefits are relatively more generous for low-income workers in Sweden than in Norway, leading to relatively longer unemployment spells for low-income workers in Sweden. Based on the between-countries variation in replacement ratios, we find that the elasticity of the outflow rate from insured unemployment...
Deterministic control theory is used to find the optimal premium strategy for an insurer in order to maximise a given objective. The optimal strategy can be loss-leading depending on the model parameters, which may result in negative premium values. In such circumstances, it is optimal to capture as much of the market as possible before making a profit towards the end of the time horizon. In reality, the amount by which an insurer can lower premiums is constrained by borrowing restrictions an...
To succeed in the current financial markets, small hospitals need flexible project and financing plans. Many small local banks today can offer small hospitals financing solutions on par with what was previously offered only by the country's strongest investment-grade rated banks. Federal assistance through programs such as HUD's Section 242 mortgage insurance program is also a viable option for small hospitals.
Changes implemented on 1 January 2011 In addition to the information provided in the Official News section of the Bulletin concerning the CHIS, the following changes are in place since 1 January 2011. Benefits The list of benefits including the ceilings will remain initially unchanged while the CHIS Board prepares proposals to the Director-General, who has been authorized by the Council to take timely measures to limit the increase of the CHIS expenses, by encouraging the use of health care providers and treatments which provide the best quality-to-cost ratio. Termination of the agreement with “La Metairie” Attempts to find an agreement with the management of “La Metairie” on the conditions to continue to collaborate failed. The present agreement that CHIS, as well as the other international organisations (WHO, ILO/ITU, UNOG) had signed, therefore came to an end on 31 December 2010. As a result, the rules applicable to hospitals without an agreement will apply to &...
Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud
It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social
University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....
It is understood that construction projects usually have in force several simultaneous contractual ... business witlloct suficient cover of insurance. The aim of this paper is, therefore, to discuss the needs and .... D: Risks associated with the Technical aspects of the project. E: Risks associated with Acts of Man. F: Design risks.
Lagerlöf, Johan N. M.; Schottmüller, Christoph
We study a monopoly insurance model with endogenous information acquisi- tion. Through a continuous effort choice, consumers can determine the precision of a privately observed signal that is informative about their accident risk. The equilibrium effort is, depending on parameter values, either...
Roč. 11, č. 10 (2004), s. 651-656 ISSN 1350-4851 Institutional research plan: CEZ:AV0Z7085904 Keywords : recalls * unemployment insurance taxes Subject RIV: AH - Economics Impact factor: 0.135, year: 2004 http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=14132347&site=ehost-live
of good practice to be used as a design aid by engineers. ..... an ethical and professipnal atmosphere. It is also essential for the local ..... If your answer is no, please write the reason/sf or not purchasing insurance policies? 10. What types of ...
Costa, M.P.R. da.
The insurance is presented as a way to offer the guarantees to the reparing of the nuclear energy damages, enphasizing the adoption of the associations and pools system in Brazil, since the coverings envolved are very high. (A.L.) [pt
Runsheng Yin; Bob Izlar
The long-term growth of institutional timberland investments depends on the ability of timberland investment management organizations (TIMO) to deal effectively with securitization, leveraging, arbitraging, supply contracting, portfolio insurance, tax efficiency enhancement, and other issues. Financial engineering holds great promise for many of these issues. This...
Nuclear insurance pools have provided insurance for the nuclear industry for over fifty years and it is fair to say that the development of civil nuclear power would not have been possible without the support of the commercial insurance market. The unknown risks presented by the nascent nuclear power industry in the 1950s required a leap of faith by insurers who developed specialist pooled insurance capacity to ensure adequate capacity to back up the operators' compensation obligations. Since then, nuclear insurance pools have evolved to become comprehensive suppliers of most types of insurance for nuclear plant globally. This paper will outline the structure, development, products and current operations of nuclear insurance pools.(author)
U.S. Department of Health & Human Services — A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified...
S V Martynenko
This article shows how globalization resolves problems, which are motivated in a new way by modern situational context of social-insurance, how the 'insurance cocoon' of civilization leads to narrowing of conflict space in the world politics.
U.S. Department of Health & Human Services — This tool will help you find the health insurance best suited to your needs, whether its private insurance for individuals, families, and small businesses, or public...
Norberg, Ragnar; Planchet, Frédéric
Focussing on life insurance and pensions, this book addresses various aspects of modelling in modern insurance: insurance liabilities; asset-liability management; securitization, hedging, and investment strategies. With contributions from internationally renowned academics in actuarial science, finance, and management science and key people in major life insurance and reinsurance companies, there is expert coverage of a wide range of topics, for example: models in life insurance and their roles in decision making; an account of the contemporary history of insurance and life insurance mathematics; choice, calibration, and evaluation of models; documentation and quality checks of data; new insurance regulations and accounting rules; cash flow projection models; economic scenario generators; model uncertainty and model risk; model-based decision-making at line management level; models and behaviour of stakeholders. With author profiles ranging from highly specialized model builders to decision makers at chief ex...
... property owned by the recipient. Federally-owned property need not be insured unless required by the terms... Requirements Property Standards § 518.31 Insurance coverage. Recipients shall, at a minimum, provide the...
... by the recipient. Federally-owned property need not be insured unless required by the terms and... Property Standards § 74.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent...
... property owned by the recipient. Federally-owned property need not be insured unless required by the terms... Requirements Property Standards § 19.31 Insurance coverage. Recipients shall, at a minimum, provide the...
... provided to property owned by the recipient. Federally-owned property need not be insured unless required... Nonprofit Organizations Post-Award Requirements § 600.131 Insurance coverage. Recipients shall, at a minimum...
... funds as provided to property owned by the recipient. Federally-owned property need not be insured... ORGANIZATIONS Post-Award Requirements Property Standards § 435.31 Insurance coverage. Recipients must, at a...
U.S. Department of Health & Human Services — The Affordable Care Act created the new Pre-Existing Condition Insurance Plan (PCIP) program to make health insurance available to Americans denied coverage by...
Harrison, Glenn W.; Martínez-Correa, Jimmy; Ng, Jia Min
affects both the demand for the product and the welfare of individuals making take-up decisions. We study the impact of basis risk on insurance take-up and on expected welfare in a laboratory experiment with an insurance frame. We measure the expected welfare of index insurance to individuals while......Index insurance was conceived to be a product that would simplify the claim settlement process and make it more objective, reducing transaction costs and moral hazard. However, index insurance also exposes the insured to basis risk, which arises because there can be a mismatch between the index...... risks that are different from preferences exhibited for their actuarially-equivalent counterparts. We study the potential link between index insurance demand and attitudes towards compound risks. We test the hypothesis that the compound risk nature of index insurance induced by basis risk negatively...
Insurance mechanisms are prevalent in industrialized societies, in both public and private sectors. Insurance is offered for various risks ranging from fire to accident. They also constitute the core of the modern welfare state (public health insurance, unemployment benefits and public pensions......). The analysis of (public) insurance has however remained marginal in political theory because insurance is often perceived as a simple tool for pursuing equality, i.e. a tool without any moral significance proper. This text proposes an alternative view by drawing a continuum between insurance as a technology......, which is the common interpretation in economics, and insurance as a social practice, which characterizes social theory. The goal is to underline how the technology of insurance alters social practices by, for instance, promoting equal standing or transforming the paradigm of individual responsibility...
Full Text Available The importance and increasing role of Internet in nowadays business area are officially recognized. No matter the industry a company is operating in, the distribution channels include direct sales through Internet. Following this idea, also the insurance companies decided to sell their insurance policy online. In this paper we analyze the advantages of Internet for insurance companies, the threats and the actual situation for Romanian insurers
Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French.......Can compulsory occupational injury insurance be used as a strategy for prevention in the work place? This is discussed on the basis of two different insurance systems - the Danish and the French....
In many welfare states, tightening financial constraints suggest excluding some medical services, including new ones, from social security coverage. This may create opportunities for private health insurance. This study analyses the performance of supplementary private health insurance (SPHI) in markets for excluded services in terms of population covered, risk selection and insurer profits. Using a utility-based simulation model, the insurance market is described as a composite of sub-market...
In this article, the effects of fee-for-service personal financial planning on the decision making of a profit-maximizing life insurance general agent are examined. Three refutable propositions are developed which implicate the movements of the general agent who must adjust to a new optimal profit-maximizing allocation of financial planning, personal insurance sales, and agent insurance sales when there is a change in one of the fee or commission rate parameters. It is demonstrated that insur...
ICD coding quality from an electronic patient discharge record for clinicians. ... RE Dyers, J Evans, GA Ward, S du Plooy, H Mahomed ... After 6 months, the quality of ICD codes was determined by comparing ICD code descriptors with medical concepts in a random sample of original patient records selected over a 6-week ...
... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... the agency. Each insurer's report includes information about thefts and recoveries of motor vehicles... more vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than...
... passenger motor vehicle insurers that are required to file reports on their motor vehicle theft loss... information about thefts and recoveries of motor vehicles, the rating rules used by the insurer to establish... companies with a fleet of 20 or more vehicles not covered by theft insurance policies issued by insurers of...
... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... the agency. Each insurer's report includes information about thefts and recoveries of motor vehicles... vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than any...
Ballantyne, H C
The 1982 Annual Report of the Board of Trustees of the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) Trust Funds indicates sever financial problems in both the short and the long range. The short-range financial status is significantly worse than was estimated last year, after enactment of the 1981 legislation, because of continuing unfavorable economic conditions. The estimated long-range deficit is the same as the deficit that was estimated last year before the 1981 legislation and is therefore somewhat worse than was estimated immediately after enactment of the legislation. Under present law, which authorizes temporary interfund borrowing amount the OASI, DI, and Hospital Insurance (HI) Trust Funds, the OASI Trust Fund would become unable to pay benefits on time by July 1983. The assets of the DI Trust Fund, on the other hand, are expected to grow rapidly in both the short and long range. If the assets of both the OASI and DI Trust Funds were combined, however, the two funds would still become unable to pay benefits on time by the latter half of 1983, based on all four sets of economic and demographic assumptions in the 1982 report. Even if the temporary interfund borrowing authority in present law were extended, the combined assets of the OASI, DI, and HI Trust Funds would become insufficient to pay benefits on time by 1984, based on the two less favorable sets of assumptions in the 1982 report. Based on the other two, more favorable, sets of assumptions, the three combined funds could pay benefits on time through the 1980's but there would be little or no margin of safety to permit timely payment of benefits if economic conditions are even slightly less favorable.
The following questions are discussed in connection with the insurance of nuclear risks: insurance techniques, the nuclear operator's limitation of liability in amount and in time, its channelling, the principle of sole liability and exonerations, the insurers' position, the cover provided and state intervention beyond that amount. (NEA) [fr
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Unemployment insurance. 617.58 Section 617.58 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TRADE ADJUSTMENT ASSISTANCE... Unemployment insurance. Unemployment insurance payable to an adversely affected worker shall not be denied or...
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Transportation insurance... MANAGEMENT TRANSPORTATION General 47.102 Transportation insurance. (a) The Government generally (1) retains... assumed responsibility. The cost of this insurance to the carrier shall be part of the transportation cost...
Sheremet, O.; Lucas, A.
We study the possibility for international diversification of catastrophe risk by the insurance sector. Adopting the argument that large insurance losses may be a 'globalizing factor' for the industry, we study the dependence of geographically distant insurance markets via equity returns. In
Comments are made on nuclear insurance experience in the United States. The subject is discussed in more detail under the headings: direct physical damage insurance; workers' compensation insurance; third party liability (premises and operations considerations; products considerations); possible alternatives to the existing arrangement. (U.K.)
... 7 Agriculture 10 2010-01-01 2010-01-01 false Insurance. 1427.166 Section 1427.166 Agriculture... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.166 Insurance. The seed cotton must be insured at the full loan value against loss or damage by fire. ...
Within the actuarial profession a major challenge can be found in the construction of a fair tariff structure. In light of the heterogeneity within, for instance, a car insurance portfolio, an insurance company should not apply the same premium for all insured risks. Otherwise the so-called concept
M. van Dijk (Machiel); M. Pomp (Marc); R.C.H.M. Douven (Rudy); T. Laske-Aldershof (Trea); F.T. Schut (Erik); W. de Boer (Willem); A. Boo (Anne)
textabstractAim: To estimate the price sensitivity of consumer choice of health insurance firm. Method: Using paneldata of the flows of insured betweenpairs of Dutch sickness funds during the period 1993-2002, we estimate the sensitivity of these flows to differences in insurance premium. Results:
... Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided to property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...
....31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with NHPRC funds as provided to property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...
... a commitment for insured advances, initial endorsement of the credit instrument shall occur before... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance endorsement. 200.100... Endorsement Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance endorsement. 241.1245... Rights and Obligations § 241.1245 Insurance endorsement. (a) Endorsement. The Commissioner shall indicate his insurance of the equity loan or acquisition loan by endorsing the original credit instrument and...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance endorsement. 241.570... § 241.570 Insurance endorsement. (a) Initial endorsement. The Commissioner shall indicate his/her insurance of the mortgage by endorsing the original credit instrument and identifying the section of the Act...
Sekhri, Neelam; Savedoff, William
Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage.
Ejrnaes, Mette; Hochguertel, Stefan
We study risk behavior of Danish self-employed entrepreneurs, whose income risk may be driven by both exogenous factors and effort choice (moral hazard). Partial insurance is available through voluntary unemployment insurance (UI). Additional incentives to sign insurance contracts stem from a
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance benefits. 241.885 Section... § 241.885 Insurance benefits. (a) Method of payment. Payment of claims shall be made in the following... acceptable assignment of the note and security instrument to the Commissioner, the insurance benefits shall...
... Health Insurance Providers Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... insurance for United States health risks. This fee is imposed by section 9010 of the Patient Protection and... insurance for United States health risks. DATES: Written or electronic comments must be received by June 3...
Szilagyi, Peter G.
Few people would disagree that children with disabilities need adequate health insurance. But what kind of health insurance coverage would be optimal for these children? Peter Szilagyi surveys the current state of insurance coverage for children with special health care needs and examines critical aspects of coverage with an eye to helping policy…
... 3 The President 1 2010-01-01 2010-01-01 false State Children's Health Insurance Program... Insurance Program Memorandum for the Secretary of Health and Human Services The State Children's Health Insurance Program (SCHIP) encourages States to provide health coverage for uninsured children in families...
Suijs, J.P.M.; De Waegenaere, A.M.B.; Borm, P.E.M.
This paper shows how problems in `non life'-insurance and `non life'-reinsurance can be modelled simultaneously as cooperative games with stochastic payoffs.Pareto optimal allocations of the risks faced by the insurers and the insureds are determined.It is shown that the core of the corresponding
... insurance premiums to protect the service company against losses and damages to owned or leased property... covered, and the applicable premiums. Any dividends distributed by mutual insurance companies shall be credited to the accounts to which the insurance premiums were charged. ...
... health insurance kicks in. As a general rule, insurance plans with low premiums have high deductibles, and plans with high premiums ... other plans due to hardship. This type of insurance can have low premiums but very high deductibles. Plans generally cover less ...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance premium. 203.443 Section... premium. All of the provisions of §§ 203.260 through 203.269 1 concerning mortgage insurance premiums... DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES SINGLE...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance premiums. 232.805 Section... FACILITIES Contract Rights and Obligations Premiums § 232.805 Insurance premiums. (a) First premium. The... insurance premium equal to one percent of the original face amount of the note. (b) Second premium. The...
Insurance mathematics today is considered a part of applied probability theory. Main objectives are modelling of claims that arrive in an insurance business, and decide how premiums are to be charged to avoid ruin of the insurance company. GENERAL I ARTICLE various results and the heuristics can be appreciated.
Transparency in insurance law attaches to the rights and duties of the parties, the ... protection principles as envisaged by South African insurance legislation. ... an insurance contract, the insurer's duty to speak is not based on a general ...
Full Text Available Introduction. Despite the considerable arsenal of developments in the issues of assessing the management of the insurance portfolio remains unresolved. In order to detail, specify and further systematize the indicators for the indicated evaluation, the publications of scientists are analyzed. The purpose of the study is to analyze existing methods by which it is possible to formulate and manage the insurance portfolio in order to achieve its balance, which will contribute to ensuring the financial reliability of the insurance company. Results. The description of the essence of the concept of “management of insurance portfolio”, as the application of actuarial methods and techniques to the combination of various insurance risks offered for insurance or are already part of the insurance portfolio, allowing to adjust the size and structure of the portfolio in order to ensure its financial stability, achievement the maximum level of income of an insurance organization, preservation of the value of its equity and financial security of insurance liabilities. It is determined that the main methods by which the insurer’s insurance portfolio can be formed and managed is the selection of risks; reinsurance operations that ensure diversification of risks; formation and placement of insurance reserves, which form the financial basis of insurance activities. The method of managing an insurance portfolio, which can be both active and passive, is considered. Conclusions. It is determined that the insurance portfolio is the basis on which all the activities of the insurer are based and which determines its financial stability. The combination of methods and technologies applied to the insurance portfolio is a management method that can be both active and passive and has a number of specific methods through which the insurer’s insurance portfolio can be formed and managed. It is substantiated that each insurance company aims to form an efficient and
Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny
Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.
Lattof, Samantha R
People working in Ghana's informal sector have low rates of enrolment in the publicly funded National Health Insurance Scheme. Informal sector workers, including migrant girls and women from northern Ghana working as head porters (kayayei), report challenges obtaining insurance and seeking formal health care. This article analyses how health insurance status affects kayayei migrants' care-seeking behaviours. This mixed-methods study involved surveying 625 migrants using respondent-driven sampling and conducting in-depth interviews with a sub-sample of 48 migrants. Analyses explore health status and health seeking behaviours for recent illness/injury. Binary logistic regression modelled the effects of selected independent variables on whether or not a recently ill/injured participant (n = 239) sought health care. Although recently ill/injured participants (38.4%) desired health care, less than half (43.5%) sought care. Financial barriers overwhelmingly limit kayayei migrants from seeking health care, preventing them from registering with the National Health Insurance Scheme, renewing their expired health insurance policies, or taking time away from work. Both insured and uninsured migrants did not seek formal health services due to the unpredictable nature of out-of-pocket expenses. Catastrophic and impoverishing medical expenses also drove participants' migration in search of work to repay loans and hospital bills. Health insurance can help minimize these expenditures, but only 17.4% of currently insured participants (58.2%) reported holding a valid health insurance card in Accra. The others lost their cards or forgot them when migrating. Access to formal health care in Accra remains largely inaccessible to kayayei migrants who suffer from greater illness/injury than the general female population in Accra and who are hindered in their ability to receive insurance exemptions. With internal migration on the rise in many settings, health systems must recognize the
Full Text Available Insurance provides financial protection to the insured, though; its acceptance by Nigerian insuring public is still low. This can sharply be traced to low awareness of insurance service. More importantly, quality of service to the few who embraced it had been low. Therefore, insuring public perceives insurance service as defective because customers’ expectations are not met. The objective of this research is to find out whether application of service quality measurement will drive demand for insurance products. Hypothesis was tested to find out whether SERVQUAL measurement is not significantly related to demand for insurance products in Nigeria. The study adopts descriptive research design; hypothesis was tested using regression analysis. The study reveals that there is a significant relationship between application of SERVQUAL measurement and demand for insurance. It is recommended that insurance companies operating in Nigeria should adopt SERVQUAL measurement which will further increase customer retention and loyalty.
Thailand has a universal multi-payer system with two main types of health insurance: National Health Security Office or public health insurance and private insurance. National health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Thai citizens are required to be enrolled in either national health insurance or employees? health insurance. There are many differences be...
Steffan G. Ball; Hamish W. Low
In this paper we show the extent to which public insurance and self-insurance mitigate the cost of health shocks that limit the ability to work. We use consumption data from the UK to estimate the insurance provided by the government disability programme and account for the effectiveness of alternative self-insurance mechanisms. Individuals with a work-limiting health condition, but in receipt of disability insurance, have 7 percent lower consumption than those without such a condition. Self-...
Nataliya Prikazyuk; Ganna Oliynik
The article highlights how the cooperation of insurance companies and banks affects the insurance system. Defined the concept of bancassurance, provided a brief description of the main bancassurance models in the context of their impact on the insurance system. Defined the main benefits and risks that accompany cooperation of insurance companies and banks within different models of association. It is noted that despite the generally accepted benefits of cooperation between insurers and banks,...
Rohendi, Keukeu; Putra, Ilham Eka
Sinarmas currently has several insurance services featured. To perform its function as a good insurance company is need for reform in terms of services in the process of calculating insurance premiums of insurance carried by marketing to use a calculator which interferes with the activities of marketing activities, slow printing insurance policies, automobile claims process that requires the customer to come to the office ASM, slow printing of Work Order (SPK) and the difficulty recap custome...
Dr. H. Christy Cynthia; Dr. T. Jebasheela; V. Maheswari
Insurance is a way of reducing uncertainty of occurrence of an event. Insurance is an investment. Its basic purpose is to derive plans to counteract the financial consequences of unfavorable events. Insurance is a social device for eliminating or reducing the cost to society to certain types of risks. Insurance is essentially a co-operative endeavor. It is the function of the insurance to protect the few against the heavy financial impact of anticipated misfortunes by spreading losses among m...
Full Text Available Background: Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. Objectives: This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. Materials and Methods: The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. Results: Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. Conclusion : Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective.
Savitha, S; Kiran, Kb
Health seeking behaviour in the event of illness is influenced by the availability of good health care facilities and health care financing mechanisms. Micro health insurance not only promotes formal health care utilization at private providers but also reduces the cost of care by providing the insurance coverage. This paper explores the impact of Sampoorna Suraksha Programme, a micro health insurance scheme on the health seeking behaviour of households during illness in Karnataka, India. The study was conducted in three randomly selected districts in Karnataka, India in the first half of the year 2011. The hypothesis was tested using binary logistic regression analysis on the data collected from randomly selected 1146 households consisting of 4961 individuals. Insured individuals were seeking care at private hospitals than public hospitals due to the reduction in financial barrier. Moreover, equity in health seeking behaviour among insured individuals was observed. Our finding does represent a desirable result for health policy makers and micro finance institutions to advocate for the inclusion of health insurance in their portfolio, at least from the HSB perspective.
Dror, David M; Radermacher, Ralf; Khadilkar, Shrikant B; Schout, Petra; Hay, François-Xavier; Singh, Arbind; Koren, Ruth
Microinsurance--low-cost health insurance based on a community, cooperative, or mutual and self-help arrangements-can provide financial protection for poor households and improve access to health care. However, low benefit caps and a low share of premiums paid as benefits--both designed to keep these arrangements in business--perversely limited these schemes' ability to extend coverage, offer financial protection, and retain members. We studied three schemes in India, two of which are member-operated and one a commercial scheme, using household surveys of insured and uninsured households and interviews with managers. All three enrolled poor households and raised their use of hospital services, as intended. Financial exposure was greatest, and protection was least, in the commercial scheme, which imposed the lowest caps on benefits and where income was the lowest.
Wu, Yue; Zhang, Liang; Liu, Xuejiao; Ye, Ting; Wang, Yongfei
Health insurance contributes to reducing the economic burden of disease and improving access to healthcare. In 2016, the Chinese government announced the integration of the New Cooperative Medical Scheme (NCMS) and Urban Resident Basic Medical Insurance (URBMI) to reduce system segmentation. Nevertheless, it was unclear whether there would be any geographic variation in health insurance benefits if the two types of insurance were integrated. The aim of this study was to identify the potential geographic variation in health insurance benefits and the related contributing factors. This cross-sectional study was carried out in Qianjiang District, where the NCMS and URBMI were integrated into Urban and Rural Resident Basic Medical Insurance Scheme (URRBMI) in 2010. All beneficiaries under the URRBMI were hospitalized at least once in 2013, totaling 445,254 persons and 65,877 person-times, were included in this study. Town-level data on health insurance benefits, healthcare utilization, and socioeconomic and geographical characteristics were collected through health insurance system, self-report questionnaires, and the 2014 Statistical Yearbook of Qianjiang District. A simplified Theil index at town level was calculated to measure geographic variation in health insurance benefits. Colored maps were created to visualize the variation in geographic distribution of benefits. The effects of healthcare utilization and socioeconomic and geographical characteristics on geographic variation in health insurance benefits were estimated with a multiple linear regression analysis. Different Theil index values were calculated for different towns, and the Theil index values for compensation by person-times and amount were 2.5028 and 1.8394 in primary healthcare institutions and 1.1466 and 0.9204 in secondary healthcare institutions. Healthcare-seeking behavior and economic factors were positively associated with health insurance benefits in compensation by person-times significantly
Danish Society of Insurance Medicine was formed in 1902 as an association between the Danish Society of Accident Insurance and the Danish Society of Life Insurance Medicine, both founded a year before. The purpose of the society is to apply and to further the scientific basis of insurance medicine. The meetings also play a role as a forum for discussions. The members of the society are all working part-time in an insurance company in Denmark (in contrast to many other countries where it is a full-time job). The members are mainly specialists in medicine and surgery. During the first half life of the society nearly all members were high-qualified doctors, i.e. professors and consultants at a university hospital in Copenhagen usually with a doctoral degree. These prominent doctors had a significant influence on insurance medicine in Denmark. The managing directors of the Insurance Companies were invited to the meetings. Many scientific works and textbooks were written on the subject. The society arranges two meetings yearly - one concerning with life insurance and one with accident-insurance medicine. Previously, the question put to the medical adviser was always "Which impairments can still be insured?", but today the question is the opposite "Which impairments are not insurable?" The members have increased to currently 112, still only men, but today the members are younger, comprise fewer professors and fewer with a doctoral degree. During the last 6 years, all interested members in the insurance companies have been invited to the meetings, providing a broader input for the discussions. The topic of the meeting is of current interest: new laws or a new treatment of a disease (medication, surgery) which has been introduced. One to three speakers open the meeting, followed by a discussion. The meetings are always concluded with a light meal and a glass of wine, in earlier days also with cigars and Danish schnaps. 190 meetings have been held during the last 100 years
Kerssens, Jan J.; Groenewegen, Peter P.
Objective To promote managed competition in Dutch health insurance, the insured are now able to change heaith insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to
Saskatchewan Consumer and Commercial Affairs, Regina.
This booklet provides consumers with an overview of information about life insurance. Chapter 1, "Why Life Insurance?" outlines the primary purposes of life insurance coverage and presents basic facts about the Canadian life insurance industry. Chapter 2, "Do I Need Life Insurance?" discusses life insurance coverage at specific…
Kerssens, J.J.; Groenewegen, P.P.
Objective: To promote managed competition in Dutch health insurance, the insured are now able to change health insurers. They can choose a health insurer with a low flat-rate premium, the best supplementary insurance and/or the best service. As we do not know why people prefer one health insurer to
Full Text Available The paper focuses on the traditional and alternative mechanisms for insurance risk transfer that are available to global as well as to domestic insurance companies. The findings suggest that traditional insurance risk transfer solutions available to insurance industry nowadays will be predominant in the foreseeable future but the increasing role of alternative solutions is to be expected as the complementary rather than supplementary solution to traditional transfer. Additionally, findings suggest that it is reasonable to expect that future development of risk transfer solutions in Serbia will follow the path that has been passed by global insurance industry.
Reitsma, S. M. S.
Since fifty years insurers respond to the need of both governments and the electricity industry to provide financial protection to cover the perils presented by the use of nuclear energy for peaceful purposes. This paper aims at explaining what difficulties had to be solved in order to enable insurers to provide such protection, that as a solution to these difficulties Nuclear Insurance Pools were formed, how such pools operate and what security they provide. Thereby not only a number of universal principles underlying nuclear pool insurance will be explained, but also some differences in the characteristics of such insurance per group of countries. (author)
MARIA MIRABELA FLOREA IANC
Full Text Available The insurance companies operating in a competitive and dynamic economic climate, so solvency is a very important problem. The guarantee funds protect policyholders against situations where insurers can not meet its contractual obligations, and supervisors constant attention is how to regulate the insurance business. Overall solvency of insurance companies show that has been achieved relative success in this area due to regulations adopted. Although in recent years the number of insolvency cases increased worrying emphasis on solvency control should lead to a reduction in the occurrence of such cases and the increased safety offered by insurance products.
Deitchman, J.V.; King, W.T. Jr.; Olding, R.P.
In the nascent years of commercial nuclear power, the insurance industry expressed confidence in the safety of nuclear operations by committing unprecedented insurance capacity to nuclear risks. As the nuclear industry has developed, it has compiled an enviable safety record. The initial confidence of the insurance industry has thus been justified and an ever-increasing portion of the financial liability associated with nuclear operations has been accepted by the world-wide insurance markets. This increasing acceptance and understanding of nuclear risks by the insurance industry has resulted in significantly reduced rates and large premium refunds for nuclear operators
Full Text Available The advantages of Usage-Based Insurance for automotive covers over conventional rating methods have been discussed in literature for over four decades. Notwithstanding their adoption in insurance markets has been slow. This paper seeks to establish the viability of introducing fleet Telematics-Based Insurance by investigating the perceptions of insurance operators, tracking service providers and corporate fleet owners. At its core, the study involves a SWOT-analysis to appraise Telematics-Based Insurance against conventional premium rating systems. Twenty five key stakeholders in Malta, a country with an insurance industry that represents others in microcosm, were interviewed to develop our analysis. We assert that local insurers have interests in such insurance schemes as enhanced fleet management and monitoring translate into an improved insurance risk. The findings presented here have implications for all stakeholders as we argue that telematics enhance fleet management, TBI improves risk management for insurers and adoption of this technology is dependent on telematics providers increasing the perceived control by insurers over managing this technology.
Full Text Available The life insurance sector is an important sector of the economy all over the world. Life insurance provides the economy and the individuals as well, a variety of fundamental financial services.Regardless the importance it has all around the world, life insurance market in Albania is still underdeveloped comparing not only to the Western European countries, but to the region countries as well. The comparative analysis of insurance market is carried out by means of two indexes: insurance density and penetration index. The life insurance market in Albania is facing several problems which will be further explained in the paper, together with some recommendations to be taken in account by Albanian insurance companies and the Albanian government as well.
Jou, Judy; Kozhimannil, Katy B; Blewett, Lynn A; McGovern, Patricia M; Abraham, Jean M
This study evaluates the associations between workplace accommodations for pregnancy, including paid and unpaid maternity leave, and changes in women's health insurance coverage postpartum. Secondary analysis using Listening to Mothers III, a national survey of women ages 18 to 45 years who gave birth in U.S. hospitals during 2011 to 2012 (N = 700). Compared with women without access to paid maternity leave, women with access to paid leave were 0.4 times as likely to lose private health insurance coverage, 0.3 times as likely to lose public health coverage, and 0.3 times as likely to become uninsured after giving birth. Workplace accommodations for pregnant employees are associated with health insurance coverage via work continuity postpartum. Expanding protections for employees during pregnancy and after childbirth may help reduce employee turnover, loss of health insurance coverage, and discontinuity of care.
Garla, Bharath Kumar; Satish, G; Divya, K T
To review uses of finance in dentistry. A search of 25 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Insurance has come of ages and has become the mainstay of payment in many developed countries. So much so that all the alternative forms of payment which originated as an alternative to fee for service now depend on insurance at one point or the other. Fee for service is still the major form of payment in many developing countries including India. It is preferred in many instances since the payment is made immediately.
disaster response plans, how employees and others access data systems, and at a minimum, the antivirus and anti- malware software used by the business, the...a policy for insuring data stored in the cloud. Typically, businesses that install or ser- vice software or networks or provide IT consulting for...security, and privacy. Errors and omissions covers claims related to performance of services such as software development or consulting services
Thomas J. Kniesner; James P. Ziliak
October 2001 (Revised from July 2001). Abstract: By supplementing income explicitly through payments or implicitly through taxes collected, income-based taxes and transfers make disposable income less variable. Because disposable income determines consumption, policies that smooth disposable income also create welfare improving consumption insurance. With data from the Panel Study of Income Dynamics we find that annual consumption variation is reduced by almost 20 percent due to explicit and ...
Literature concerning the institutional use of options indicates that the main purpose of option trading is to provide investors with the opportunity to create return distributions previously unavailable, considering that options provide the means to manipulate portfolio returns. In such a context, this study intends to analyse the returns of insured portfolios generated by hedging strategies on underlying stock portfolios. Because dynamic hedging is too expensive, we have hedged the stock po...
A customer information system is a typical information management system. It involves three aspects, the backstage database establishment, the application development and the system maintenance. A car insurance information management system is based on browser/server structure. Microsoft SQL Server establishes the backstage database. Active Server Pages, from Microsoft as well is used as the interface layer. The objective of this thesis was to apply ASP to the dynamic storage of a web page...
This paper develops the view that employer-sponsored pension plans are best understood as retirement income insurance for employees and from that perspective addresses a number of questions regarding the reasons for their existence, their design, and their funding and investment policies. The most important of these questions are: - Why do employers provide pension plans for their employees and why is participation usually mandatory? - Why is the defined benefit form of pension plan the domin...
... 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... certain health insurance policies and plan sponsors of certain self-insured health plans to fund the... health insurance policies) or R. Lisa Mojiri-Azad at (202) 622-6080 (regarding self- insured health...
Vylder, F Etienne
This book is different from all other books on Life Insurance by at least one of the following characteristics 1-4. 1. The treatment of life insurances at three different levels: time-capital, present value and price level. We call time-capital any distribution of a capital over time: (*) is the time-capital with amounts Cl, ~, ... , C at moments Tl, T , ..• , T resp. N 2 N For instance, let (x) be a life at instant 0 with future lifetime X. Then the whole oO oO life insurance A is the time-capital (I,X). The whole life annuity ä is the x x time-capital (1,0) + (1,1) + (1,2) + ... + (I,'X), where 'X is the integer part ofX. The present value at 0 of time-capital (*) is the random variable T1 T TN Cl V + ~ v , + ... + CNV . (**) In particular, the present value ofA 00 and ä 00 is x x 0 0 2 A = ~ and ä = 1 + v + v + ... + v'X resp. x x The price (or premium) of a time-capital is the expectation of its present value. In particular, the price ofA 00 and äx 00 is x 2 A = E(~) and ä = E(I + v + v + ... + v'X...
Schneider, Andrew; Hutcheon, Deborah A; Hale, Allyson; Ewing, Joseph A; Miller, Megan; Scott, John D
Many insurance companies require patient participation in a medically supervised weight management program (WMP) before offering approval for bariatric surgery. Clinical data surrounding benefits of participation are limited. To evaluate the relationship between preoperative insurance-mandated WMP participation and postoperative outcomes in bariatric surgery patients. Regional referral center and teaching hospital. A retrospective review of patients who underwent vertical sleeve gastrectomy or Roux-en-Y gastric bypass between January 2014 and January 2016 was performed. Patients (N = 354) were divided into 2 cohorts and analyzed according to presence (n = 266) or absence (n = 88) of an insurance-mandated WMP requirement. Primary endpoints included rate of follow-up and percent of excess weight loss (%EWL) at postoperative months 1, 3, 6, and 12. All patients, regardless of the insurance-mandated WMP requirement, followed a program-directed preoperative diet. The majority of patients with an insurance-mandated WMP requirement had private insurance (63.9%). Both patient groups experienced a similar proportion of readmissions and reoperations, rate of follow-up, and %EWL at 1, 3, 6, and 12 months (P = NS). Median operative duration and hospital length of stay were also similar between groups. Linear regression analysis revealed no significant improvement in %EWL at 12 months in the yes-WMP group. These data show that patients who participate in an insurance-mandated WMP in addition to completing a program-directed preoperative diet experience no significant benefit to rate of readmission, reoperation, follow-up, or %EWL up to 12 months postoperation. Our findings suggest that undergoing bariatric surgery without completing an insurance-mandated WMP is safe and effective. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Douven, Rudy C H M; Schut, Frederik T
In this paper we examine the pricing behaviour of nonprofit health insurers in the Dutch social health insurance market. Since for-profit insurers were not allowed in this market, potential spillover effects from the presence of for-profit insurers on the behaviour of nonprofit insurers were absent. Using a panel data set for all health insurers operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of nonprofit health insurers. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. In the presence of weak price competition, health insurers did not set premiums to maximize profits. Nevertheless, our findings suggest that regulations on financial reserves are needed to restrict premiums. Copyright © 2011 Elsevier B.V. All rights reserved.
Since its election to office in 1996, reform of Private Health Insurance (PHI) has been the most obvious health policy focus of the Howard Government. The reform process has focussed on price, product, promotion, legislation and regulation. It has resulted in one of the largest new Commonwealth health outlays in recent memory. Health insurance funds have emerged as active purchasers of care, not just passive reimbursers of costs. PHI fund reserves have moved from precarious liquidity to healthy surplus. Private hospitals are busier than ever before, but margins are slim. Anecdotally, public hospitals report little benefit to date. Waiting lists have not been reduced, and their budgets are unchanged as a result of the $2 Bn allocated under the 30% Rebate scheme. The paper begins by describing the origins of the PHI reform. Its objectives, policy initiatives, results to date and criticisms are analysed. Criticisms include the actual and opportunity costs. Specific concerns remain as to its effectiveness to date in reducing pressure on public hospitals, and perceived lack of equity for certain client groups. The most significant result is that much of the reform package is here to stay including the expensive and much criticised 30% rebate. Like Medicare before it, the PHI reforms have achieved bipartisan support. The paper concludes by describing future implications for Government, industry, consumers and the medical profession.
Katona, Katalin; Canoy, Marcel
There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.
William Encinosa; Didem Bernard; Avi Dor
We estimate the impact of diabetic drug adherence on hospitalizations, ER visits, and hospital costs, using insurance claims from MarketScan® employer data. However, it is often difficult to measure the impact of drug adherence on hospitalizations since both adherence and hospitalizations may be correlated with unobservable patient severity. We control for such unobservables using propensity score methods and instrumental variables for adherence such as drug coinsurance levels and direct-to- ...
Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu
The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.
By the mid-1950's the United States recognised that it was in the interest to promote commercial development of nuclear energy. But the uncertainties of the technology and the potential for severe accidents were clear obstacles to commercial development. Exposure to potentially serious uninsured liability inhibited the private sector. These impediments led Congress to enact the Price-Anderson Act in 1957. The Act had several purposes: the first was to encourage private development of nuclear power; the second was to establish a legal framework for handling potential liability claims; and the third was to provide a ready source of funds to compensate injured victims of a nuclear accident. Insurers chose the pooling technique by creating in the US the American Nuclear Insurers. ANI acts as a managing agent for its members insurance companies. The accident of three Miles Island occurred on 28 March 1979 and with came the claims experience in US. The 1988 amendments to the Price-Anderson Act directed the President to establish a Commission for the purpose of developing a means to assure full compensation of victims of a catastrophic nuclear accident that exceeds the limitation on aggregate public liability, or currently just over US$ 9.7 billion. The Presidential Commission issued its report in August 1990, in which it reached a number of conclusions and offered a number of recommendations.The US Congress has not acted on the Commission's report, but may revisit its recommendations as debate begins this year (1999) or next on the renewal of the Price-Anderson Act. (N.C.)
Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku
Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. In addition, insuring that the network is always available is important. Herein, we discuss security countermeasures and points to insure availability that must be taken to insure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at Shimane University Hospital. Security countermeasures differ according to their purpose, such as for preventing illegal use or insuring availability, both of which are discussed. It is our hope that this information will assist others in their efforts to insure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.
A new document which groups together the general principles, the contributions, benefits, reimbursement procedures and other information making up the Rules of the CERN Health Insurance Scheme has been established. It was approved by the Director-General on 7th July 2000 and is being distributed to all contributing members of the Scheme. It has been dispatched by internal mail to members of the personnel and by postal mail to pensioners. These Rules will enter into force on 1st September 2000. Please make sure that you have received your copy. Should this not be the case, an additional copy may be obtained by telephoning 78003
A new document which groups together the general principles, the contributions, benefits, reimbursement procedures and other information making up the Rules of the CERN Health Insurance Scheme has been established. It was approved by the Director-General on 7th July 2000 and is being distributed to all contributing members of the Scheme. It has been dispatched by internal mail to members of the personnel and by postal mail to pensioners. These Rules will enter into force on 1st September 2000. Please make sure that you have received your copy. Should this not be the case, an additional copy may be obtained by telephoning 78003.
Full Text Available Abstract Background Cataracts are the leading cause of blindness in China, and poverty is a major barrier to having cataract surgery. In 2003, the Chinese government began a series of new national health insurance reforms, including the New Cooperative Medical Scheme (NCMS and the Urban Resident Basic Health Insurance scheme (URBMI. These two programs, combined with the previously existing Urban Employee Basic Health Insurance (UEBMI program, aimed to make it easier for individuals to receive medical treatment. This study reports cataract surgery numbers in rural and urban populations and the proportion of these who had health insurance in Chongqing, China from 2003 to 2008. Methods The medical records of a consecutive case series, including 14,700 eyes of 13,262 patients who underwent age-related cataract surgery in eight hospitals in Chongqing from January 1, 2003, to December 31, 2008, were analysed retrospectively via multi-stage cluster sampling. Results In the past six years, the total number of cataract surgeries had increased each year as had the number of patients with insurance. Both the number of surgeries and the number of insured patients were much higher in the urban group than in the rural group. The rate of increase in the rural group however was much higher than in the urban group, especially in 2007 and 2008. The odds ratios of having health insurance for urban vs. rural individuals were relatively stable from 2003 to 2006, but it decreased in 2007 and was significantly lower in 2008. Conclusions Health insurance appears to be an important factor associated with increased cataract surgery in Chongqing, China. With the implementation of health insurance, the number of Chongqing's cataract surgeries was increased year by year.
Sockwell, Oliver R.
For many colleges, universities, and teaching hospitals, the need to expand, renovate, or replace aging structures and equipment is crucial. Institutions need not be large and well known to tap nationwide capital pools. By using municipal bond insurance when issuing tax-exempt bonds for financing, they improve their credit rating and increase…
... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 8a.440 Section 8a.440 Commerce and Foreign Trade Office of the Secretary of Commerce... benefits and services. Subject to § 8a.235(d), in providing a medical, hospital, accident, or life...
Hill, R C
The rather abrupt introduction of payors to hospitals and vice versa that started a few years ago has now settled down into a learning situation. To be price competitive in the health insurance marketplace, the payor must obtain full contractual performance in price, administrative and utilization review areas. Hospitals need the patients that payors can refer, but there is only a minimal understanding of how the health insurance industry operates both internally and in the marketplace. By selecting payors and soliciting those selected, hospitals have an excellent chance to accomplish their patient and revenue goals while payors have the opportunity to determine the effectiveness of their various programs to help meet their goals. By making a little effort, hospitals can accomplish a lot by adding this new "P" to their marketing mix.
Full Text Available Introduction: As millions of uninsured citizens who use emergency department (ED services are now eligible for health insurance under the Affordable Care Act, the ED is ideally situated to facilitate linkage to insurance. Forty percent of U.S. EDs report having an insurance linkage program. This is the first national study to examine the characteristics of EDs that offer or do not offer these programs. Methods: This was a secondary analysis of data from the National Survey for Preventive Health Services in U.S. EDs conducted in 2008-09. We compared EDs with and without insurance programs across demographic and operational factors using univariate analysis. We then tested our hypotheses using multivariable logistic regression. We also further examined program capacity and priority among the sub-group of EDs with no insurance linkage program. Results: After adjustment, ED-insurance linkage programs were more likely to be located in the West (RR= 2.06, 95% CI = 1.33 – 2.72. The proportion of uninsured patients in an ED, teaching hospital status, and public ownership status were not associated with insurance linkage availability. EDs with linkage programs also offer more preventive services (RR = 1.87, 95% CI = 1.37–2.35 and have greater social worker availability (RR = 1.71, 95% CI = 1.12–2.33 than those who do not. Four of five EDs with a patient mix of ≥25% uninsured and no insurance linkage program reported that they could not offer a program with existing staff and funding. Conclusion: Availability of insurance linkage programs in the ED is not associated with the proportion of uninsured patients served by an ED. Policy or hospital-based interventions to increase insurance linkage should first target the 27% of EDs with high rates of uninsured patients that lack adequate program capacity. Further research on barriers to implementation and cost effectiveness may help to facilitate increased adoption of insurance linkage programs. [West J
This paper analyzes and compares liability and liability insurance in the fields of aviation and spaceflight in order to propose solutions for a liability regime and insurance options for suborbital flights. Suborbital flights can be said to take place in the grey zone between air and space, between air law and space law, as well as between aviation insurance and space insurance. In terms of liability, the paper discusses air law and space law provisions in the fields of second and third party liability for damage to passengers and 'innocent bystanders' respectively, touching upon international treaties, national law and EU law, and on insurance to cover those risks. Although the insurance market is currently not ready to provide tailor-made products for operators of suborbital flights, it is expected to adapt rapidly once such flights will become reality. A hybrid approach will provide the best solution in the medium term.
Reitsma, S. M. S.
The development of nuclear installations to produce electricity led to the establishment of Nuclear Insurance Pools and the introduction of international Conventions on Third Party Liability. Nuclear Pools offer both Third Party Liability insurance, reflecting the Conventions' principles, and other insurance products. They are market-wide, providing a facility for participation by insurers who could not otherwise write the insurance for the particularly sensitive nuclear risk. All acceptances are for the net retention of each Member without recourse to individual reinsurance protection. Common account reinsurance is arranged with other Nuclear Pools all over the world. Thus, a transparency is created, which ensures the highest degree of reinsurance security and imposes a known finite limit to each participating insurer's commitment. Therefore, Pool-members are prepared to make a greater commitment to nuclear risks than would be case where they felt uncertain as regards their total exposure following a significant loss. (author)
The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.
I study the impact of ambiguity on insurance decisions and the optimality of insurance contracts. My tractable approach allows me to study the interaction between risk and ambiguity attitudes. When insurance decisions are made independently of other assets, for a given increase in wealth, both risk...... portfolio theory that assumes Subjective Expected Utility theory; however, it provides hints to a possible solution of the under-diversification puzzle of households. I also identify conditions under which more risk or ambiguity aversion decreases the demand for coinsurance. Additionally, I show...... a counterexample to a classical result in insurance economics where an insurance contract with straight deductible is dominated by a coinsurance contract. Finally, I find that a modified Borch rule characterizes the optimal insurance contract with bilateral risk and ambiguity attitudes and heterogeneity in beliefs....
Reimbursement challenges, spiraling healthcare costs, and a slow economic recovery are driving the latest wave of hospital consolidation. Health insurance companies and provider systems are forming partnerships in the consolidation field with the goal of reducing healthcare costs and improving quality. The "cost" of the acquisition may include debt and other obligations of the acquired hospital, such as pension liabilities, along with a multiyear capital commitment.
Although careful consideration is given to insurance against physical damage to plant and equipment, little thought is given to the costs that will be incurred in replacing the power that is lost while a relatively efficient system is out of action. The results of an investigation carried out for a generating authority with an installed capacity of about 3000 MW is given. Replacement power costs for different cases of severity of damage range from Pound1.17m per month for damage to central services taking out all four units. (author)
MĂRĂCINE MIHAELA SIMONA
Full Text Available The role of corporate social responsibility has increased significantly nowadays. The studies conducted have shown that consumers are increasingly no longer interested only in buying good quality and reliable products, but they are also interested whether they were produced in a socially responsible manner. In the recent years investors have increasingly realised that investing in social responsibility regarding the social and environmental areas, greatly contributes to the growth of the internal and external image of management. This paper aims at presenting a number of interesting issues related to social responsibility manifested by the insurance companies.
To an extent, public opinion is against Koeberg, inspite of the fact that Escom, Koeberg's prospective licensee, are liable for damages caused in the event of an accident, that they carry public liability insurance bought in the market place to the maximum of ten million rand, and if that is not enough the government will take over responsibility for the rest. A question is put that if this kind of protection carries on, won't there always be a minority of the public who will find nuclear power socially, psychologically and politically unacceptable
In the world outside the former Soviet Union, insurance industries in their respective domestic markets have pooled their resources so as to provide a secure and cost-effective conduit for the transaction of insurance business on behalf of the nuclear industry. These are the so-called nuclear pools. This paper explains the four main principles behind nuclear liability insurance and discusses their application to Central Europe and in particular to the problems facing the nuclear industry in Eastern Europe. (author)
Hao, Mingjie; Radfall Charitable Trust
Insurers hope to make profit through pooling policies from a large number of individuals. Unless the risk in question is similar for all potential customers, an insurer is exposed to the possibility of adverse selection by attracting only high-risk individuals. To counter this, insurers have traditionally employed underwriting principles, identifying suitable risk factors to subdivide their potential customers into homogeneous risk groups, based on which risk-related premiums can be charged. ...
Haerig, Michael [Marsh GmbH, Duesseldorf (Germany)
Companies of the energy industry are facing risks which only insufficiently can be covered with classical insurance solutions. In particular, further developments and new technologies confront operators of power stations with challenges to attain a sufficient insurance protection. By means of a comprehensive risk management and insurance management tailor-made, convincing solutions and concepts are possible. The contribution under consideration exemplary presents some selected topics.
Full Text Available The aim of this paper is to define a communications centre model in an insurance company that essentially has two objectives. The first objective is focused on providing quality support with the sales process thereby creating a strategic advantage over the competition while the second objective is focused on improving the link between internal organizational units whose behaviour can often render decision-making at all levels difficult. The function of sales is fundamental for an insurance company. Whether an insurance company will fulfil its basic function, which is transfer of risk from the insured party to the insurer who agrees tonreimburse incidental damages to the damaged party and distribute them among all members of the risk group on the principles of reciprocity and solidarity, depends on successful sales and billing (Andrijašević & Petranović, 1999. For an insurance company to operate successfully in a demanding market, it is necessary to meet the needs of potential clients who then must be at the centre of all the activities of the insurer. A satisfied policy holder, who is respected by the insurer as a partner, is a guarantee that the sales of insurance services will be successful and that the insured party will come back to the same insurance company. In the era of globalization and all-pervading new technologies and modes of communication, policy holders need to be able to communicate with insurance company employees. Quality communication is a good foundation for a sales conversation. A fast flow of all types of information within an organisation using a single communication module makes decision-making at all levels quicker and easier.
Burcã Ana-Maria; Bãtrînca Ghiorghe
In insurance industry, the financial stability of insurance companies represents an issue of vital importance. In order to maintain the financial stability and meet minimum regulatory requirements, actuaries apply actuarial modeling. Modeling has been at the center of actuarial science and of all the sciences from the beginning of their journey. In insurance industry, actuarial modeling creates a framework that allows actuaries to identify, understand, quantify and manage a wide range of risk...
Jonathan Carroll; Shino Takayama
This paper develops a hierarchical agency model of deposit insurance. The main purpose is to undertake a game theoretic analysis of the consequences of deposit insurance schemes and their effects on monitoring incentives for banks. Using this simple framework, we analyze both risk- independent and risk-dependent premium schemes along with reserve requirement constraints. The results provide policymakers with not only a better understanding of the effects of deposit insurance on welfare and th...
Kevin Lang; Hong Kang
We develop a model in which firms hire heterogeneous workers but must offer all workers insurance benefits under similar terms. In equilibrium, some firms offer free health insurance, some require an employee premium payment and some do not offer insurance. Making the employee contribution pre-tax lowers the cost to workers of a given employee premium and encourages more firms to charge. This increases the offer rate, lowers the take-up rate, increases (decreases) coverage among high (low) de...
van den Heuvel, J.; Does, R.J.M.M.; de Koning, H.
Abstract Hospitals today face major challenges. Patients demand quality of care to be improved continuously. Health insurance companies demand the lowest possible prices. Lean Six Sigma is a program that can help healthcare providers to achieve these (seemingly) conflicting goals. Lean Six Sigma is
Angkinand, Apanard; Wihlborg, Clas
level require analyses of institutional factors affecting the credibility of non-insurance. In particular, the implementation of effective distress resolution procedures for banks would allow governments to reduce explicit deposit insurance coverage and, thereby, to strengthen market discipline......The ambiguity in existing empirical work with respect to effects of deposit insurance schemes on banks' risk-taking can be resolved if it is recognized that absence of deposit insurance is rarely credible and that the credibility of non-insurance can be enhanced by explicit deposit insurance...... schemes. We show that under reasonable conditions for effects on risk-taking of creditor protection in banking, and for effects on credibility of non-insurance of explicit coverage of deposit insurance schemes, there exists a partial level of coverage that maximizes market discipline and minimizes moral...
The purpose of the study is to find out and improve on strategy used in the Marketing of Insurance Products in Kenya; Case of African Merchants Assurance Company Ltd (AMACO). AMACO is one of the 44 insurance firms in Kenya. Among others it is a local incorporated company, which makes a difference in that it is not one of the leading insurance firms in Kenya, which is held by such firms as British-American insurance company. The methodology used is quantitative, qualitative methods, interview ...
Full Text Available The purpose of the paper is to provide some support to the thesis that insurance may reduce the cost of capital in a company by influencing both the cost of capital components and the need for rising capital. The problem is here perceived from two perspectives – the classical concept related to the weighted average cost of capital (WACC and a novel concept related to the risk-based capital structure model with the total average cost of capital (TACC. The paper explains the idea of insurance as a retrospective (post-loss risk financing tool and the risk transfer mechanism upon it. As the risk financing tool insurance reduces the need for the balance-sheet capital in a company and thus the financial distress costs. Also, insurance may reduce the level of operating risk and thus influences the required returns of the capital providers. These observations allow emphasising the impact of insurance on the WACC. However, according to the novel concept of the risk-based capital structure, insurance (as a risk financing tool represents an off-balance sheet capital component. As a consequence, it extends the volume of total capital. The presented conceptual model, based on the TACC concept, indicates that large volume of insurance (the insurance sum and its relatively low cost (the insurance premium gives the possibility to the significant reduction of the cost of capital on average. The concluding remarks discuss some dilemmas over the utility of the TACC concept.
Andersen, Torben M.
the sensitivity of labour supply to taxes, which tends to reduce tax distortions and lower the marginal costs of public funds. The relation between incentives and insurance and thus efficiency and equity is flattened by the insurance effect and it may even be non-monotone. However, the optimal utilitarian policy......Tax distortions cause a trade-off between efficiency and equity. However, taxes not only affect incentives; they also provide implicit insurance, and this may critically affect the efficiency–equity relationship. For a standard labour supply problem it is shown that the insurance effect mutes...
Social Security Administration — While Social Security is best known for providing retirement benefits, the program also provides Disability Insurance (DI) protection to workers and their families...
Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizesthe necessity and the opportunity of creating in Romania a medical service market based on the competingsystem. In Romania, the social insurances for health care are at their very beginning. The development of thedomain of the private insurances for health care is prevented even by its legislation, due to the lack of anormative act that may regulate the management of the private insurances for health care. The establishment ofthe legislation related to the optional insurances for health care might lead to some activity norms for thecompanies which carry out optional insurances for health care. The change of the legislation is made in order tocreate normative and financial opportunities for the development of the optional medical insurances. Thischange, as part of the social protection of people, will positively influence the development of the medicalinsurance system. The extension of the segment of the optional insurances into the medical insurance segmentincreases the health protection budget with the value of the financial sources which do not belong to thebudgetary funds.
Ejrnæs, Mette; Hochguertel, Stefan
We study risk behavior of Danish self-employed entrepreneurs, whose income risk may be driven by both exogenous factors and effort choice (moral hazard). Partial insurance is available through voluntary unemployment insurance (UI). Additional incentives to sign insurance contracts stem from a UI......-embedded, government-subsidized early retirement (ER) program, giving benefits that are unrelated to business risk. Indeed, we argue that the self-employeds' incentives to insure themselves stem from the ER plan rather than from the UI cover. We show how to use a policy reform to identify moral hazard in observed...
Full Text Available The current state of the insurance market of Ukraine in the post-crisis period, by comparison with the pre-crisis was investigated in the paper. The insurance market in the pre-crisis period grew rapidly, but was unable to withstand the economic crisis and suffered a crushing blow. The economic crisis of 2008-2009 led to a decrease of the demand for financial services in general and insurance services in particular. The lack of development of the insurance market created high barriers for responding and adapting to changes that occurred during the crisis.
Shetty, Nikhil; Schwartz, Galina; Felegyhazi, Mark; Walrand, Jean
This paper investigates how competitive cyber-insurers affect network security and welfare of the networked society. In our model, a user's probability to incur damage (from being attacked) depends on both his security and the network security, with the latter taken by individual users as given. First, we consider cyberinsurers who cannot observe (and thus, affect) individual user security. This asymmetric information causes moral hazard. Then, for most parameters, no equilibrium exists: the insurance market is missing. Even if an equilibrium exists, the insurance contract covers only a minor fraction of the damage; network security worsens relative to the no-insurance equilibrium. Second, we consider insurers with perfect information about their users' security. Here, user security is perfectly enforceable (zero cost); each insurance contract stipulates the required user security. The unique equilibrium contract covers the entire user damage. Still, for most parameters, network security worsens relative to the no-insurance equilibrium. Although cyber-insurance improves user welfare, in general, competitive cyber-insurers fail to improve network security.
Hansen, Jan V.; Højbjerg Jacobsen, Rasmus; Lau, Morten I.
We estimate the maximum amount that Danish households are willing to pay for three different types of insurance: auto, home and house insurance. We use a unique combination of claims data from the largest private insurance company in Denmark, measures of individual risk attitudes and discount rates...... possible states of nature, where all uncertainty is realized in the initial period and any loss incurred by an accident is subtracted from initial wealth. The estimated willingness to pay is based on annual claims and should thus be considered as an annual premium. Since there is some uncertainty about...... of the insurance claims....
Full Text Available The objective of this study was to find out the gender disparities in Ghana national health insurance claims. In this work, data was collected from the policyholders of the Ghana National Health Insurance Scheme with the help of the National Health Insurance database and the patients’ attendance register of the Koforidua Regional Hospital, from 1st January to 31st December 2011. The generalized linear regression (GLR models and the SPSS version 17.0 were used for the analysis. Among men, the younger people prefer attending hospital for treatment as compared to their adult counterparts. In contrast to women, younger women favor attending hospital for treatment as compared to their adult counterparts. Among men, various levels of income impact greatly on their propensity to make an insurance claim, whereas among women only the highest income level did as compared to lowest income level.Men, who completed senior high school education, were less likely to make an insurance claim as compared to their counterparts with basic or no education. However it was women who had basic education that preferred using the hospital as compared to their more educated counterparts. It is suggested that the government should consider building more health centers, clinics and cheap-compounds in at least every community, to help reduce the travel time in accessing health care. The ministry of health and the Ghana health service should engage older citizens by encouraging them to use hospitals when they are sick instead of other alternative care providers.
Livingston James M
Full Text Available Abstract Background Claims data provide rapid indicators of SSIs for coronary artery bypass surgery and have been shown to successfully rank hospitals by SSI rates. We now operationalize this method for use by payers without transfer of protected health information, or any insurer data, to external analytic centers. Results We performed a descriptive study testing the operationalization of software for payers to routinely assess surgical infection rates among hospitals where enrollees receive cardiac procedures. We developed five SAS programs and a user manual for direct use by health plans and payers. The manual and programs were refined following provision to two national insurers who applied the programs to claims databases, following instructions on data preparation, data validation, analysis, and verification and interpretation of program output. A final set of programs and user manual successfully guided health plan programmer analysts to apply SSI algorithms to claims databases. Validation steps identified common problems such as incomplete preparation of data, missing data, insufficient sample size, and other issues that might result in program failure. Several user prompts enabled health plans to select time windows, strata such as insurance type, and the threshold number of procedures performed by a hospital before inclusion in regression models assessing relative SSI rates among hospitals. No health plan data was transferred to outside entities. Programs, on default settings, provided descriptive tables of SSI indicators stratified by hospital, insurer type, SSI indicator (inpatient, outpatient, antibiotic, and six-month period. Regression models provided rankings of hospital SSI indicator rates by quartiles, adjusted for comorbidities. Programs are publicly available without charge. Conclusion We describe a free, user-friendly software package that enables payers to routinely assess and identify hospitals with potentially high SSI
Full Text Available In the article some historical aspects of insurance, domestic trends in insurance risk management with aspects of international experience, the modern role of insurance and insurance companies in a market economy, factors of risk management system and the nature of the insurance portfolio are analyzed. Factors of risk events in insurance, the spectrum of risks, imbalance of the insurance market in crisis conditions are outlined; expert’s estimations of the insurance market in recent years are examined. Problems of insurance business perform are determined, especially insurance risk management. The ability to use the provisions of European insurance regulation on internal domestic insurance market is analyzed, and also the aspects of integration of Ukrainian insurance market are determined.
Kaigorodova, G. N.; Mustafina, A. A.; Alyakina, D. P.
The article presents a study of the information technologies impact on the insurance industry development. At present, any business, especially business in the field of financial intermediation, can count on maintaining its positions only as a technology company. For the insurance business it is now especially important. Other segments of the financial market - the stock and credit market - are actively developing and applying IT-technologies. The insurance business at present is getting opportunities for a technological breakthrough. There is a growing demand for traditional insurance products - property insurance, motor insurance, health insurance. There is a rapidly growing demand for life insurance and insurance against cyber risks. To implement insurance protection in new conditions, the insurance company should actively use information systems. The article presents a possible variant of systematization of the insurer's business processes within the information system of the insurance company.
Pérez-Perdomo, R; Pérez-Cardona, C; Rodríguez-Lugo, L
The purpose of this study was to determine the prevalence of diabetes mellitus in persons covered by a health insurance company. The medical claims of persons insured with Triple S Health Insurance Co. of Puerto Rico, whose main diagnosis was diabetes (ICD9-250.0-9), were selected for analysis. Prevalence and medical utilization rates were estimated. General characteristics and services utilization were compared by age and sex using the chi-square distribution. Overall prevalence was 4.73%. Prevalence in the male population (5.07%) was higher than that of females (4.43%) in all age groups, but the difference was not statistically significant (p > 0.05). The proportion of diabetic cases was larger in the > 60 age group. 64% of the cases had 1 or more visits to a physician office, 2% were hospitalized, and almost 3% had emergency room visits. 29% of the cases had insulin prescriptions while 59% had oral prescriptions. The younger age group (diabetes in this group was lower than the prevalence reported in the Behavioral Risk Factor Surveillance System. This may be partially explained by the fact that the study group did not represent the composition of the Puerto Rican population. Prevalence studies using other groups will be helpful to determine the prevalence of diabetes in Puerto Rico.
Baicker, Katherine; Mullainathan, Sendhil; Schwartzstein, Joshua
A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample evidence, though, that people misuse care for a different reason: mistakes, or “behavioral hazard.” Much high-value care is underused even when patient costs are low, and some useless care is bought even when patients face the full cost. In the presence of behavioral hazard, welfare calculations using only the demand curve can be off by orders of magnitude or even be the wrong sign. We derive optimal copay formulas that incorporate both moral and behavioral hazard, providing a theoretical foundation for value-based insurance design and a way to interpret behavioral “nudges.” Once behavioral hazard is taken into account, health insurance can do more than just provide financial protection—it can also improve health care efficiency. PMID:23930294
... and Veterans' Group Life Insurance--Slayer's Rule Exclusion AGENCY: Department of Veterans Affairs... Veterans' Group Life Insurance--Slayer's Rule Exclusion.'' Copies of comments received will be available...) (slayer's rule ``is undoubtedly an implicit provision of the Servicemen's Group Life Insurance Act of 1965...
... (protection for production losses only) within one Basic Provisions and the applicable Crop Provisions to..., Macadamia Nut Crop Insurance Provisions, Onion Crop Insurance Provisions, Dry Pea Crop Insurance Provisions... (protection for production losses only) and revenue protection (protection against loss of revenue caused by...
... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than any... than any governmental entity) used for rental or lease whose vehicles are not covered by theft...
.... Each insurer's report includes information about thefts and recoveries of motor vehicles, the rating... state and; (3) Rental and leasing companies with a fleet of 20 or more vehicles not covered by theft...) used for rental or lease whose vehicles are not covered by theft insurance policies issued by insurers...
The Pensions and Savings group handles three types of payment into and out of Fluor Daniel Hanford related to insurance benefits: Premium payment to insurance company; Application of employee insurance withholding against insurance costs; Remittance of insurance claims, and administrative fees. General approach in making and recording the remittance is by forwarding payment information to Accounts Payable Master.
... REQUIREMENTS BONDS AND INSURANCE Insurance 28.308 Self-insurance. (a) When it is anticipated that 50 percent or... risks, limits of coverage, assignments of safety and loss control, and legal service responsibilities... projected average loss; and (10) A disclosure of all captive insurance company and re-insurance agreements...
... Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE Second Seamen's War Risk Insurance § 308.300 Insured amount—application. An applicant for Second Seamen's war risk insurance shall not state the amount of insurance desired, which shall be as provided in...
... 7 Agriculture 6 2010-01-01 2010-01-01 false Northern potato crop insurance provisions. 457.142... INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.142 Northern potato crop insurance provisions. The Northern Potato Crop Insurance Provisions for the 2008 and succeeding...
Dementieva, M.; Verhoef, E.T.
We study road safety when insurance companies have market power, and can influence drivers' behavior via insurance premiums. We obtain first- and second-best premiums for different insurance market structures. The insurance program consists of an insurance premium, and marginal dependencies of that
... 42 Public Health 1 2010-10-01 2010-10-01 false The insurance premium. 60.14 Section 60.14 Public... LOAN PROGRAM The Loan § 60.14 The insurance premium. (a) General. (1) The Secretary insures each lender... lender an insurance premium. The insurance premium is due to the Secretary on the date of disbursement of...
Lee, Choong Ryeol; Kim, Joon Youn; Hong, Young Seoub; Lim, Hyun Sul; Lee, Yong Hwan; Lee, Jong Tae; Moon, Jai Dong; Jeong, Baek Geun
The incidence of work-related musculoskeletal disorder including low back pain sharply increased since 2000 in Korea. The objectives of the present study are to compare disability duration of lumbar intervertebral disc displacement among types of insurances, and to obtain its appropriate duration. The medical records of all patients whose final diagnosis in discharge summary of chart was lumber specified intervertebral disc displacement (LIVD) in 6 large general hospitals in Korea were reviewed to compare the length of admission and disability among different types of insurances. The information on age, gender, the length of admission, the length of follow-up for LIVD, occupation, operation, combined musculoskeletal diseases, and type of insurance was investigated. 552 cases were selected and analyzed to calculate arithmetic mean, median, mode, and geometric mean of disability duration. There was a significant difference in the length of admission and disability among types of insurance after controlling covariates such as age and combined diseases by the analysis of covariance. The length of admission in cases of IACI and AI was much longer than that of HI, and the length of disability in cases of IACI was much longer than that of HI. Prolonged duration of admission and disability was not assumed due to combined diseases, complication or other unexplainable personal factors in cases of those with industrial accidents compensation insurance and automobile insurance. This means that proper management of evidence-based disability duration guidelines is urgently needed in Korea.
Laurentine, Kyle Alexander; Bramstedt, Katrina A
Donor organs are a scarce gift. Additionally, transplantation is very expensive and the United States lacks universal health insurance for all citizens. These facts combine to make personal finance and insurance some of the criteria for wait listing at US transplant centers. Previous research has shown that the poor and the uninsured (as well as women and nonwhites) are less likely to receive a transplant. Living donor candidates are also limited by the US insurance system. To determine the effect of finance and insurance variables on access to transplant and living donation. A qualitative descriptive study of ethics consultation data contained in a research registry approved by the institutional review board at California Pacific Medical Center. This study analyzes research registry data from a large community hospital in Northern California that serves patients from California, Oregon, and Nevada. The registry data are derived from transplant ethics consultations occurring between January 1, 2007, and June 30, 2009. This study explores the restriction of access to transplantation and of participation in living donation. More than a quarter of all transplant ethics consultation reports described the restriction of transplant-related treatment for reasons rooted in finance or insurance. Individuals on the recipient side and on the donor side were hindered with regard to access. Insurance status and personal ability to pay significantly affect access to transplantation in the United States, and this theme is a frequent feature of ethics consultations at California Pacific Medical Center.
Objectives. I examined the relationship between insurance coverage, which may influence physician incentives and maternal choices, and cesarean delivery before labor. Methods. I analyzed hospital discharge data for mothers without previous cesarean deliveries in New Jersey between 2004 and 2007, with adjustment for maternal age, race, marital status, and maternal, fetal, and placental conditions. Results. Nearly 1 in 7 women (13.9%) had a cesarean delivery without laboring. Insurance status was strongly associated with cesarean birth. Women insured by Medicaid (adjusted relative risk [ARR] = 0.88; 95% confidence interval [CI] = 0.84, 0.91) or self-paying (ARR = 0.81; 95% CI = 0.78, 0.85) had a significantly lower likelihood, and women insured by BlueCross (ARR = 1.06; 95% CI = 1.03, 1.09) or standard commercial plans (ARR = 1.06; 95% CI = 1.02, 1.10) had a significantly higher likelihood of cesarean delivery than did women insured by commercial health maintenance organizations. These associations persisted in subsets restricted to lower-risk women and in qualitative sensitivity analyses for a hypothetical single, binary, unmeasured confounder. Conclusions. Insurance status has a small, independent impact on whether a woman without a previous cesarean delivery proceeds to labor or has a cesarean delivery without labor. PMID:21940911
Yang, Yu Xin Ou; Chew, Boon Cheong; Loo, Heoy Shin; Tan, Lay Hong
Green building construction is growing tremendously globally even in Malaysia. Currently, there are approximate 636 buildings have registered and to be certified with Green Building Index. Among these buildings, 45 buildings have already fulfilled the requirements and fully certified. The other buildings still under provisional certification stage. Malaysia had adopted Green Building Index in 2009 to support a move to promote green building concept. Malaysia starts to move towards green building because Malaysian construction and building industry realizes that both energy consumed and waste produced are reduced without irreversible impacts to ecosystems. Consequently, insurance companies such as Fireman's Fund from America has started the green building insurance policies for their green building in the year of 2006, while Malaysia still remain the coverage for green buildings using conventional property insurance. There are lacks of efforts to be seen from insurance companies to propose green building insurance for these green buildings. There are a few factors which can take into consideration for insurance companies to start the very first green building insurance in Malaysia. Although there are challenges, some efficient strategies have been identified to overcome the problems. The methods used in this research topic is qualitative research. The results obtained shows that green commercial building insurance has a huge business opportunity in Malaysia because the number of green commercial buildings are increasing tremendously in Malaysia. It is a favor to implement green building insurance in Malaysia. Furthermore, insurance companies can consider to add in extra coverage in standard building policy to provide extra protection for non-certified green buildings which have the intention to rebuilt in green when damage happens. Generally, it is very important to introduce green commercial buildings insurance into Malaysia so that all of the green commercial
Full Text Available The purpose of this paper is the investigation of the model of interaction between insurance intermediaries and insurance companies in the assurance of sustainable development of the insurance market. The methodology is based on the new studies and books. It is underlined the importance of potency and effectiveness of this model, its influence on the insurance market stability. It is analysed the European experience and specific of Ukrainian insurance market. The main ways for improving its model and ways of its practical realization are characterized. Results. The problems that exist in the broker market in general are connected with an ineffective state policy. In particular, we can say about the absence of many laws, acts, resolutions, which explain what a broker have to do in case of different problems with insurance companies, another brokers and clients. At the same time, the problem of distrust to national brokers exists. It provokes a decline of the demand for their services and so on. However, it is possible to solve these problems. Practical implications. For this, it is necessary to do some acts. The first one is to implement resolutions that regulate relationships between insurance brokers and insurance companies, clearly regulate the model of its interaction. This model affects the stability of the insurance market in general. The second is to find methods of solving problems of the increase in insurance culture of the population (for example, by the way of advertisement. The third one is to solve problems connected with the appearance of foreign brokers in the insurance market of Ukraine. Actually, the Ukrainian market of insurance brokers is not developed enough. That is why it needs big changes and reforms. Value/originality. Among alternatives of the strategic development of insurance, the method of quick liberalization and gradual development is distinguished. According to the liberal way, it is possible to transfer to the
Willemse-Duijmelinck, Daniëlle M I D; van de Ven, Wynand P M M; Mosca, Ilaria
Nearly everyone with a supplementary insurance (SI) in the Netherlands takes out the voluntary SI and the mandatory basic insurance (BI) from the same health insurer. Previous studies show that many high-risks perceive SI as a switching cost for BI. Because consumers' current insurer provides them with a guaranteed renewability, SI is a switching cost if insurers apply selective underwriting to new applicants. Several changes in the Dutch health insurance market increased insurers' incentives to counteract adverse selection for SI. Tools to do so are not only selective underwriting, but also risk rating and product differentiation. If all insurers use the latter tools without selective underwriting, SI is not a switching cost for BI. We investigated to what extent insurers used these tools in the periods 2006-2009 and 2014-2015. Only a few insurers applied selective underwriting: in 2015, 86% of insurers used open enrolment for all their SI products, and the other 14% did use open enrolment for their most common SI products. As measured by our indicators, the proportion of insurers applying risk rating or product differentiation did not increase in the periods considered. Due to the fear of reputation loss insurers may have used 'less visible' tools to counteract adverse selection that are indirect forms of risk rating and product differentiation and do not result in switching costs. So, although many high-risks perceive SI as a switching cost, most insurers apply open enrolment for SI. By providing information to high-risks about their switching opportunities, the government could increase consumer choice and thereby insurers' incentives to invest in high-quality care for high-risks. Copyright © 2017 Elsevier B.V. All rights reserved.
... mutual), mutual marine insurance companies, mutual fire insurance companies issuing perpetual policies, and mutual fire or flood insurance companies operating on the basis of premium deposits; taxable years... fire insurance companies issuing perpetual policies, and mutual fire or flood insurance companies...
... and no-fault automobile insurance. 220.11 Section 220.11 National Defense Department of Defense... insurance and no-fault automobile insurance. (a) Active duty members covered. In addition to Uniformed.... 1095 and this part. (c) Exclusion of automobile liability insurance and no-fault automobile insurance...
To increase healthcare workers' knowledge of reimbursement concerns. Chronological survey of transplants reimbursed at the University of Nebraska Medical Center from December 1997 to October 2003, which include accounts of 30 patients who received intestine transplants. Gross billed hospital charges for the past 30 transplantations ranged from dollars 112094 to dollars 667597. Length of stay ranged from 18 to 119 days. Charges include organ procurement fees. All 30 intestine transplants were reimbursed by third-party healthcare coverage; combination of coverage; and/or patient and family payments, which resulted in adherence to financial guidelines prearranged by the hospital. Financial guidelines are usually cost plus a percentage. Thirteen transplantations occurred after April 2001, when Medicare made a national coverage decision to reimburse this form of transplantation. Since then, obtaining surgical authorization and reimbursement is easier. Most insurance companies and state public health agencies accept intestinal transplantations as a form of treatment. Researching transplant coverage before evaluation is essential to be compensated adequately. Financial guidelines will secure the fiscal success of the program. Educating patients to insurance and entitlements may reduce the out-of-pocket cost to patients. Transplant financial coordinators coordinate these efforts for the facility. The best coverage option for the patient and transplant programs is a combination of commercial healthcare coverage, secondary entitlement program, and fund-raising. With length of stay ranging up to 119 days and a lifetime of posttransplant outpatient follow-up care, it is beneficial for the facility to also have a fundraising program to assist patients.
Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B
To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.
Friedrichs, M; Friedel, H; Bödeker, W
This study investigates differences in sex, age, and educational level between participants and non-participants of prevention bonus programmes. The differences in the utilisation of drugs, hospital care, and sickness absence before the start of the programmes between these groups are also shown. Finally the economic benefit of the health insurance funds attributed to these programmes is estimated. Data from some 5.2 million insured subjects of 74 company health insurance funds in Germany were linked to information on enrollment into a prevention bonus programme anonymously. In a descriptive analysis the differences in the sociodemographic patterns between both groups are shown as well as the differences in costs to the health insurances in the three sectors mentioned above. The benefit to the health insurance funds is estimated by means of an analysis of covariance. Prevention bonus programmes yields an annual benefit of at least 129 euro per participant. Men aged 40 and older and women aged 30 and older are more likely to opt into such a programme. The same is true for persons with a higher educational level. There are only few differences in health-care utilisation between the participants and non-participants of the programmes before enrollment. Only 1.4% of all insured persons participated in the programmes. There is at least a short-term gain to both involved parties: the insured and the health insurance funds. The programmes are not dominated by deadweight effects. Long-term effects and effectiveness of prevention bonus programmes still have to be investigated. Copyright Georg Thieme Verlag KG Stuttgart . New York.
Shippee, Tetyana P; Kozhimannil, Katy B; Rowan, Kathleen; Virnig, Beth A
Breast reconstruction after mastectomy offers clinical, cosmetic, and psychological benefits compared with mastectomy alone. Although reconstruction rates have increased, racial/ethnic disparities in breast reconstruction persist. Insurance coverage facilitates access to care, but few studies have examined whether health insurance ameliorates disparities. We used the Nationwide Inpatient Sample for 2002 through 2006 to examine the relationships between health insurance coverage, race/ethnicity, and breast reconstruction rates among women who underwent mastectomy for breast cancer. We examined reconstruction rates as a function of the interaction of race and the primary payer (self-pay, private health insurance, government) while controlling for patient comorbidity, and we used generalized estimating equations to account for clustering and hospital characteristics. Minority women had lower breast reconstruction rates than White women (adjusted odds ratio [AOR], 0.57 for African American; AOR, 0.70 for Hispanic; AOR, 0.45 for Asian; p women (AOR, 0.33) and those with public coverage were less likely to undergo reconstruction (AOR, 0.35; p women. Racial/ethnic disparities were less prominent within insurance types. Minority women, whether privately or publicly insured, had lower odds of undergoing reconstruction than White women. Among those without insurance, reconstruction rates did not differ by race/ethnicity. Insurance facilitates access to care, but does not eliminate racial/ethnic disparities in reconstruction rates. Our findings-which reveal persistent health care disparities not explained by patient health status-should prompt efforts to promote both access to and use of beneficial covered services for women with breast cancer. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Full Text Available The purpose is to define a role and significance of elements of the world insurance market infrastructure. Tasks of the study are the next: to consider the dynamics of development of the world insurance market from 2012 to 2016; to define groups of elements of the world insurance market infrastructure; to characterize elements of the world insurance market infrastructure. Methodology. These tasks are done because of using such methods as: grouping of elements of the world insurance market infrastructure; a collection of information about elements of the world insurance market infrastructure; generalization to define role and significance of elements of the world insurance market infrastructure. Results. World insurance premiums were increasing and decreasing from 2012 to 2016 and did not exceed 6.3% of Gross Domestic Product. Lots of factors influence global insurance premium volume as an indicator of the development of world insurance market. One of them is an activity of the elements of the world insurance market infrastructure. It is necessary to divide them into some groups: A International insurance associations (associations of organizations connected with insurance but members of such associations do not provide insurance services – International Association of Insurance Supervisors, International Association of Insurance Fraud Agencies, Global Federation of Insurance Associations, International Insurance Foundation; B International associations of insurers (includes associations of insurers and other organizations in a certain area of insurance – International Association of Deposit Insurers, International Union of Credit and Investment Insurers, International Association of Agricultural Production Insurers, International Group of P&I Clubs, International Union of Aerospace Insurers, International Union of Marine Insurance, International Association of Engineering Insurers; C International associations of insurance experts
Annual double-digit increases in health insurance premiums may be the reality for school districts and private-sector employers for the foreseeable future. The author presents several factors that account for this unwelcome possibility. One cost-saving alternative for districts is to self-insure employees and assume the risks. Districts are…
Summarizing, it is prognosticated that nuclear insurance practice will not drastically change on account of the Internal Market. This assumption is based on the unanimous estimation of the nuclear energy risk by the international insurance industry, as is documented by their traditional good cooperation in pools. (orig.) [de
... secure reasonable premium and copayment pricing through multiple tier options to allow enrollees to... program that offers premium-based dental insurance to enrolled veterans and certain survivors and... regulations to establish VADIP, a pilot program that would offer premium-based dental insurance to enrolled...
... 7 Agriculture 15 2010-01-01 2010-01-01 false Insurance. 2201.24 Section 2201.24 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD LOCAL TELEVISION LOAN GUARANTEE PROGRAM-PROGRAM REGULATIONS Loan Guarantees § 2201.24 Insurance. The Borrower of a...
by Regulatory Board)a Securities Firm Bankb I Other Firms Not BHC U Permitted :I~( Barik Regulators>. j ..: or SEC)C . ...... _.. Insurance Firm Other BHC...Growth, interest rate, and dividend restrictions, higher capital and/or Insurance premiums, civil money penalties. E J Trlpwire 3: Prbes Capital below
... REGULATIONS (CONTINUED) GENERAL Business and Industrial Loan Program § 1980.481 Insured loans. Applications...) Constructing and equipping industrial plants for lease to private businesses (not including loans for operating... concurrence prior to approval. B. Applications from private parties for insured loans will not be encouraged...
Adan, I.J.B.F.; Kulkarni, V.G.
In this article we consider an insurance company selling life insurance policies. New policies are sold at random points in time, and each policy stays active for an exponential amount of time with rate µ, during which the policyholder pays premiums continuously at rate r. When the policy expires,
Прокопенко, Жанна Володимирівна
The problematic issues of determining the authorities of the internal controls subjects at insurance companies have been elucidated. The list of internal controls subjects of insurer depending on the form of control as well as the purposefulness of such kind of control have been determined.
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Insurance coverage. 226.31 Section 226.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Property Standards § 226.31 Insurance coverage. Recipients...
S V Martynenko
Full Text Available This article shows how globalization resolves problems, which are motivated in a new way by modern situational context of social-insurance, how the 'insurance cocoon' of civilization leads to narrowing of conflict space in the world politics.
J.P.B. De Mot (Jef); B. Depoorter (Ben); M.G. Faure (Michael)
textabstractBecause legal insurance policies cover the expenses of plaintiffs in bringing legal claims, such policies increase the risk of negligent or careless acts by tortfeasors. For this reason, potential tortfeasors would prefer to avoid injuring holders of legal insurance policies. Since
Cohen, Abby J.
Provides advice on insurance coverage for child care centers. Suggests that before purchasing insurance you inquire about the agent's qualifications, company's financial stability, and corporate ratings; and obtain written answers to questions about specific coverage issues such as volunteers, legal defense costs, special events, and…
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Flood insurance. 120.170 Section 120.170 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Policies Applying to All Business Loans Requirements Imposed Under Other Laws and Orders § 120.170 Flood insurance...
Full Text Available The insurance market can be considered a market where all sorts of anomalies can be encountered or a current acquisition for a situation considered to be certain or relative future, depending on the type of insurance. For the most part, assurance is based on a premise, a hypothesis that is generally based on several factors of influence. Generally, the most important factors in making such a decision are generated by the human-sensitive factor or the economicprotective. Therefore, by joining the insurance market and purchasing any kind of insurance, we must also take into account the risks that arise from these products. Generally, most people perceive these insurance policies in different areas as a future guarantee without considering additional elements that can highlight risk elements that may alter the expected outcome of the acquirer. An important element to mitigate these risks would be the implementation and use of internal control over the supply chain, control that would make a difference between an activity under normal, predictable and legal conditions and a random activity with many elements of risk that can cause major damage to those involved, and to the insurer and the insured. Through this paper, the author aimed to highlight the importance of internal control in insurance companies, as well as the consequences of the lack of internal control within these societies
... coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided for property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...
Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizes the necessity and the opportunity ofcreating in Romania a medical service market based on the competing system. In Romania, the social insurances for health care are at their verybeginning. The development of the domain of the private insurances for health care is prevented even by its legislation, due to the lack of a normativeact that may regulate the management of the private insurances for health care. The establishment of the legislation related to the optional insurancesfor health care might lead to some activity norms for the companies which carry out optional insurances for health care. The change of the legislationis made in order to create normative and financial opportunities for the development of the optional medical insurances. This change, as part of thesocial protection of people, will positively influence the development of the medical insurance system. The extension of the segment of the optionalinsurances into the medical insurance segment increases the health protection budget with the value of the financial sources which do not belong tothe budgetary funds.
... Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE ANTIDUMPING AND COUNTERVAILING DUTIES Identification and Measurement of Countervailable Subsidies § 351.520 Export insurance. (a) Benefit—(1) In general. In the case of export insurance, a benefit exists if the premium rates charged are inadequate to...
Cseres, K.J.; Szilágyi, P.; Rodger, B.
his chapter discusses the landmark Hungarian case relating to the car insurance and repair markets, which involved both vertical and horizontal agreements. The case concerned the horizontal relationship between Hungary’s two largest insurance companies and their vertical relationships with car
Krawczyk, Michal; Trautmann, Stefan; van de Kuilen, Gijs
We study behavioral patterns of insurance demand for low-probability large-loss events (catastrophic losses). Individual patterns of belief formation and risk attitude that were suggested in the behavioral decisions literature emerge robustly in the current set of insurance choices. However, social
Special conditions must be taken into account in transport insurance for nuclear materials even if the nuclear risk involved is negligible, as in shipments of unirradiated nuclear fuels. The shipwreck of the 'Mont Louis' has raised a number of open points which must be solved pragmatically within the framework of transport insurance. Some proposals are outlined in the article. (orig.) [de
Full Text Available One of the most important phenomena of the last decade has been the convergence of the financial services industry, especially the capital and insurance markets. The convergence in the insurance industry was determined by the increased frequency and the severity of catastrophic risks, market inefficiency in the past, and the new technologies in IT and communications. These globally developments can be observed much better at EU level, one of the most integrated areas of the world, which aimed the convergence of financial market, including an important component such as insurance market. As part of the EU, Romania also aims to financial market convergence with the EU countries. The article offers an overview and an analysis of the insurance market in the EU and Romania. Through a wide series of indicators such as: the amount of insurance premiums, degree of penetration, number of employees or number of insurance companies, it will analyze the evolution of this market convergence, as per all EU countries and Romania. It will identify the stage in which the insurance market in Romania is, regarding the requirements of full integration. Finally, there will be identified factors encouraging and particularly those who are impediments to insurance market convergence in Romania.
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Insurance benefits. 232.885 Section 232.885 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued....885 Insurance benefits. (a) Method of payment. Payment of claim shall be made in the following manner...
Krzysztof Burnecki; Rafal Weron
This chapter develops on risk processes which, perhaps, are most suitable for computer visualization of all insurance objects. At the same time, risk processes are basic instruments for any non-life actuary – they are vital for calculating the amount of loss that an insurance company may incur.
The principal goal of this study was to provide analysis of and recommendations on the need for and feasibility of a geothermal reservoir insurance program. Five major tasks are reported: perception of risk by major market sectors, status of private sector insurance programs, analysis of reservoir risks, alternative government roles, and recommendations.
... financial institutions in cooperation with minority- and women-owned financial institutions and low-income... Financial Assets Transferred by an Insured Depository Institution: The Federal Deposit Insurance Corporation...: Market Risk: The OCC, Board and the FDIC proposed revisions to the market risk capital rule to enhance...
Dillingh, Rik; Kooreman, Peter; Potters, Jan
This paper provides new field evidence on the role of probability numeracy in health insurance purchase. Our regression results, based on rich survey panel data, indicate that the expenditure on two out of three measures of health insurance first rises with probability numeracy and then falls again.
The National Employer Health Insurance Survey (NEHIS) was developed to produce estimates on employer-sponsored health insurance data in the United States. The NEHIS was the first Federal survey to represent all employers in the United States by State and obtain information on all...
This book is a contribution to the scholarly engagement with the wider problem of governing through risk and the politics of uncertainty. It takes life insurance as an empirical site from which to ask: what is the kind of governance created through insurance an instance of, and how does it
PURCELL, FRANK X.
A COMPARISON OF FIRE INSURANCE COSTS OF WOOD, MASONRY, STEEL AND CONCRETE STRUCTURES SHOWS FIRE INSURANCE PREMIMUMS ON WOOD STRUCTURES TEND TO BE HIGHER THAN PREMIUMS ON MASONRY, STEEL AND CONCRETE BUILDINGS, HOWEVER, THE INITIAL COST OF THE WOOD BUILDINGS IS LOWER. DATA SHOW THAT THE SAVINGS ACHIEVED IN THE INITIAL COST OF WOOD STRUCTURES OFFSET…
Frank, Richard G; McGuire, Thomas G
Two important individual health insurance markets-Medicare Advantage and the Marketplaces-are tightly regulated but rely on competition among insurers to supply and price health insurance products. Many local health insurance markets have little competition, which increases prices to consumers. Furthermore, both markets are highly subsidized in ways that can exacerbate the impact of market power-that is, the ability to set price above cost-on health insurance prices. Policy makers need to foster robust competition in both sectors and avoid designing subsidies that make the market-power problem worse. Project HOPE—The People-to-People Health Foundation, Inc.
Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising
Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan
Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates
This paper explores the consequences of the oft ignored fact that public health insurance must actually be supplied by the state. Depending how the state is modeled, different health insurance outcomes are expected. The benevolent model of the state does not account for many actual features of public health insurance systems. One alternative is to use a standard public choice model, where state action is determined by interaction between self-interested actors. Another alternative--related to a strand in public choice theory--is to model the state as Leviathan. Interestingly, some proponents of public health insurance use an implicit Leviathan model, but not consistently. The Leviathan model of the state explains many features of public health insurance: its uncontrolled growth, its tendency toward monopoly, its capacity to buy trust and loyalty from the common people, its surveillance ability, its controlling nature, and even the persistence of its inefficiencies and waiting lines.