WorldWideScience

Sample records for providing insurance coverage

  1. Health insurance eroding for working families: employer-provided coverage declines for fifth consecutive year.

    Science.gov (United States)

    Gould, Elise

    2007-01-01

    In 2005, the percentage of Americans with employer-provided health insurance fell for the fifth year in a row. Workers and their families have been falling into the ranks of the uninsured at alarming rates. The downward trend in employer-provided coverage for children also continued into 2005. In the previous four years, children were less likely to become uninsured as public sector health coverage expanded, but in 2005 the rate of uninsured children increased. While Medicaid and SCHIP still work for many, the government has not picked up coverage for everybody who lost insurance. The weakening of this system-notably for children-is particularly difficult for workers and their families in a time of stagnating incomes. Furthermore, these programs are not designed to prevent low-income adults or middle- or high-income families from becoming uninsured. Government at the federal and state levels has responded to medical inflation with policy changes that reduce public insurance eligibility or with proposals to reduce government costs. Federal policy proposals to lessen the tax advantage of workplace insurance or to encourage a private purchase system could further destabilize the employer-provided system. Now is a critical time to consider health insurance reform. Several promising solutions could increase access to affordable health care. The key is to create large, varied, and stable risk pools.

  2. Women's Health Insurance Coverage

    Science.gov (United States)

    ... 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 ...

  3. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Science.gov (United States)

    2010-05-13

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ45 Group Health Plans and Health Insurance Issuers Providing... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... health plans and health insurance coverage offered in connection with a group health plan under the...

  4. The health and healthcare impact of providing insurance coverage to uninsured children: A prospective observational study.

    Science.gov (United States)

    Flores, Glenn; Lin, Hua; Walker, Candice; Lee, Michael; Currie, Janet M; Allgeyer, Rick; Portillo, Alberto; Henry, Monica; Fierro, Marco; Massey, Kenneth

    2017-05-23

    Of the 4.8 million uninsured children in America, 62-72% are eligible for but not enrolled in Medicaid or CHIP. Not enough is known, however, about the impact of health insurance on outcomes and costs for previously uninsured children, which has never been examined prospectively. This prospective observational study of uninsured Medicaid/CHIP-eligible minority children compared children obtaining coverage vs. those remaining uninsured. Subjects were recruited at 97 community sites, and 11 outcomes monitored monthly for 1 year. In this sample of 237 children, those obtaining coverage were significantly (P health (27% vs. 46%); no PCP (7% vs. 40%); experienced never/sometimes getting immediate care from the PCP (7% vs. 40%); no usual source of preventive (1% vs. 20%) or sick (3% vs. 12%) care; and unmet medical (13% vs. 48%), preventive (6% vs. 50%), and dental (18% vs. 62%) care needs. The uninsured had higher out-of-pocket doctor-visit costs (mean = $70 vs. $29), and proportions of parents not recommending the child's healthcare provider to friends (24% vs. 8%) and reporting the child's health caused family financial problems (29% vs. 5%), and lower well-child-care-visit quality ratings. In bivariate analyses, older age, birth outside of the US, and lacking health insurance for >6 months at baseline were associated with remaining uninsured for the entire year. In multivariable analysis, children who had been uninsured for >6 months at baseline (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.4-10.3) and African-American children (OR, 2.8; 95% CI, 1.1-7.3) had significantly higher odds of remaining uninsured for the entire year. Insurance saved $2886/insured child/year, with mean healthcare costs = $5155/uninsured vs. $2269/insured child (P = .04). Providing health insurance to Medicaid/CHIP-eligible uninsured children improves health, healthcare access and quality, and parental satisfaction; reduces unmet needs and out-of-pocket costs; and saves

  5. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Science.gov (United States)

    2010-07-19

    ... Insurance Issuers To Provide Coverage of Preventive Services Under the Patient Protection and Affordable... Care Act (the Affordable Care Act) regarding preventive health services. The IRS is issuing the....9815-2713 is added to read as follows: Sec. 54.9815-2713 Coverage of preventive health services. [The...

  6. 49 CFR 19.31 - Insurance coverage.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Insurance coverage. 19.31 Section 19.31... Requirements Property Standards § 19.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided to...

  7. 15 CFR 14.31 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Insurance coverage. 14.31 Section 14... COMMERCIAL ORGANIZATIONS Post-Award Requirements Property Standards § 14.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired...

  8. 40 CFR 30.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Insurance coverage. 30.31 Section 30.31... NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 30.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment...

  9. 45 CFR 74.31 - Insurance coverage.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Insurance coverage. 74.31 Section 74.31 Public..., AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Property Standards § 74.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment...

  10. 28 CFR 70.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Insurance coverage. 70.31 Section 70.31...-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 70.31 Insurance coverage. Recipients must, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired...

  11. 32 CFR 32.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Insurance coverage. 32.31 Section 32.31 National... NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 32.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment...

  12. 38 CFR 49.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Insurance coverage. 49.31... NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 49.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment...

  13. 24 CFR 84.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Insurance coverage. 84.31 Section 84.31 Housing and Urban Development Office of the Secretary, Department of Housing and Urban... Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real...

  14. Insurance Coverage Policies for Personalized Medicine

    OpenAIRE

    Andrew Hresko; Haga, Susanne B.

    2012-01-01

    Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent ...

  15. Limited Deposit Insurance Coverage and Bank Competition

    OpenAIRE

    SHY, Oz; Stenbacka, Rune; Yankov, Vladimir

    2014-01-01

    Deposit insurance schemes in many countries place a limit on the coverage of deposits in each bank. However, no limits are placed on the number of accounts held with different banks. Therefore, under limited deposit insurance, some consumers open accounts with different banks to achieve higher or full deposit insurance coverage. We compare three regimes of deposit insurance: No deposit insurance, unlimited deposit insurance, and limited deposit insurance. We show that limited deposit insuranc...

  16. Insurance Coverage Policies for Personalized Medicine

    Directory of Open Access Journals (Sweden)

    Andrew Hresko

    2012-10-01

    Full Text Available Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related and pharmacogenetic (PGx tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit.

  17. 76 FR 7767 - Student Health Insurance Coverage

    Science.gov (United States)

    2011-02-11

    ... HUMAN SERVICES 45 CFR Parts 144 and 147 RIN 0950-AA20 Student Health Insurance Coverage AGENCY: Centers... proposed regulation that would establish rules for student health insurance coverage under the Public Health Service Act and the Affordable Care Act. The proposed rule would define ``student health insurance...

  18. Conceptualising the lack of health insurance coverage.

    Science.gov (United States)

    Davis, J B

    2000-01-01

    This paper examines the lack of health insurance coverage in the US as a public policy issue. It first compares the problem of health insurance coverage to the problem of unemployment to show that in terms of the numbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment. Secondly, the paper discusses the methodology involved in measuring health insurance coverage, and argues that the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance. Third, the paper briefly introduces Amartya Sen's functioning and capabilities framework to suggest a way of representing the extent to which individuals are uninsured. Fourth, the paper sketches a means of operationalizing the Sen representation of the uninsured in terms of the disability-adjusted life year (DALY) measure.

  19. Insurance coverage for male infertility care in the United States

    Directory of Open Access Journals (Sweden)

    James M Dupree

    2016-01-01

    Full Text Available Infertility is a common condition experienced by many men and women, and treatments are expensive. The World Health Organization and American Society of Reproductive Medicine define infertility as a disease, yet private companies infrequently offer insurance coverage for infertility treatments. This is despite the clear role that healthcare insurance plays in ensuring access to care and minimizing the financial burden of expensive services. In this review, we assess the current knowledge of how male infertility care is covered by insurance in the United States. We begin with an appraisal of the costs of male infertility care, then examine the state insurance laws relevant to male infertility, and close with a discussion of why insurance coverage for male infertility is important to both men and women. Importantly, we found that despite infertility being classified as a disease and males contributing to almost half of all infertility cases, coverage for male infertility is often excluded from health insurance laws. Excluding coverage for male infertility places an undue burden on their female partners. In addition, excluding care for male infertility risks missing opportunities to diagnose important health conditions and identify reversible or irreversible causes of male infertility. Policymakers should consider providing equal coverage for male and female infertility care in future health insurance laws.

  20. Insurance coverage for male infertility care in the United States

    Science.gov (United States)

    Dupree, James M

    2016-01-01

    Infertility is a common condition experienced by many men and women, and treatments are expensive. The World Health Organization and American Society of Reproductive Medicine define infertility as a disease, yet private companies infrequently offer insurance coverage for infertility treatments. This is despite the clear role that healthcare insurance plays in ensuring access to care and minimizing the financial burden of expensive services. In this review, we assess the current knowledge of how male infertility care is covered by insurance in the United States. We begin with an appraisal of the costs of male infertility care, then examine the state insurance laws relevant to male infertility, and close with a discussion of why insurance coverage for male infertility is important to both men and women. Importantly, we found that despite infertility being classified as a disease and males contributing to almost half of all infertility cases, coverage for male infertility is often excluded from health insurance laws. Excluding coverage for male infertility places an undue burden on their female partners. In addition, excluding care for male infertility risks missing opportunities to diagnose important health conditions and identify reversible or irreversible causes of male infertility. Policymakers should consider providing equal coverage for male and female infertility care in future health insurance laws. PMID:27030084

  1. Mold insurance: crafting coverage for a spreading problem.

    OpenAIRE

    Barrett, Julia R.

    2003-01-01

    Mold contamination is a growing concern for homeowners in terms of both physical health and insurance. Health experts, although they concede that exposure to mold can cause respiratory illnesses, are calling for further research into other mold-related health effects and for development of standards for mold sampling and data analysis. The insurance industry is grappling with how---and whether---to provide coverage for household damage caused by mold, while some state and federal legislators ...

  2. Employee Costs and the Decline in Health Insurance Coverage

    OpenAIRE

    David M. Cutler

    2002-01-01

    This paper examines why health insurance coverage fell despite the lengthy economic boom of the 1990s. I show that insurance coverage declined primarily because fewer workers took up coverage when offered it, not because fewer workers were offered insurance or were eligible for it. The reduction in take-up is associated with the increase in employee costs for health insurance. Estimates suggest that increased costs to employees can explain the entire decline in take-up rates in the 1990s.

  3. Coverage or costs: the role of health insurance in labor market reentry among early retirees.

    Science.gov (United States)

    Kail, Ben Lennox

    2012-01-01

    This study evaluated the impact of insurance coverage on the odds of returning to work after early retirement and the change in insurance coverage after returning to work. The Health and Retirement Study was used to estimate hierarchical linear models of transitions to full-time work and part-time work relative to remaining retired. A chi-square test was also used to assess change in insurance coverage after returning to work. Insurance coverage was unrelated to the odds of transitioning to full-time work. However, relative to employer-provided insurance, private nongroup insurance increased the odds of transitioning to part-time work, whereas public insurance reduced the odds of making this transition. Additionally, after returning to work, insurance coverage increased among those who were without employer-provided insurance in retirement. Results indicated that source of coverage may be more useful in explaining returns to part-time work than simply whether people have coverage at all. In other words, the mechanism underlying the positive relationship between insurance and returning to work appeared to be limited to those who return to work because of the cost of private nongroup insurance. Among these people, however, there was some evidence that they are able to secure new coverage once they return to work.

  4. Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

    Science.gov (United States)

    Jin, Yinzi; Hou, Zhiyuan; Zhang, Donglan

    2016-01-01

    Background China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. Methods We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. Results In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. Conclusion The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance. PMID:27564320

  5. Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance.

    Directory of Open Access Journals (Sweden)

    Yinzi Jin

    Full Text Available China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China.We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance.In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR = 0.40, 95% Confidence Interval (CI: 0.34-0.47 and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16-0.31. But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24-1.57. Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48-0.63, particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage.The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance.

  6. Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance.

    Science.gov (United States)

    Jin, Yinzi; Hou, Zhiyuan; Zhang, Donglan

    2016-01-01

    China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34-0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16-0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24-1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48-0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance.

  7. Strategies for expanding health insurance coverage in vulnerable populations.

    Science.gov (United States)

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-11-26

    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

  8. Pricing of drugs with heterogeneous health insurance coverage.

    Science.gov (United States)

    Ferrara, Ida; Missios, Paul

    2012-03-01

    In this paper, we examine the role of insurance coverage in explaining the generic competition paradox in a two-stage game involving a single producer of brand-name drugs and n quantity-competing producers of generic drugs. Independently of brand loyalty, which some studies rely upon to explain the paradox, we show that heterogeneity in insurance coverage may result in higher prices of brand-name drugs following generic entry. With market segmentation based on insurance coverage present in both the pre- and post-entry stages, the paradox can arise when the two types of drugs are highly substitutable and the market is quite profitable but does not have to arise when the two types of drugs are highly differentiated. However, with market segmentation occurring only after generic entry, the paradox can arise when the two types of drugs are weakly substitutable, provided, however, that the industry is not very profitable. In both cases, that is, when market segmentation is present in the pre-entry stage and when it is not, the paradox becomes more likely to arise as the market expands and/or insurance companies decrease deductibles applied on the purchase of generic drugs. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. 77 FR 16453 - Student Health Insurance Coverage

    Science.gov (United States)

    2012-03-21

    ... which it is incorporated; (7) be provided in languages other than English; and (8) be allowed to be... the front of the insurance policy or certificate and any other plan materials. Model language was... is appropriately sold to students--for instance, foreign students studying for only one semester in...

  10. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Science.gov (United States)

    2011-08-03

    ... Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human Services... with respect to group health plans and health insurance coverage offered in connection with a group.... The temporary regulations provide guidance to employers, group health plans, and health insurance...

  11. Determinants of the demand for health insurance coverage

    NARCIS (Netherlands)

    K.P.M. Winssen van (Kayleigh)

    2017-01-01

    markdownabstractThe health insurance density in the Netherlands is among the highest in the world. This is shown by the fact that, in 2016, only 12 per cent of the Dutch insured opted for a reduction of health insurance coverage in the form of a voluntary deductible, while, at the same time, 84 per

  12. Long-term determinants of patterns of health insurance coverage in the Medicare population.

    Science.gov (United States)

    Lillard, L; Rogowski, J; Kington, R

    1997-06-01

    Using data from the 1990 Health Supplement to the Panel Study of Income Dynamics, we examine the determinants of patterns of insurance coverage among the elderly. Among those with supplemental insurance through an employment-based source, the primary determinant of having insurance is work history, specifically job tenure and occupation of household heads and their spouses. Among those who do not have employer-provided insurance, wealth is the most important economic factor in the purchase of private insurance. Blacks, persons with less education and women household heads are less likely to purchase supplemental insurance. We find little evidence that persons in prior poor health are more likely to purchase supplemental insurance, and the most important determinant of dental or drug coverage is having employer-based insurance. The current trend toward decreased generosity of post-retirement benefits implies that fewer older Americans will have insurance for these services.

  13. Strategies for expanding health insurance coverage in vulnerable populations

    OpenAIRE

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    Background Health insurance has the potential to improve access to health care and protect people from the financial risks of diseases. However, health insurance coverage is often low, particularly for people most in need of protection, including children and other vulnerable populations. Objectives To assess the effectiveness of strategies for expanding health insurance coverage in vulnerable populations. Search methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), pa...

  14. Strategies for expanding health insurance coverage in vulnerable populations

    Science.gov (United States)

    Jia, Liying; Yuan, Beibei; Huang, Fei; Lu, Ying; Garner, Paul; Meng, Qingyue

    2014-01-01

    ) 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

  15. 78 FR 14034 - Health Insurance Providers Fee

    Science.gov (United States)

    2013-03-04

    ... Internal Revenue Service 26 CFR Part 57 RIN 1545-BL20 Health Insurance Providers Fee AGENCY: Internal... covered entities engaged in the business of providing health insurance for United States health risks... regulations affect persons engaged in the business of providing health insurance for United States health...

  16. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-06-17

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage Rules... respect to group health plans and health insurance coverage offered in connection with a group health plan... temporary regulations provide guidance to employers, group health plans, and health insurance issuers...

  17. Insurance Coverage and Whither Thou Goest for Health Info

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Insurance Coverage and Whither Thou Goest for Health Information in 2012, recently published in Volume 4, Issue 4 of the Medicare and Medicaid Research...

  18. The effect of health insurance coverage and the doctor-patient relationship on health care utilization in high poverty neighborhoods

    National Research Council Canada - National Science Library

    Destini A. Smith; Alan Akira; Kenneth Hudson; Andrea Hudson; Marcellus Hudson; Marcus Mitchell; Errol Crook

    2017-01-01

    .... We hypothesize that in low socioeconomic status neighborhoods, having health insurance coverage and a regular health care provider increases the likelihood of receiving diagnostic tests for cardio...

  19. Chiropractic Use by Urban and Rural Residents with Insurance Coverage

    Science.gov (United States)

    Lind, Bonnie K.; Diehr, Paula K.; Grembowski, David E.; Lafferty, William E.

    2009-01-01

    Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use…

  20. Does the Market Choose Optimal Health Insurance Coverage

    NARCIS (Netherlands)

    Boone, J.

    2013-01-01

    Abstract Consumers, when buying health insurance, do not know the exact value of each treatment that they buy coverage for. This leads them to overvalue some treatments and undervalue others. We show that the insurance market cannot correct these mistakes. This causes research labs to overinvest in

  1. Discontinuous insurance coverage predicts prolonged hospital stay after pediatric adenotonsillectomy.

    Science.gov (United States)

    Tumin, Dmitry; King, Adele; Walia, Hina; Tobias, Joseph D; Raman, Vidya T

    2017-10-01

    Changes in health insurance coverage have been implicated in limiting access to care and increasing morbidity risk. The consequences of insurance discontinuity for surgical outcomes are unclear. In this study, we explored whether recent insurance discontinuity was associated with prolonged inpatient hospitalization after adenotonsillectomy in children. We retrospectively evaluated single-center data on children aged 2-18 y undergoing adenotonsillectomy with overnight stay in 2009-2014. Insurance coverage at surgery and over the preceding year was categorized as (1) continuous private, (2) continuous Medicaid, or (3) discontinuous (changes or gaps in coverage). The association between insurance discontinuity and prolonged hospitalization (≥2 d) was evaluated using multivariable logistic regression. The study included 1013 girls and 983 boys (aged 4.5 ± 2.9 y), of whom 205 (10%) required prolonged hospitalization. Insurance was continuous private for 749 patients (38%), continuous Medicaid for 1121 patients (56%), and discontinuous for 126 patients (6%). Prolonged stay was most common with discontinuous insurance (23/126, 18%), followed by continuous Medicaid (117/1,121, 10%), and continuous private insurance (65/749, 9%; P = 0.004). In multivariable analysis, discontinuous insurance remained associated with prolonged hospital stay, compared with continuous private insurance (odds ratio = 1.88; 95% confidence interval: 1.06-3.33; P = 0.031), and compared with continuous Medicaid (odds ratio = 1.86; 95% confidence interval: 1.09-3.19; P = 0.023). This study demonstrates greater odds of prolonged hospitalization after adenotonsillectomy among children with recent gaps or changes in insurance coverage and illustrates the feasibility of studying influences of health insurance change on surgical outcomes using existing data in hospital electronic records. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Insurance Coverage and Utilization at a Sexually Transmitted Disease Clinic in a Medicaid Expansion State.

    Science.gov (United States)

    Montgomery, Madeline C; Raifman, Julia; Nunn, Amy S; Bertrand, Thomas; Uvin, A Ziggy; Marak, Theodore; Comella, Jaime; Almonte, Alexi; Chan, Philip A

    2017-05-01

    In Rhode Island, the Patient Protection and Affordable Care Act has led to over 95% of the state's population being insured. We evaluated insurance coverage and barriers to insurance use among patients presenting for services at the Rhode Island sexually transmitted disease (STD) clinic. We analyzed factors associated with insurance coverage and utilization among patients presenting for STD services between July and December 2015. A total of 692 patients had insurance information available; of those, 40% were uninsured. Patients without insurance were more likely than those with insurance to be nonwhite (50% among uninsured, compared with 40% among insured; P = 0.014) and Hispanic or Latino/a (25%, compared with 16%; P = 0.006), and less likely to be men who have sex with men (27%, compared with 39%; P = 0.001). Of those with health insurance, 26% obtained coverage as a result of the Affordable Care Act, and 56% of those were previously uninsured. Among uninsured individuals, barriers to obtaining health insurance included cost and unemployment. Among those with insurance, 43% reported willingness to use insurance for STD services. Barriers to insurance use included concerns about anonymity and out-of-pocket costs. Despite expanded insurance access, many individuals presenting to the Rhode Island STD Clinic were uninsured. Among those who were insured, significant barriers still existed to using insurance. STD clinics continue to play an important role in providing safety-net STD services in states with low uninsured rates. Both public and private insurers are needed to address financial barriers and optimize payment structures for services.

  3. The Affordable Care Act's insurance market regulations' effect on coverage.

    Science.gov (United States)

    Wettstein, Gal

    2017-09-21

    Much of the debate surrounding reform of the Patient Protection and Affordable Care Act (ACA) revolves around its insurance market regulation. This paper studies the impact on health insurance coverage of those provisions. Using data from the American Community Survey, years 2008-2015, I focus on individuals, ages 26 to 64, who are ineligible for the subsidies or Medicaid expansions included in the ACA to isolate the effect of its market regulation. To account for time trends, I utilize a differences-in-differences approach with a control group of residents of Massachusetts who were already subject to a similarly regulated health insurance market. I find that the ACA's regulations caused an increase of 0.95 percentage points in health insurance coverage for my sample in 2014. This increase was concentrated among younger individuals, suggesting that the law's regulations ameliorated adverse selection in the individual health insurance market. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Insure Kids Now (IKN) (Dental Care Providers)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Insure Kids Now (IKN) Dental Care Providers in Your State locator provides profile information for oral health providers participating in Medicaid and Children's...

  5. Disparities in Private Health Insurance Coverage of Skilled Care

    Directory of Open Access Journals (Sweden)

    Stacey A. Tovino

    2017-10-01

    Full Text Available This article compares and contrasts public and private health insurance coverage of skilled medical rehabilitation, including cognitive rehabilitation, physical therapy, occupational therapy, speech-language pathology, and skilled nursing services (collectively, skilled care. As background, prior scholars writing in this area have focused on Medicare coverage of skilled care and have challenged coverage determinations limiting Medicare coverage to beneficiaries who are able to demonstrate improvement in their conditions within a specific period of time (the Improvement Standard. By and large, these scholars have applauded the settlement agreement approved on 24 January 2013, by the U.S. District Court for the District of Vermont in Jimmo v. Sebelius (Jimmo, as well as related motions, rulings, orders, government fact sheets, and Medicare program manual statements clarifying that Medicare covers skilled care that is necessary to prevent or slow a beneficiary’s deterioration or to maintain a beneficiary at his or her maximum practicable level of function even though no further improvement in the beneficiary’s condition is expected. Scholars who have focused on beneficiaries who have suffered severe brain injuries, in particular, have framed public insurance coverage of skilled brain rehabilitation as an important civil, disability, and educational right. Given that approximately two-thirds of Americans with health insurance are covered by private health insurance and that many private health plans continue to require their insureds to demonstrate improvement within a short period of time to obtain coverage of skilled care, scholarship assessing private health insurance coverage of skilled care is important but noticeably absent from the literature. This article responds to this gap by highlighting state benchmark plans’ and other private health plans’ continued use of the Improvement Standard in skilled care coverage decisions and

  6. Deposit Insurance Coverage, Credibility of Non-insurance, and Banking Crises

    DEFF Research Database (Denmark)

    Angkinand, Apanard; Wihlborg, Clas

    2005-01-01

    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...... hazard incentives for risk-taking in banking. Using both the occurrence of banking crises and non-performing loans in the banking sector as proxies for excessive risk-taking the results strongly support this hypothesis in industrial and emerging market economies. Policy recommendations on the country...

  7. Insurance coverage for male infertility care in the United States

    OpenAIRE

    Dupree, James M

    2016-01-01

    Infertility is a common condition experienced by many men and women, and treatments are expensive. The World Health Organization and American Society of Reproductive Medicine define infertility as a disease, yet private companies infrequently offer insurance coverage for infertility treatments. This is despite the clear role that healthcare insurance plays in ensuring access to care and minimizing the financial burden of expensive services. In this review, we assess the current knowledge of h...

  8. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Science.gov (United States)

    2010-11-17

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage... provide guidance to employers, group health plans, and health insurance issuers providing group health... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar...

  9. The value of coverage in the medicare advantage insurance market.

    Science.gov (United States)

    Dunn, Abe

    2010-12-01

    This paper examines the impact of coverage on demand for health insurance in the Medicare Advantage (MA) insurance market. Estimating the effects of coverage on demand poses a challenge for researchers who must consider both the hundreds of benefits that affect out-of-pocket costs (OOPC) to consumers, but also the endogeneity of coverage. These problems are addressed in a discrete choice demand model by employing a unique measure of OOPC that considers a consumer's expected payments for a fixed bundle of health services and applying instrumental variable techniques to address potential endogeneity bias. The results of the demand model show that OOPC have a significant effect on consumer surplus and that not instrumenting for OOPC results in a significant underestimate of the value of coverage. Copyright © 2010 Elsevier B.V. All rights reserved.

  10. 45 CFR 148.122 - Guaranteed renewability of individual health insurance coverage.

    Science.gov (United States)

    2010-10-01

    ... insurance coverage. 148.122 Section 148.122 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE INDIVIDUAL HEALTH INSURANCE MARKET... health insurance coverage. (a) Applicability. This section applies to all health insurance coverage in...

  11. Welfare reform and older immigrants' health insurance coverage.

    Science.gov (United States)

    Nam, Yunju

    2008-11-01

    I examined changes in older immigrants' health insurance coverage after welfare reform in the United States to determine whether the reform measures achieved their goal of saving money by reducing Medicaid participation without increasing the number of uninsured people. Data were obtained from older adults who participated in the Current Population Survey's Annual Social and Economic Supplement from 1994 to 1996 and 2001 to 2005. I used logistic regression to estimate changes in the sample's Medicaid and health insurance coverage after welfare reform, paying special attention to noncitizens and recent immigrants. Older immigrants' health insurance status was associated with their citizenship status and length of stay in the United States. Medicaid participation significantly decreased among noncitizens and recent immigrants but increased among naturalized citizens. Private health insurance and employer-sponsored insurance coverage significantly increased among recent immigrants but decreased among established immigrants and naturalized citizens. The probability of being uninsured did not significantly change among any group of immigrants. Given increases in postreform Medicaid participation among some immigrant groups, my findings suggest that the long-term cost-saving effectiveness of the current restrictive Medicaid eligibility policy is doubtful.

  12. Breast Health Services: Accuracy of Benefit Coverage Information in the Individual Insurance Marketplace.

    Science.gov (United States)

    Hamid, Mariam S; Kolenic, Giselle E; Dozier, Jessica; Dalton, Vanessa K; Carlos, Ruth C

    2017-04-01

    The aim of this study was to determine if breast health coverage information provided by customer service representatives employed by insurers offering plans in the 2015 federal and state health insurance marketplaces is consistent with Patient Protection and Affordable Care Act (ACA) and state-specific legislation. One hundred fifty-eight unique customer service numbers were identified for insurers offering plans through the federal marketplace, augmented with four additional numbers representing the Connecticut state-run exchange. Using a standardized patient biography and the mystery-shopper technique, a single investigator posed as a purchaser and contacted each number, requesting information on breast health services coverage. Consistency of information provided by the representative with the ACA mandates (BRCA testing in high-risk women) or state-specific legislation (screening ultrasound in women with dense breasts) was determined. Insurer representatives gave BRCA test coverage information that was not consistent with the ACA mandate in 60.8% of cases, and 22.8% could not provide any information regarding coverage. Nearly half (48.1%) of insurer representatives gave coverage information about ultrasound screening for dense breasts that was not consistent with state-specific legislation, and 18.5% could not provide any information. Insurance customer service representatives in the federal and state marketplaces frequently provide inaccurate coverage information about breast health services that should be covered under the ACA and state-specific legislation. Misinformation can inadvertently lead to the purchase of a plan that does not meet the needs of the insured. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Operationalizing universal health coverage in Nigeria through social health insurance

    Science.gov (United States)

    Okpani, Arnold Ikedichi; Abimbola, Seye

    2015-01-01

    Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme. PMID:26778879

  14. Health insurance coverage, medical expenditure and coping strategy: evidence from Taiwan.

    Science.gov (United States)

    Fang, Kuangnan; Shia, Ben-Chang; Ma, Shuangge

    2012-12-03

    The health insurance system in Taiwan is comprised of public health insurance and private health insurance. The public health insurance, called "universal national health insurance" (NHI), was first established in 1995 and amended in 2011. The goal of this study is to provide an updated description of several important aspects of health insurance in Taiwan. Of special interest are household insurance coverage, medical expenditures (both gross and out-of-pocket), and coping strategies. Data was collected via a phone call survey conducted in August and September of 2011. A household was the unit for survey and data analysis. A total of 2,424 households covering all major counties and cities in Taiwan were surveyed. The survey revealed that households with smaller sizes and higher incomes were more likely to have higher coverage of public and private health insurance. In addition, households with the presence of chronic diseases were more likely to have both types of insurance. Analysis of both gross and out-of-pocket medical expenditure was conducted. It was suggested that health insurance could not fully remove the financial burden caused by illness. The presence of chronic disease and inpatient treatment were significantly associated with higher gross and out-of-pocket medical expenditure. In addition, the presence of inpatient treatment was significantly associated with extremely high medical expenditure. Regional differences were also observed, with households in the northern, central, and southern regions having less gross medical expenditures than those on the offshore islands. Households with the presence of inpatient treatment were more likely to cope with medical expenditure using means other than salaries. Despite the considerable achievements of the health insurance system in Taiwan, there is still room for improvement. This study investigated coverage, cost, and coping strategies and may be informative to stakeholders of both basic and commercial health

  15. Insurance coverage of pediatric burns: Switzerland versus USA.

    Science.gov (United States)

    Deghayli, Lina; Moufarrij, Sara; Norberg, Michael; Sheridan, Robert; Raffoul, Wassim; de Buys Roessingh, Anthony; Hirt-Burri, Nathalie; Applegate, Lee Ann

    2014-08-01

    Burn care and research have significantly improved over the past years. However, insurance coverage of such treatments does not reflect the improvements in this multi-disciplinary field. Government insurance policies in first world countries renown for burn care treatment, such as Switzerland and the United States, have not adapted to the complexity and longitudinal nature of burn care. Using case studies from both countries, we have analyzed both the institutional and policy approach to pediatric burn treatment coverage. Subsequently, by presenting the Shriners burn care model, we offer a policy recommendation to both the Swiss and the American governments to better their present legislation and infrastructure on pediatric burn coverage. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  16. 76 FR 61245 - Provision of Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and...

    Science.gov (United States)

    2011-10-03

    ... Coverage for Commercial Air Carrier Service in Domestic and International Operations #0; #0; #0... Aviation Insurance Coverage for Commercial Air Carrier Service in Domestic and International Operations...

  17. The likely effects of employer-mandated complementary health insurance on health coverage in France.

    Science.gov (United States)

    Pierre, Aurélie; Jusot, Florence

    2017-03-01

    In France, access to health care greatly depends on having a complementary health insurance coverage (CHI). Thus, the generalisation of CHI became a core factor in the national health strategy created by the government in 2013. The first measure has been to compulsorily extend employer-sponsored CHI to all private sector employees on January 1st, 2016 and improve its portability coverage for unemployed former employees for up to 12 months. Based on data from the 2012 Health, Health Care and Insurance survey, this article provides a simulation of the likely effects of this mandate on CHI coverage and related inequalities in the general population by age, health status, socio-economic characteristics and time and risk preferences. We show that the non-coverage rate that was estimated to be 5% in 2012 will drop to 4% following the generalisation of employer-sponsored CHI and to 3.7% after accounting for portability coverage. The most vulnerable populations are expected to remain more often without CHI whereas non coverage will significantly decrease among the less risk averse and the more present oriented. With its focus on private sector employees, the policy is thus likely to do little for populations that would benefit most from additional insurance coverage while expanding coverage for other populations that appear to place little value on CHI. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Variations in health insurance coverage: benefits vs. premiums.

    Science.gov (United States)

    Wilensky, G R; Farley, P J; Taylor, A K

    1984-01-01

    Renewed national interest in market forces to promote more efficient and cost-conscious behavior by patients and providers increasingly focuses on the structure of private health insurance benefits. Two features of procompetitive legislative proposals are considered: a ceiling on tax-free employer insurance premiums and offering greater choice of insurance plans. The interests of efficiency and equity invoke different kinds of risks and transfers; no single institutional approach is likely to yield the promised benefits.

  19. Patient Experience Of Provider Refusal Of Medicaid Coverage And Its Implications.

    Science.gov (United States)

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2016-01-01

    Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance coverage reported by 23,992 adults with continuous coverage for the past 12 months. We find that among Medicaid enrollees, 6.73% reported their coverage being refused by a provider in 2012, a rate higher than that in Medicare and private insurance by 4.07 (p<.01) and 3.68 (p<.001) percentage points, respectively. Refusal of Medicaid coverage is associated with delaying needed care, using emergency room (ER) as a usual source of care, and perceiving current coverage as worse than last year. In view of the Affordable Care Act's (ACA) Medicaid expansion, future studies should continue monitoring enrollees' experience of coverage refusal.

  20. 78 FR 54996 - Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under...

    Science.gov (United States)

    2013-09-09

    ... on Health Insurance Coverage Offered Under Employer-Sponsored Plans AGENCY: Internal Revenue Service... credit to help individuals and families afford health insurance coverage purchased through an Affordable... health insurance coverage offered by an employer to the employee that is (1) a governmental plan, within...

  1. Health insurance coverage, income distribution and healthcare quality in local healthcare markets.

    Science.gov (United States)

    Damianov, Damian S; Pagán, José A

    2013-08-01

    We develop a theoretical model of a local healthcare system in which consumers, health insurance companies, and healthcare providers interact with each other in markets for health insurance and healthcare services. When income and health status are heterogeneous, and healthcare quality is associated with fixed costs, the market equilibrium level of healthcare quality will be underprovided. Thus, healthcare reform provisions and proposals to cover the uninsured can be interpreted as an attempt to correct this market failure. We illustrate with a numerical example that if consumers at the local level clearly understand the linkages between health insurance coverage and the quality of local healthcare services, health insurance coverage proposals are more likely to enjoy public support. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Insurance cancellations in context: stability of coverage in the nongroup market prior to health reform.

    Science.gov (United States)

    Sommers, Benjamin D

    2014-05-01

    Recent cancellations of nongroup health insurance plans generated much policy debate and raised concerns that the Affordable Care Act (ACA) may increase the number of uninsured Americans in the short term. This article provides evidence on the stability of nongroup coverage using US census data for the period 2008-11, before ACA provisions took effect. The principal findings are threefold. First, this market was characterized by high turnover: Only 42 percent of people with nongroup coverage at the outset of the study period retained that coverage after twelve months. Second, 80 percent of people experiencing coverage changes acquired other insurance within a year, most commonly from an employer. Third, turnover varied across groups, with stable coverage more common for whites and self-employed people than for other groups. Turnover was particularly high among adults ages 19-35, with only 21 percent of young adults retaining continuous nongroup coverage for two years. Given estimates from 2012 that 10.8 million people were covered in this market, these results suggest that 6.2 million people leave nongroup coverage annually. This suggests that the nongroup market was characterized by frequent disruptions in coverage before the ACA and that the effects of the recent cancellations are not necessarily out of the norm. These results can serve as a useful pre-ACA baseline with which to evaluate the law's long-term impact on the stability of nongroup coverage.

  3. Health insurance coverage among women in Indonesia's major cities: A multilevel analysis.

    Science.gov (United States)

    Christiani, Yodi; Byles, Julie E; Tavener, Meredith; Dugdale, Paul

    2017-03-01

    We examined women's access to health insurance in Indonesia. We analyzed IFLS-4 data of 1,400 adult women residing in four major cities. Among this population, the health insurance coverage was 24%. Women who were older, involved in paid work, and with higher education had greater access to health insurance (p health insurance across community levels (Median Odds Ratios = 3.40). Given the importance of health insurance for women's health, strategies should be developed to expand health insurance coverage among women in Indonesia, including the disparities across community levels. Such problems might also be encountered in other developing countries with low health insurance coverage.

  4. Employer Cooperation in Group Insurance Coverage for Public-School Personnel, 1964-65.

    Science.gov (United States)

    National Education Association, Washington, DC.

    This study presents data on group insurance coverage for public school personnel during the 1964-65 academic year, collected from 646 school systems of all sizes throughout the United States. Areas covered include (1) group life insurance, (2) group hospitalization insurance, (3) group medical-surgical insurance, (4) group major medical insurance,…

  5. The effect of health insurance coverage and the doctor-patient relationship on health care utilization in high poverty neighborhoods

    Directory of Open Access Journals (Sweden)

    Destini A. Smith

    2017-09-01

    Full Text Available African Americans have higher rates of mortality than whites who are the same age and sex. We hypothesize that in low socioeconomic status neighborhoods, having health insurance coverage and a regular health care provider increases the likelihood of receiving diagnostic tests for cardiovascular disease and diabetes. We use data from a random two-stage cluster sample of 230 adults living in high poverty census tracts to examine the effects of insurance coverage and having a regular doctor on the likelihood receiving diagnostic tests for high cholesterol, high blood sugar, and blood pressure. We find that health insurance coverage increases the odds of having a regular health care provider (p < 0.05 and of receiving the diagnostic tests (p < 0.05. Having a regular doctor mediates the effect of insurance coverage on the likelihood of receiving the tests, especially when the participant can report the physician's name.

  6. The effect of health insurance coverage and the doctor-patient relationship on health care utilization in high poverty neighborhoods.

    Science.gov (United States)

    Smith, Destini A; Akira, Alan; Hudson, Kenneth; Hudson, Andrea; Hudson, Marcellus; Mitchell, Marcus; Crook, Errol

    2017-09-01

    African Americans have higher rates of mortality than whites who are the same age and sex. We hypothesize that in low socioeconomic status neighborhoods, having health insurance coverage and a regular health care provider increases the likelihood of receiving diagnostic tests for cardiovascular disease and diabetes. We use data from a random two-stage cluster sample of 230 adults living in high poverty census tracts to examine the effects of insurance coverage and having a regular doctor on the likelihood receiving diagnostic tests for high cholesterol, high blood sugar, and blood pressure. We find that health insurance coverage increases the odds of having a regular health care provider (p < 0.05) and of receiving the diagnostic tests (p < 0.05). Having a regular doctor mediates the effect of insurance coverage on the likelihood of receiving the tests, especially when the participant can report the physician's name.

  7. Vaccination coverage in children can be estimated from health insurance data

    Directory of Open Access Journals (Sweden)

    Tauscher Martin

    2008-03-01

    Full Text Available Abstract Background The introduction of new vaccines for young children requires instruments for a rapid and timely assessment of the progressively increasing vaccination coverage. We assessed whether routine data generated by statutory health insurances (SHI might be used to monitor vaccination coverage in young children. Methods For 90% of the population Germany's healthcare system is premium-funded through SHI. Specific medical codes on childhood vaccination are used for billing. These were used to analyse vaccine uptake up to 24 months in children born in Bavaria between 2001–10–01 and 2002–12–31. For children insured in the biggest SHI, vaccination coverage estimates based on billing data were compared to estimates considering only continuously insured children since birth, based on additional data provided by this SHI. Results Definition of an appropriate denominator from the billing data was a major challenge: defining the denominator by any consultation by children with different ID numbers yielded 196,732 children, exceeding the number of births in Bavaria by a factor of 1.4. The main causes for this inflated denominator were migration and change of health insurance number. A reduced dataset based on at least one physician's visit in the first six months and 2nd year of life yielded 111,977 children. Vaccination coverage estimates for children in the biggest SHI were at maximum 1.7% higher than in the data set based on continuously insured children. Conclusion With appropriate adjustments to define the denominator physician's billing data provide a promising tool to estimate immunisation coverage. A slight overestimation based on these data was explained by children never seeing a physician.

  8. Determinants for employer-paid health insurance coverage: a population-based study of the Danish labour force.

    Science.gov (United States)

    Christensen, Ann; Søgaard, Rikke

    2013-08-01

    In 2002, the Danish tax law was changed, giving employees a tax exemption on supplemental, employer-paid health insurance. This might have conflicted with one of the key foundations of the healthcare system, namely equal access for equal needs. The aim of this study was to investigate determinants for employer-paid health insurance coverage. Because the policy change affected only people who were part of the labour force and because the public sector at that time had no tradition of providing fringe benefits, the analysis was restricted to the private labour force. The analysis was based on data from a range of Danish person-level and company-level registers (explanatory variables). These data were combined with information on insurance status obtained from the trade organisation for insurance (dependent variable). A logistic regression was performed to estimate the odds of having employer-paid health insurance coverage. The individuals who were most likely to be insured were those employed in foreign companies as mid-level managers within the field of building and construction. Other important variables were the number of persons employed in a company, gender, ethnicity, region of residence, years of education, and annual income. Both company and individual characteristics were found to be important and significant predictors for employer-paid health insurance coverage. The Danish tax exemption on private health insurance in the years 2002-12 thus seems to have led to inequality in employer-paid health insurance coverage.

  9. A reappraisal of private employers' role in providing health insurance.

    Science.gov (United States)

    Carrasquillo, O; Himmelstein, D U; Woolhandler, S; Bor, D H

    1999-01-14

    In 1996, according to official figures, 61 percent of Americans received health insurance through employers. However, this estimate includes persons who relied primarily on government insurance such as Medicare, workers whose employers arranged their insurance but contributed nothing toward the premiums, and government employees whose private coverage was paid for by taxpayers. To estimate the number of persons whose principal health insurance was paid for in whole or in part by employers in the private sector and the number receiving government-funded insurance, we analyzed data from the March 1997 Current Population Survey. Approximately 130,000 persons representative of the noninstitutionalized U.S. population were sampled. We considered people to be covered principally by health insurance paid for by private-sector employers if they had no public insurance coverage and were covered by insurance from a non-governmental employer who paid all or part of their premiums. Those who were covered by Medicaid, Medicare, insurance resulting from former or current military service, or the Indian Health Service were considered to be receiving government insurance. In 1996, 43.1 percent of the population (90 percent confidence interval, 42.7 to 43.5 percent) depended principally on health insurance paid for by private-sector employers, 34.2 percent (90 percent confidence interval, 33.8 to 34.6 percent) had publicly funded insurance, 7.1 percent (90 percent confidence interval, 6.8 to 7.6 percent) purchased their own coverage, and 15.6 percent (90 percent confidence interval, 15.3 to 15.9 percent) were uninsured. In only six states was more than half the population covered principally by health insurance paid for by private-sector employers. Current definitions of health insurance overemphasize the role of private employers and underestimate the extent to which government pays for health insurance.

  10. Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China

    Science.gov (United States)

    Zhao, Yinjun; Kang, Bowei; Liu, Yawen; Li, Yichong; Shi, Guoqing; Shen, Tao; Jiang, Yong; Zhang, Mei; Zhou, Maigeng; Wang, Limin

    2014-01-01

    Background China has the world's largest floating (migrant) population, which has characteristics largely different from the rest of the population. Our goal is to study health insurance coverage and its impact on medical cost for this population. Methods A telephone survey was conducted in 2012. 644 subjects were surveyed. Univariate and multivariate analysis were conducted on insurance coverage and medical cost. Results 82.2% of the surveyed subjects were covered by basic insurance at hometowns with hukou or at residences. Subjects' characteristics including age, education, occupation, and presence of chronic diseases were associated with insurance coverage. After controlling for confounders, insurance coverage was not significantly associated with gross or out-of-pocket medical cost. Conclusion For the floating population, health insurance coverage needs to be improved. Policy interventions are needed so that health insurance can have a more effective protective effect on cost. PMID:25386914

  11. Individual health insurance within the family : can subsidies promote family coverage?

    OpenAIRE

    Kapur, Kanika; Marquis, M Susan; Escarce, José J.

    2007-01-01

    This paper examines the role of price in health insurance coverage decisions within the family to guide policy in promoting whole family coverage. We analyze the factors that affect individual health insurance coverage among families, and explore family decisions about whom to cover and whom to leave uninsured. The analysis uses household data from California combined with abstracted individual health plan benefit and premium data. We find that premium subsidies for individual insurance would...

  12. The effect of Medicare coverage for the disabled on the market for private insurance.

    Science.gov (United States)

    Cogan, John F; Hubbard, R Glenn; Kessler, Daniel P

    2010-05-01

    We investigate whether the removal of high-cost individuals from private insurance markets leads to greater coverage for individuals who are similar but not as high cost. Using data on insurance coverage from the Panel Study of Income Dynamics, we estimate the effect of the extension of Medicare to the disabled on the private insurance coverage of non-disabled individuals. We find that the insurance coverage of individuals who had a health condition that limited their ability to work increased significantly in states with high versus low rates of disability.

  13. Clinical trial insurance coverage for cancer patients under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Christine B. Mackay

    2016-04-01

    Conclusion: Three main factors limit the effectiveness of the ACA provisions in expanding clinical trial coverage: 1 ‘grandfathered’ self-funded employer plans not subject to state Employee Retirement Income Security Act (ERISA regulations, 2 Medicaid coverage limits not addressed under the ACA, 3 populations that remain uninsured. Kansas saw a negligible increase in insurance coverage as a result of the ACA thus lack of insurance coverage is likely to remain a concern for cancer patients.

  14. Deciphering the complex intermediate role of health coverage through insurance in the context of well-being by network analysis

    CERN Document Server

    Cifuentes, Myriam Patricia

    2016-01-01

    Recent initiatives that overstate health insurance coverage for well-being conflict with the recognized antagonistic facts identified by the determinants of health that identify health care as an intermediate factor. By using a network of controlled interdependences among multiple social resources including health insurance, which we reconstructed from survey data of the U.S. and Bayesian networks structure learning algorithms, we examined why health insurance through coverage, which in most countries is the access gate to health care, is just an intermediate factor of well-being. We used social network analysis methods to explore the complex relationships involved at general, specific and particular levels of the model. All levels provide evidence that the intermediate role of health insurance relies in a strong relationship to income and reproduces its unfair distribution. Some signals about the most efficient type of health coverage emerged in our analyses.

  15. Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States.

    Science.gov (United States)

    Courtemanche, Charles; Marton, James; Ukert, Benjamin; Yelowitz, Aaron; Zapata, Daniela

    2017-01-01

    The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates. This strategy allows us to identify the effects of the ACA in both Medicaid expansion and non-expansion states. Our preferred specification suggests that, at the average pre-treatment uninsured rate, the full ACA increased the proportion of residents with insurance by 5.9 percentage points compared to 2.8 percentage points in states that did not expand Medicaid. Private insurance expansions from the ACA were due to increases in both employer-provided and non-group coverage. The coverage gains from the full ACA were largest for those without a college degree, non-whites, young adults, unmarried individuals, and those without children in the home. We find no evidence that the Medicaid expansion crowded out private coverage.

  16. Moving towards universal coverage in South Africa? Lessons from a voluntary government insurance scheme

    Directory of Open Access Journals (Sweden)

    Veloshnee Govender

    2013-01-01

    Full Text Available Background: In 2005, the South African government introduced a voluntary, subsidised health insurance scheme for civil servants. In light of the global emphasis on universal coverage, empirical evidence is needed to understand the relationship between new health financing strategies and health care access thereby improving global understanding of these issues. Objectives: This study analysed coverage of the South African government health insurance scheme, the population groups with low uptake, and the individual-level factors, as well as characteristics of the scheme, that influenced enrolment. Methods: Multi-stage random sampling was used to select 1,329 civil servants from the health and education sectors in four of South Africa's nine provinces. They were interviewed to determine factors associated with enrolment in the scheme. The analysis included both descriptive statistics and multivariate logistic regression. Results: Notwithstanding the availability of a non-contributory option within the insurance scheme and access to privately-provided primary care, a considerable portion of socio-economically vulnerable groups remained uninsured (57.7% of the lowest salary category. Non-insurance was highest among men, black African or coloured ethnic groups, less educated and lower-income employees, and those living in informal-housing. The relatively poor uptake of the contributory and non-contributory insurance options was mostly attributed to insufficient information, perceived administrative challenges of taking up membership, and payment costs. Conclusion: Barriers to enrolment include insufficient information, unaffordability of payments and perceived administrative complexity. Achieving universal coverage requires good physical access to service providers and appropriate benefit options within pre-payment health financing mechanisms.

  17. 24 CFR 965.215 - Lead-based paint liability insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Lead-based paint liability... Insurance Coverage § 965.215 Lead-based paint liability insurance coverage. (a) General. The purpose of this... with lead-based paint activities that the PHA undertakes, in accordance with the PHA's ACC with HUD...

  18. Health Insurance Stability and Health Status: Do Family-Level Coverage Patterns Matter?

    Science.gov (United States)

    Nielsen, Robert B.; Garasky, Steven

    2008-01-01

    Being uninsured affects one's ability to access medical services and maintain health. Using longitudinal data from the Survey of Income and Program Participation, the authors investigated how individual and family insurance coverage affects adult health. They found that health insurance coverage often varies across family members and changes…

  19. Organization A Comprehensive System Of Insurance Coverage In The Potential Chemical And Biological Contamination Zone In Regions

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2014-12-01

    Full Text Available The article provides a scientific rationale for an integrated approach to the provision of insurance coverage in the potential chemical and biological contamination zone. The following modern forms of chemical safety in the Russian Federation were considered: state reserve’s system, target program financing, state social insurance. The separate issue tackles the obligatory civil liability insurance for owners of dangerous objects. For improvement of the existing insurance protection system against emergency situations, risks were analyzed (shared on exogenous and endogenous. Among the exogenous risks including natural and climatic conditions of a region, its geographical arrangement, economic specialization, the seismic and terrorist risks were chosen and approaches to its solution were suggested. In endogenous risks’ group, the special focus is on wear and tear and obsolescence of hazardous chemical and biological object’s fixed assets. In case of high risk of an incident, it is suggested to increase in extent of insurance protection through self-insurance, a mutual insurance in the form of the organization of societies of a mutual insurance or the self-regulating organizations, and also development of voluntary insurance of a civil liability, both the owner of hazardous object, and regions of the Russian Federation and municipalities. The model of insurance coverage in the potential chemical and biological contamination zone is based on a differentiated approach to the danger level of the area. A matrix of adequate forms and types of insurance (required for insurance coverage of the population in the potential chemical and biological contamination zone was constructed. Proposed health risk management toolkit in the potential chemical and biological contamination zone will allow to use financial resources for chemical and biological safety in the regions more efficiently.

  20. [Coverage by health insurance or discount cards: a household survey in the coverage area of the Family Health Strategy].

    Science.gov (United States)

    Fontenelle, Leonardo Ferreira; Camargo, Maria Beatriz Junqueira de; Bertoldi, Andréa Dâmaso; Gonçalves, Helen; Maciel, Ethel Leonor Noia; Barros, Aluísio J D

    2017-10-26

    This study was designed to assess the reasons for health insurance coverage in a population covered by the Family Health Strategy in Brazil. We describe overall health insurance coverage and according to types, and analyze its association with health-related and socio-demographic characteristics. Among the 31.3% of persons (95%CI: 23.8-39.9) who reported "health insurance" coverage, 57.0% (95%CI: 45.2-68.0) were covered only by discount cards, which do not offer any kind of coverage for medical care, but only discounts in pharmacies, clinics, and hospitals. Both for health insurance and discount cards, the most frequently cited reasons for such coverage were "to be on the safe side" and "to receive better care". Both types of coverage were associated statistically with age (+65 vs. 15-24 years: adjusted odds ratios, aOR = 2.98, 95%CI: 1.28-6.90; and aOR = 3.67; 95%CI: 2.22-6.07, respectively) and socioeconomic status (additional standard deviation: aOR = 2.25, 95%CI: 1.62-3.14; and aOR = 1.96, 95%CI: 1.34-2.97). In addition, health insurance coverage was associated with schooling (aOR = 7.59, 95%CI: 4.44-13.00) for complete University Education and aOR = 3.74 (95%CI: 1.61-8.68) for complete Secondary Education, compared to less than complete Primary Education. Meanwhile, neither health insurance nor discount card was associated with health status or number of diagnosed diseases. In conclusion, studies that aim to assess private health insurance should be planned to distinguish between discount cards and formal health insurance.

  1. 42 CFR 457.80 - Current State child health insurance coverage and coordination.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

  2. Health Insurance without Single Crossing : Why Healthy People have High Coverage

    NARCIS (Netherlands)

    Boone, J.; Schottmuller, C.

    2011-01-01

    Standard insurance models predict that people with high (health) 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

  3. Universal health insurance coverage for 1.3 billion people: What accounts for China's success?

    Science.gov (United States)

    Yu, Hao

    2015-09-01

    China successfully achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history. While the achievement is widely recognized, it is still largely unexplored why China was able to attain it within a short period. This study aims to fill the gap. Through a systematic political and socio-economic analysis, it identifies seven major drivers for China's success, including (1) the SARS outbreak as a wake-up call, (2) strong public support for government intervention in health care, (3) renewed political commitment from top leaders, (4) heavy government subsidies, (5) fiscal capacity backed by China's economic power, (6) financial and political responsibilities delegated to local governments and (7) programmatic implementation strategy. Three of the factors seem to be unique to China (i.e., the SARS outbreak, the delegation, and the programmatic strategy.) while the other factors are commonly found in other countries' insurance expansion experiences. This study also discusses challenges and recommendations for China's health financing, such as reducing financial risk as an immediate task, equalizing benefit across insurance programs as a long-term goal, improving quality by tying provider payment to performance, and controlling costs through coordinated reform initiatives. Finally, it draws lessons for other developing countries. Copyright © 2015 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. How does complementary private prescription drug insurance coverage affect seniors' use of publicly funded medications?

    Science.gov (United States)

    Allin, Sara; Law, Michael R; Laporte, Audrey

    2013-05-01

    Like in many other high-income jurisdictions, the public drug program in Ontario, Canada provides comprehensive coverage of prescription drugs to the 65 years and older population with some cost sharing. The objective of this study was to examine the marginal impact of holding private drug coverage on the use of publicly funded medicines among the senior population in Ontario. We drew on linked survey and administrative data sources to examine the impact of private drug coverage first on total spending and utilization of medications, and second, on clinically recommended medications for individuals with a diagnosis of diabetes. Approximately 27% of Ontario seniors reported having private prescription drug insurance from a current or prior employer. The population-level analysis of all seniors found that individuals with private insurance coverage, on average, took about a quarter of an additional drug and incurred 16% more in costs to the public program in a year compared to those without additional coverage. The disease-specific analysis of seniors with a diagnosis of diabetes found that private coverage was associated with two-fold higher odds of taking an anti-hypertensive drug, but it had no association with the use of statins or anti-diabetic medications. The results of this study provide some evidence that seniors in Ontario are sensitive to the price of drugs. These findings raise equity concerns relating to the cost sharing arrangements in the public system and our policy of allowing private plans to "top-up" the public plan. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. Moving toward universal coverage of health insurance in Vietnam: barriers, facilitating factors, and lessons from Korea.

    Science.gov (United States)

    Do, Ngan; Oh, Juhwan; Lee, Jin-Seok

    2014-07-01

    Vietnam has pursued universal health insurance coverage for two decades but has yet to fully achieve this goal. This paper investigates the barriers to achieve universal coverage and examines the validity of facilitating factors to shorten the transitional period in Vietnam. A comparative study of facilitating factors toward universal coverage of Vietnam and Korea reveals significant internal forces for Vietnam to further develop the National Health Insurance Program. Korea in 1977 and Vietnam in 2009 have common characteristics to be favorable of achieving universal coverage with similarities of level of income, highly qualified administrative ability, tradition of solidarity, and strong political leadership although there are differences in distribution of population and structure of the economy. From a comparative perspective, Vietnam can consider the experience of Korea in implementing the mandatory enrollment approach, household unit of eligibility, design of contribution and benefit scheme, and resource allocation to health insurance for sustainable government subsidy to achieve and sustain the universal coverage of health insurance.

  6. Maritime Insurance. On Damage and Means of Coverage

    OpenAIRE

    Pandele Adina Laura

    2011-01-01

    Maritime transport can not be conceived outside the protection offered by insurers. Maritime insurance offers protection to maritime vessels and their cargoes, contributes to the development of maritime transport and, implicitly, to international trade development.

  7. Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage over the Life-Course.

    Science.gov (United States)

    Sohn, Heeju

    2017-04-01

    Health insurance coverage varies substantially between racial and ethnic groups in the United States. Compared to non-Hispanic whites, African Americans and people of Hispanic origin had persistently lower insurance coverage rates at all ages. This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. It uses the longitudinal 2008 Panel of the Survey of Income and Program Participation (N=114,345) to describe age-specific patterns of disparity prior to the Affordable Care Act (ACA). A formal decomposition on increment-decrement life-tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups' greater propensity to lose the insurance that they already have. Uninsured African Americans were faster to gain insurance than non-Hispanic whites but their high rates of insurance loss more than negated this advantage. Disparities from greater rates of loss among minority groups emerge rapidly at the end of childhood and persist throughout adulthood. This is especially true for African Americans and Hispanics and their relative disadvantages again heighten in their 40s and 50s.

  8. 45 CFR 148.120 - Guaranteed availability of individual health insurance coverage to certain individuals with prior...

    Science.gov (United States)

    2010-10-01

    ... INDIVIDUAL HEALTH INSURANCE MARKET Requirements Relating to Access and Renewability of Coverage § 148.120 Guaranteed availability of individual health insurance coverage to certain individuals with prior group... furnishes health insurance coverage in the individual market must meet the following requirements with...

  9. Examining levels, distribution and correlates of health insurance coverage in Kenya.

    Science.gov (United States)

    Kazungu, Jacob S; Barasa, Edwine W

    2017-09-01

    To examine the levels, inequalities and factors associated with health insurance coverage in Kenya. We analysed secondary data from the Kenya Demographic and Health Survey (KDHS) conducted in 2009 and 2014. We examined the level of health insurance coverage overall, and by type, using an asset index to categorise households into five socio-economic quintiles with quintile 5 (Q5) being the richest and quintile 1 (Q1) being the poorest. The high-low ratio (Q5/Q1 ratio), concentration curve and concentration index (CIX) were employed to assess inequalities in health insurance coverage, and logistic regression to examine correlates of health insurance coverage. Overall health insurance coverage increased from 8.17% to 19.59% between 2009 and 2014. There was high inequality in overall health insurance coverage, even though this inequality decreased between 2009 (Q5/Q1 ratio of 31.21, CIX = 0.61, 95% CI 0.52-0.0.71) and 2014 (Q5/Q1 ratio 12.34, CIX = 0.49, 95% CI 0.45-0.52). Individuals that were older, employed in the formal sector; married, exposed to media; and male, belonged to a small household, had a chronic disease and belonged to rich households, had increased odds of health insurance coverage. Health insurance coverage in Kenya remains low and is characterised by significant inequality. In a context where over 80% of the population is in the informal sector, and close to 50% live below the national poverty line, achieving high and equitable coverage levels with contributory and voluntary health insurance mechanism is problematic. Kenya should consider a universal, tax-funded mechanism that ensures revenues are equitably and efficiently collected, and everyone (including the poor and those in the informal sector) is covered. © 2017 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  10. Coverage for Gender-Affirming Care: Making Health Insurance Work for Transgender Americans.

    Science.gov (United States)

    Padula, William V; Baker, Kellan

    2017-08-01

    Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures. Although the Affordable Care Act explicitly protects health insurance for transgender individuals, these laws are being threatened; therefore, this article reviews their importance to transgender-inclusive healthcare coverage.

  11. Insurance Coverage and Health Outcomes in Young Adults With Mental Illness Following the Affordable Care Act Dependent Coverage Expansion.

    Science.gov (United States)

    Kozloff, Nicole; Sommers, Benjamin D

    2017-07-01

    As a provision of the Affordable Care Act, young adults were able to remain on their parents' health insurance plans until age 26. We examined the impact of the 2010 dependent coverage expansion on insurance coverage and health outcomes among young adults with mental illness. Data are from the 2008-2013 National Survey on Drug Use and Health, an annual population-based survey of noninstitutionalized US individuals aged 12 and older. We used a difference-in-differences approach to compare young adults with mental illness subject to the provision (aged 19-25 years, n = 19,051) with an older comparison group (aged 26-34 years, n = 7,958) before (2008-2009) and after (2011-2013) the dependent coverage expansion in their insurance coverage, use of health services, and self-reported health. In adjusted analyses, following the dependent coverage expansion, private insurance coverage increased by 11.7 percentage points (95% CI, 8.4-15.1, P mental illness, relative to 26- to 34-year-olds. The provision was associated with a modest increase in young adults with mental illness who received outpatient mental health treatment at least monthly on average (+2.0% [95% CI, 0.1% to 4.0%, P = .04]) and a modest decrease in those reporting their overall health as fair or poor (-2.3% [95% CI, -4.6% to -0.0%, P = .05]). Unmet mental health needs due to cost decreased significantly among those with moderate-to-serious mental illness (-12.3% [95% CI, -22.7% to -2.0%, P = .02]), but did not change among those with mild illness. The 2010 dependent coverage expansion was associated with an increase in insurance coverage, several indicators of mental health treatment, and improved self-reported health among young adults with mental illness.

  12. Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act.

    Science.gov (United States)

    Hoerl, Maximiliane; Wuppermann, Amelie; Barcellos, Silvia H; Bauhoff, Sebastian; Winter, Joachim K; Carman, Katherine G

    2017-04-01

    The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10%-15% of the US population remains uninsured. To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant. Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013. A total of 2742 US residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel. Self-reported health insurance status and type as of spring 2015. Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared with low financial literacy, and 9.2 percentage points higher with high compared with low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance through Medicaid or the Marketplaces compared with being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates. A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics.

  13. Toward Better Access to Health Insurance Coverage for U.S. Retirees in Mexico

    Directory of Open Access Journals (Sweden)

    Warner David C.

    2001-01-01

    Full Text Available Many retirees from the United States of America have limited health insurance coverage while living in Mexico. Medicare and Medicaid benefits are not portable to other countries and Medigap (private insurance that supplements Medicare is very limited. This causes economic and medical hardships and serves as a barrier to retirement to Mexico. Increasing numbers of U.S. retirees will be interested in moving to Mexico in the future because of the climate, the culture, and the lower cost of living. The numbers are increasing as a result of several factors such as aging "baby boomers" and the rapidly growing Mexican-origin population in the U.S.A. who are citizens or permanent residents but would like to return to their communities of origin after working in the U.S.A. There are several policy initiatives that could provide opportunities for improving health insurance coverage for these retirees that could be cost-effective. The full version of this paper is available too at: http://www.insp.mx/salud/index.html

  14. Moving Beyond Blind Men and Elephants: Providing Total Estimated Annual Costs Improves Health Insurance Decision Making.

    Science.gov (United States)

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas; Long, Sharon K

    2017-10-01

    Health insurance is among the most important financial and health-related decisions that people make. Choosing a health insurance plan that offers sufficient risk protection is difficult, in part because total expected health care costs are not transparent. This study examines the effect of providing total costs estimates on health insurance decisions using a series of hypothetical choice experiments given to 7,648 individuals responding to the fall 2015 Health Reform Monitoring Survey. Participants were given two health scenarios presented in random order asking which of three insurance plans would best meet their needs. Half received total estimated costs, which increased the probability of choosing a cost-minimizing plan by 3.0 to 10.6 percentage points, depending on the scenario ( p < .01). With many consumers choosing or failing to switch out of plans that offer insufficient coverage, incorporating insights on consumer decision making with personalized information to estimate costs can improve the quality of health insurance choices.

  15. Long-term cost-effectiveness of providing full coverage for preventive medications after myocardial infarction.

    Science.gov (United States)

    Ito, Kouta; Avorn, Jerry; Shrank, William H; Toscano, Michele; Spettel, Claire; Brennan, Troyen; Choudhry, Niteesh K

    2015-05-01

    Adherence to drugs that are prescribed after myocardial infarction remains suboptimal. Although eliminating patient cost sharing for secondary prevention increases adherence and reduces rates of major cardiovascular events, the long-term clinical and economic implications of this approach have not been adequately evaluated. We developed a Markov model simulating a hypothetical cohort of commercially insured patients who were discharged from the hospital after myocardial infarction. Patients received β-blockers, renin-angiotensin system antagonists, and statins without cost sharing (full coverage) or at the current level of insurance coverage (usual coverage). Model inputs were extracted from the Post Myocardial Infarction Free Rx Event and Economic Evaluation trial and other published literature. The main outcome was an incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained. Patients receiving usual coverage lived an average of 9.46 quality-adjusted life years after their event and incurred costs of $171,412. Patients receiving full coverage lived an average of 9.60 quality-adjusted life years and incurred costs of $167,401. Compared with usual coverage, full coverage would result in greater quality-adjusted survival (0.14 quality-adjusted life years) and less resource use ($4011) per patient. Our results were sensitive to alterations in the risk reduction for post-myocardial infarction events from full coverage. Providing full prescription drug coverage for evidence-based pharmacotherapy to commercially insured post-myocardial infarction patients has the potential to improve health outcomes and save money from the societal perspective over the long-term. https://www.clinicaltrials.gov. Unique identifier: NCT00566774. © 2015 American Heart Association, Inc.

  16. Employer-sponsored health insurance coverage limitations: results from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Kirchhoff, Anne C; Kuhlthau, Karen; Pajolek, Hannah; Leisenring, Wendy; Armstrong, Greg T; Robison, Leslie L; Park, Elyse R

    2013-02-01

    The Affordable Care Act (ACA) will expand health insurance options for cancer survivors in the USA. It is unclear how this legislation will affect their access to employer-sponsored health insurance (ESI). We describe the health insurance experiences for survivors of childhood cancer with and without ESI. We conducted a series of qualitative interviews with 32 adult survivors from the Childhood Cancer Survivor Study to assess their employment-related concerns and decisions regarding health insurance coverage. Interviews were performed from August to December 2009 and were recorded, transcribed, and content analyzed using NVivo 8. Uninsured survivors described ongoing employment limitations, such as being employed at part-time capacity, which affected their access to ESI coverage. These survivors acknowledged they could not afford insurance without employer support. Survivors on ESI had previously been denied health insurance due to their preexisting health conditions until they obtained coverage through an employer. Survivors feared losing their ESI coverage, which created a disincentive to making career transitions. Others reported worries about insurance rescission if their cancer history was discovered. Survivors on ESI reported financial barriers in their ability to pay for health care. Childhood cancer survivors face barriers to obtaining ESI. While ACA provisions may mitigate insurance barriers for cancer survivors, many will still face cost barriers to affording health care without employer support.

  17. Patterns of Health Insurance Coverage Around the Time of Pregnancy Among Women with Live-Born Infants--Pregnancy Risk Assessment Monitoring System, 29 States, 2009.

    Science.gov (United States)

    D'Angelo, Denise V; Le, Brenda; O'Neil, Mary Elizabeth; Williams, Letitia; Ahluwalia, Indu B; Harrison, Leslie L; Floyd, R Louise; Grigorescu, Violanda

    2015-06-19

    In 2009, before passage of the 2010 Patient Protection and Affordable Care Act (ACA), approximately 20% of women aged 18-64 years had no health insurance coverage. In addition, many women experienced transitions in coverage around the time of pregnancy. Having no health insurance coverage or experiencing gaps or shifts in coverage can be a barrier to receiving preventive health services and treatment for health problems that could affect pregnancy and newborn health. With the passage of ACA, women who were previously uninsured or had insurance that provided inadequate coverage might have better access to health services and better coverage, including additional preventive services with no cost sharing. Because certain elements of ACA (e.g., no lifetime dollar limits, dependent coverage to age 26, and provision of preventive services without cost sharing) were implemented as early as September 2010, data from 2009 can be used as a baseline to measure the incremental impact of ACA on the continuity of health care coverage for women around the time of pregnancy. 2009. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences that occur before, during, and shortly after pregnancy among women who deliver live-born infants in selected U.S. states and New York City, New York. PRAMS uses mixed-mode data collection, in which up to three self-administered surveys are mailed to a sample of mothers, and those who do not respond are contacted for telephone interviews. Self-reported survey data are linked to birth certificate data and weighted for sample design, nonresponse, and noncoverage. Annual PRAMS data sets are created and used to produce statewide estimates of preconception and perinatal health behaviors and experiences in selected states and New York City. This report summarizes data from 29 states that conducted PRAMS in 2009, before the passage

  18. 78 FR 17612 - Health Insurance Providers Fee; Correction

    Science.gov (United States)

    2013-03-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 57 RIN 1545-BL20 Health Insurance Providers Fee; Correction AGENCY... entities engaged in the business of providing health insurance for United States health risks. FOR FURTHER...

  19. Improving health system quality in low- and middle-income countries that are expanding health coverage: a framework for insurance.

    Science.gov (United States)

    Mate, Kedar S; Sifrim, Zoe K; Chalkidou, Kalipso; Cluzeau, Francoise; Cutler, Derek; Kimball, Meredith; Morente, Tricia; Smits, Helen; Barker, Pierre

    2013-10-01

    Low- and middle-income countries are increasingly pursuing health financing reforms aimed at achieving universal health coverage. As these countries rapidly expand access to care, overburdened health systems may fail to deliver high-quality care, resulting in poor health outcomes. Public insurers responsible for financing coverage expansions have the financial leverage to influence the quality of care and can benefit from guidance to execute a cohesive health-care quality strategy. and selection Following a literature review, we used a cascading expert consultation and validation process to develop a conceptual framework for insurance-driven quality improvements in health care. The framework presents the strategies available to insurers to influence the quality of care within three domains: ensuring a basic standard of quality, motivating providers and professionals to improve, and activating patient and public demand for quality. By being sensitive to the local context, building will among key stakeholders and selecting context-appropriate ideas for improvement, insurers can influence the quality through four possible mechanisms: selective contracting; provider payment systems; benefit package design and investments in systems, patients and providers. This framework is a resource for public insurers that are responsible for rapidly expanding access to care, as it places the mechanisms that insurers directly control within the context of broader strategies of improving health-care quality. The framework bridges the existing gap in the literature between broad frameworks for strategy design for system improvement and narrower discussions of the technical methods by which payers directly influence the quality.

  20. Declines in employer-sponsored insurance between 2000 and 2008: examining the components of coverage by firm size.

    Science.gov (United States)

    Vistnes, Jessica; Zawacki, Alice; Simon, Kosali; Taylor, Amy

    2012-06-01

    To examine trends in employer-sponsored health insurance coverage rates and its associated components between 2000 and 2008, to provide a baseline for later evaluations of the Affordable Care Act, and to provide information to policy makers as they design the implementation details of the law. Private sector employer data from the 2000, 2001, and 2008 Medical Expenditure Panel Survey-Insurance Component (MEPS-IC). We examine time trends in employer offer, eligibility, and take-up rates. We add a new dimension to the literature by examining dependent coverage and decomposing its trends. We investigate heterogeneity in trends by firm size. The MEPS-IC is an annual survey, sponsored by the Agency for Healthcare Research and Quality and conducted by the U.S. Census Bureau. The MEPS-IC obtains information on establishment characteristics, whether an establishment offers health insurance, and details on up to four plans. We find that coverage rates for workers declined in both small and large firms. In small firms, coverage declined due to a drop in both offer and take-up rates. In the largest firms, offer rates were stable and the decline was due to falling take-up rates. In addition, enrollment shifted toward single coverage and away from dependent coverage in both small and large firms. For small firms, this shift was due to declining offer and take-up rates for dependent coverage. In large firms, offers of dependent coverage were stable but take-up rates dropped. Within the category of dependent coverage, the availability of employee-plus-one plans increased in all firm size categories, but take-up rates for these plans declined in small firms. © Health Research and Educational Trust.

  1. Insurance coverage among women diagnosed with a gynecologic malignancy before and after implementation of the Affordable Care Act.

    Science.gov (United States)

    Moss, Haley A; Havrilesky, Laura J; Chino, Junzo

    2017-09-01

    The Patient Protection and Affordable Care Act (ACA) included provisions to expand insurance coverage by expanding Medicaid eligibility, providing subsidies of private coverage and enforcing an individual mandate. The objective of this study is to examine the impact of the ACA on insurance rates among women diagnosed with a gynecologic malignancy. Using Surveillance, Epidemiology, and End Results 18 registries database, women newly diagnosed with cervical, uterine or ovarian cancer between 2008 and 2014 were identified. Insurance rates were examined before and after the passage of the ACA (2011) as well as before (January 2011-December 2013) versus after (January 2014-December 2014) Medicaid expansion to examine the impact of specific provisions. Rates of insurance were then compared between states that elected for expansion of Medicaid in 2014 vs. those states that had not. Among 181,866 diagnosed with cervical, uterine or ovarian cancer, there was a significant increase in patients enrolled in Medicaid after 2011. Between 2011 and 2014, there was a significant decrease in the rates of uninsured for all cancer types (p=0.001). Uninsured rates decreased by 50% for those diagnosed with uterine and ovarian cancer (6% to 3% and 8% to 4% respectively, p≤0.001), and by 25% in cervical cancer (8.9% to 6.7%, p=0.001) after January 2014. Decreases in the rate of the uninsured and associated increases in insurance coverage were only observed in states which expanded Medicaid coverage (p≤0.001). The Affordable Care Act resulted in expanded insurance coverage for women diagnosed with a gynecologic cancer, however, the impact was significantly increased in states which increased their Medicaid eligibility in 2014. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. 7 CFR 457.146 - Northern potato crop insurance-storage coverage endorsement.

    Science.gov (United States)

    2010-01-01

    ... endorsement. 457.146 Section 457.146 Agriculture Regulations of the Department of Agriculture (Continued... Northern potato crop insurance—storage coverage endorsement. The Northern Potato Crop Insurance Storage Coverage Endorsement Provisions for the 2008 and succeeding crop years are as follows: FCIC Policies United...

  3. Health Insurance Coverage among Young Adult Survivors of Pediatric Heart Transplantation.

    Science.gov (United States)

    Tumin, Dmitry; Li, Susan S; Nandi, Deipanjan; Gajarski, Robert J; McKee, Christopher; Tobias, Joseph D; Hayes, Don

    2017-09-01

    To describe the change in health insurance after heart transplantation among adolescents, and characterize the implications of this change for long-term transplant outcomes. Patients age 15-18 years receiving first-time heart transplantation between 1999 and 2011 were identified in the United Network for Organ Sharing registry and included in the analysis if they survived at least 5 years. The primary exposure was change or continuity of health insurance coverage between the time of transplant and the 5-year follow-up. Cox proportional hazards models were used to determine the association between insurance status change and long-term (>5 years) patient and graft survival. The analysis included 366 patients (age 16 ± 1 years at transplant), of whom 205 (56%) had continuous private insurance; 96 (26%) had continuous public insurance; and 65 (18%) had a change in insurance status. In stepwise multivariable Cox regression, change in insurance status was associated with greater mortality hazard, compared with continuous private insurance (hazard ratio = 1.9; 95% CI: 1.1, 3.2; P = .016), whereas long-term patient and graft survival did not differ between patients with continuous public and continuous private insurance. Continuity of insurance coverage is associated with improved long-term clinical outcomes among adolescent heart transplant recipients who survive into adulthood. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. 76 FR 21265 - Interest on Deposits; Deposit Insurance Coverage

    Science.gov (United States)

    2011-04-15

    ..., Federal Deposit Insurance Corporation, 550 17th Street, NW., Washington, DC 20429. Hand Delivery: Guard... Treasury and General Government Appropriations Act, enacted as part of the Omnibus Consolidated and...

  5. The effect of Health Savings Accounts on group health insurance coverage.

    Science.gov (United States)

    Ye, Jinqi

    2015-12-01

    This paper presents new empirical evidence on the impact of tax subsidies for Health Savings Accounts (HSAs) on group insurance coverage. HSAs are tax-free health care expenditure savings accounts. Coupled with high deductible health insurance plans (HDHPs), they together represent new health insurance options. The tax advantage of HSAs expands the group health insurance market by making health care more affordable. Using individual level data from the Current Population Survey and exploiting policy variation by state and year from 2004 to 2012, I find that HSA tax subsidies increase small-group coverage by a statistically significant 2.5 percentage points, although not coverage in larger firms. Moreover, if the tax price of HSA contribution decreases by 10 cents, small-group insurance coverage increases by almost 2 percentage points. I also find that for older workers or less-educated workers, HSA subsidies are associated with 2-3 percentage point increase in their group insurance coverage. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Welfare reform and health insurance coverage of low-income families.

    Science.gov (United States)

    Kaestner, Robert; Kaushal, Neeraj

    2003-11-01

    We study whether welfare reform adversely affected the health insurance coverage of low-educated single mothers and their children. Specifically, we investigate whether changes in the welfare caseload during the 1990s were associated with changes in Medicaid participation, private insurance coverage, and the number of uninsured among single mothers and their children. Estimates suggest that between 1996 and 1999, the 42% decrease in the welfare caseload was associated with the following changes in insurance coverage among low-educated, single mothers: a 7-9% decrease in Medicaid coverage; an increase in employer-sponsored, private insurance coverage of 6%; and a 2-9% increase in the proportion uninsured. Among children of low-educated, single mothers, effects were somewhat smaller. Since welfare policy was responsible for only part (e.g. one-third) of the decline in the caseload, welfare reform per se had significantly smaller effects on the health insurance status of low-income families. However, we found limited evidence that changes in the caseload due to state and federal welfare policy had fewer adverse consequences on insurance status than changes in the caseload due to other factors. This implies even smaller effects of welfare reform.

  7. "Aging Out" of Dependent Coverage and the Effects on US Labor Market and Health Insurance Choices.

    Science.gov (United States)

    Dahlen, Heather M

    2015-11-01

    I examined how labor market and health insurance outcomes were affected by the loss of dependent coverage eligibility under the Patient Protection and Affordable Care Act (ACA). I used National Health Interview Survey (NHIS) data and regression discontinuity models to measure the percentage-point change in labor market and health insurance outcomes at age 26 years. My sample was restricted to unmarried individuals aged 24 to 28 years and to a period of time before the ACA's individual mandate (2011-2013). I ran models separately for men and women to determine if there were differences based on gender. Aging out of this provision increased employment among men, employer-sponsored health insurance offers for women, and reports that health insurance coverage was worse than it was 1 year previously (overall and for young women). Uninsured rates did not increase at age 26 years, but there was an increase in the purchase of non-group health coverage, indicating interest in remaining insured after age 26 years. Many young adults will turn to state and federal health insurance marketplaces for information about health coverage. Because young adults (aged 18-29 years) regularly use social media sites, these sites could be used to advertise insurance to individuals reaching their 26th birthdays.

  8. 7 CFR 400.406 - Insurance provider responsibilities.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Insurance provider responsibilities. 400.406 Section 400.406 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE GENERAL ADMINISTRATIVE REGULATIONS General Administrative Regulations...

  9. PROVIDER CHOICE FOR OUTPATIENT HEALTH CARE SERVICES IN INDONESIA: THE ROLE OF HEALTH INSURANCE

    Directory of Open Access Journals (Sweden)

    Budi Hidayat

    2012-11-01

    Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

  10. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Science.gov (United States)

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under... and Insurance Oversight, Department of Health and Human Services. ACTION: Amendment to interim final... regulations implementing the rules for group health plans and health insurance coverage in the group and...

  11. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Science.gov (United States)

    2010-06-17

    ... Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under the Patient Protection...-AB68 Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a... Consumer Information and Insurance Oversight, Department of Health and Human Services. ACTION: Interim...

  12. Impact of free delivery care on health facility delivery and insurance coverage in Ghana's Brong Ahafo Region.

    Directory of Open Access Journals (Sweden)

    Susie Dzakpasu

    Full Text Available BACKGROUND: Many sub-Saharan countries, including Ghana, have introduced policies to provide free medical care to pregnant women. The impact of these policies, particularly on access to health services among the poor, has not been evaluated using rigorous methods, and so the empirical basis for defending these policies is weak. In Ghana, a recent report also cast doubt on the current mechanism of delivering free care--the National Health Insurance Scheme. Longitudinal surveillance data from two randomized controlled trials conducted in the Brong Ahafo Region provided a unique opportunity to assess the impact of Ghana's policies. METHODS: We used time-series methods to assess the impact of Ghana's 2005 policy on free delivery care and its 2008 policy on free national health insurance for pregnant women. We estimated their impacts on facility delivery and insurance coverage, and on socioeconomic differentials in these outcomes after controlling for temporal trends and seasonality. RESULTS: Facility delivery has been increasing significantly over time. The 2005 and 2008 policies were associated with significant jumps in coverage of 2.3% (p = 0.015 and 7.5% (p<0.001, respectively after the policies were introduced. Health insurance coverage also jumped significantly (17.5%, p<0.001 after the 2008 policy. The increases in facility delivery and insurance were greatest among the poorest, leading to a decline in socioeconomic inequality in both outcomes. CONCLUSION: Providing free care, particularly through free health insurance, has been effective in increasing facility delivery overall in the Brong Ahafo Region, and especially among the poor. This finding should be considered when evaluating the impact of the National Health Insurance Scheme and in supporting the continuation and expansion of free delivery care.

  13. Influenza vaccination coverage of Vaccine for Children (VFC)-entitled versus privately insured children, United States, 2011–2013☆

    Science.gov (United States)

    Srivastav, Anup; Zhai, Yusheng; Santibanez, Tammy A.; Kahn, Katherine E.; Smith, Philip J.; Singleton, James A.

    2016-01-01

    Background The Vaccines for Children (VFC) program provides vaccines at no cost to children who are Medicaid-eligible, uninsured, American Indian or Alaska Native (AI/AN), or underinsured and vaccinated at Federally Qualified Health Centers or Rural Health Clinics. The objective of this study was to compare influenza vaccination coverage of VFC-entitled to privately insured children in the United States, nationally, by state, and by selected socio-demographic variables. Methods Data from the National Immunization Survey-Flu (NIS-Flu) surveys were analyzed for the 2011–2012 and 2012–2013 influenza seasons for households with children 6 months–17 years. VFC-entitlement and private insurance status were defined based upon questions asked of the parent during the telephone interview. Influenza vaccination coverage estimates of children VFC-entitled versus privately insured were compared by t-tests, both nationally and within state, and within selected socio-demographic variables. Results For both seasons studied, influenza coverage for VFC-entitled children did not significantly differ from coverage for privately insured children (2011–2012: 52.0% ± 1.9% versus 50.7% ± 1.2%; 2012–2013: 56.0% ± 1.6% versus 57.2% ± 1.2%). Among VFC-entitled children, uninsured children had lower coverage (2011–2012: 38.9% ± 4.7%; 2012–2013: 44.8% ± 3.5%) than Medicaid-eligible (2011–2012: 55.2% ± 2.1%; 2012–2013: 58.6% ± 1.9%) and AI/AN children (2011–2012: 54.4% ± 11.3%; 2012–2013: 54.6% ± 7.0%). Significant differences in vaccination coverage among VFC-entitled and privately insured children were observed within some subgroups of race/ethnicity, income, age, region, and living in a metropolitan statistical area principle city. Conclusions Although finding few differences in influenza vaccination coverage among VFC-entitled versus privately insured children was encouraging, nearly half of all children were not vaccinated for influenza and coverage was

  14. Influenza vaccination coverage of Vaccine for Children (VFC)-entitled versus privately insured children, United States, 2011-2013.

    Science.gov (United States)

    Srivastav, Anup; Zhai, Yusheng; Santibanez, Tammy A; Kahn, Katherine E; Smith, Philip J; Singleton, James A

    2015-06-17

    The Vaccines for Children (VFC) program provides vaccines at no cost to children who are Medicaid-eligible, uninsured, American Indian or Alaska Native (AI/AN), or underinsured and vaccinated at Federally Qualified Health Centers or Rural Health Clinics. The objective of this study was to compare influenza vaccination coverage of VFC-entitled to privately insured children in the United States, nationally, by state, and by selected socio-demographic variables. Data from the National Immunization Survey-Flu (NIS-Flu) surveys were analyzed for the 2011-2012 and 2012-2013 influenza seasons for households with children 6 months-17 years. VFC-entitlement and private insurance status were defined based upon questions asked of the parent during the telephone interview. Influenza vaccination coverage estimates of children VFC-entitled versus privately insured were compared by t-tests, both nationally and within state, and within selected socio-demographic variables. For both seasons studied, influenza coverage for VFC-entitled children did not significantly differ from coverage for privately insured children (2011-2012: 52.0%±1.9% versus 50.7%±1.2%; 2012-2013: 56.0%±1.6% versus 57.2%±1.2%). Among VFC-entitled children, uninsured children had lower coverage (2011-2012: 38.9%±4.7%; 2012-2013: 44.8%±3.5%) than Medicaid-eligible (2011-2012: 55.2%±2.1%; 2012-2013: 58.6%±1.9%) and AI/AN children (2011-2012: 54.4%±11.3%; 2012-2013: 54.6%±7.0%). Significant differences in vaccination coverage among VFC-entitled and privately insured children were observed within some subgroups of race/ethnicity, income, age, region, and living in a metropolitan statistical area principle city. Although finding few differences in influenza vaccination coverage among VFC-entitled versus privately insured children was encouraging, nearly half of all children were not vaccinated for influenza and coverage was particularly low among uninsured children. Additional public health interventions

  15. Trends in Health Insurance Coverage of Title X Family Planning Program Clients, 2005-2015.

    Science.gov (United States)

    Decker, Emily J; Ahrens, Katherine A; Fowler, Christina I; Carter, Marion; Gavin, Loretta; Moskosky, Susan

    2017-12-13

    The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated. Using administrative data we examined changes in health insurance coverage among Title X clinic patients during 2005-2015. We found that the percentage of clients without health insurance decreased from 60% in 2005 to 48% in 2015, with the greatest annual decrease occurring between 2013 and 2014 (63% to 54%). Meanwhile, between 2005 and 2015, the percentage of clients with Medicaid or other public health insurance increased from 20% to 35% and the percentage of clients with private health insurance increased from 8% to 15%. Although clients attending Title X clinics remained uninsured at substantially higher rates compared with the national average, the increase in clients with health insurance coverage aligns with the implementation of ACA-related provisions to expand access to affordable health insurance.

  16. Do more health insurance options lead to higher wages? Evidence from states extending dependent coverage.

    Science.gov (United States)

    Dillender, Marcus

    2014-07-01

    Little is known about how health insurance affects labor market decisions for young adults. This is despite the fact that expanding coverage for people in their early 20s is an important component of the Affordable Care Act. This paper studies how having an outside source of health insurance affects wages by using variation in health insurance access that comes from states extending dependent coverage to young adults. Using American Community Survey and Census data, I find evidence that extending health insurance to young adults raises their wages. The increases in wages can be explained by increases in human capital and the increased flexibility in the labor market that comes from people no longer having to rely on their own employers for health insurance. The estimates from this paper suggest the Affordable Care Act will lead to wage increases for young adults. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Public insurance is increasingly crucial to American families even as employer-sponsored health insurance coverage ends its steady decline.

    Science.gov (United States)

    Gould, Elise

    2014-01-01

    Americans under age 65 rely on a healthy labor market for almost all facets of economic security. While 2012 marked the first year in more than a decade that the employer-sponsored health insurance (ESI) coverage rate for the under-65 population did not decline, employer-sponsored health insurance continues to fail American families. If the coverage rate had not fallen 10.8 percentage points as it did from 2000 to 2012, as many as 29 million more people under age 65 would have had ESI in 2012. Even with the end of its longstanding decline, ESI coverage rates among men and women, white and non-white, high and low income, white and blue collar, young and old remain far lower than they were in 2000. Over this period, the increase in uninsured Americans was not as steep as the fall in ESI because of increases in public coverage, including Medicaid, the Children's Health Insurance Program, and Medicare. These programs were particularly effective in reducing the share of children uninsured over the 2000s. Additionally, key components in the Patient Protection and Affordable Care Act shielded young adults from further coverage losses.

  18. Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran.

    Science.gov (United States)

    Mohammadi, Effat; Raissi, Ahmad Reza; Barooni, Mohsen; Ferdoosi, Massoud; Nuhi, Mojtaba

    2014-01-01

    Health system reforms are the most strategic issue that has been seriously considered in healthcare systems in order to reduce costs and increase efficiency and effectiveness. The costs of health system finance in our country, lack of universal coverage in health insurance, and related issues necessitate reforms in our health system financing. The aim of this research was to prepare a structure of framework for social health insurance in Iran and conducting a comparative study in selected countries with social health insurance. This comparative descriptive study was conducted in three phases. The first phase of the study examined the structure of health social insurance in four countries - Germany, South Korea, Egypt, and Australia. The second phase was to develop an initial model, which was designed to determine the shared and distinguishing points of the investigated structures, for health insurance in Iran. The third phase was to validate the final research model. The developed model by the Delphi method was given to 20 professionals in financing of the health system, health economics and management of healthcare services. Their comments were collected in two stages and its validity was confirmed. The study of the structure of health insurance in the selected countries shows that health social insurance in different countries have different structures. Based on the findings of the present study, the current situation of the health system, and the conducted surveys, the following framework is suitable for the health social insurance system in Iran. The Health Social Insurance Organization has a unique service by having five funds of governmental employees, companies and NGOs, self-insured, villagers, and others, which serves as a nongovernmental organization under the supervision of public law and by decision- and policy-making of the Health Insurance Supreme Council. Membership in this organization is based on the nationality or residence, which the insured by

  19. Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets.

    Science.gov (United States)

    Scheffler, Richard M; Arnold, Daniel R

    2017-09-01

    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.

  20. Awareness and Coverage of the National Health Insurance Scheme ...

    African Journals Online (AJOL)

    A prepayment scheme for health through the National Health Insurance Scheme (NHIS) was commenced in Nigeria about ten years ago. Nigeria operates a federal system of government. Sub- national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of ...

  1. Improving health insurance coverage in Ghana : a case study

    NARCIS (Netherlands)

    Kotoh, A.M.

    2013-01-01

    Ghana is one of the first sub-Saharan African countries to introduce national health insurance to ensure more equity in access to health care. The response of the population has been disappointing, however. This study describes and examines an experiment with so called 'problem-solving groups' that

  2. Universal Health Insurance and the Reasons of not Coverage in Iran: Secondary Analysis of a National Household Survey

    Directory of Open Access Journals (Sweden)

    Shirin Nosratnejad

    2015-08-01

    Full Text Available Background and objectives : Universal insurance coverage is considered as one of the main goals of health systems around the world. Although Universal Health Insurance Law was legislated with the objective of covering all Iranian population under health insurance coverage in 1994, but imperfect insurance coverage has remained as a threatening dilemma. Heterogeneous statistics reported by insurer in Iran and the lack of appropriate, comprehensive databases have failed any judgments about the number of uninsured people and the reasons for it. Present study aimed to give better insight on insurance coverage among Iranian people and examine key reasons of imperfect coverage through a deep analysis of a national household survey. Material and Methods : Data which were collected from a national survey of health care utilization in Iran that covered over 102000 people of Iranians were analyzed. The survey had been implemented in 2007 by Iran's Ministry of Health. In order to identify possible reasons for imperfect coverage, national and international databases like SID, Iranmedex, ISC, Pubmed, Scopus, official statistics of Statistical Center of Iran (SCI, Iranian Social Security Organization (ISSO and Central Insurance of IRIRAN (CII were searched. Data management was accomplished in Microsoft Excel software.  Results : Study results showed that 85% of Iranian households had health insurance coverage, compared to 15% without any coverage. Medical services insurance fund had the greater proportion of coverage (59.27% and basic private insurance coverage was accountable for the least coverage (0.2%. More than half of households (51% stated financial inability to pay as the main reason for not getting coverage, followed by the lack of knowledge about insurance (12%, unemployment (12% and bypass by employers (10%. A worthwhile finding was that, 13% of households implied they felt no need to health insurance and 2% found it useless. Conclusion : Despite

  3. The Impact of Private Insurance Coverage on Prescription Drug Use in Ontario, Canada

    Science.gov (United States)

    Kratzer, Jillian; Cheng, Lucy; Allin, Sara

    2015-01-01

    Canadians obtain prescription drug coverage through a patchwork of public insurance, private benefit plans and out-of-pocket payments. Prior evidence suggests that insurance coverage, in general, leads to higher utilization rates of essential medicines; it is unclear whether individuals with private insurance have better access to medicines. Using data from the 2008 Canadian Community Health Survey, we identified cohorts from Ontario who reported having been diagnosed by a physician with asthma, high blood pressure or diabetes. Using propensity score stratification techniques, we compared drug utilization of individuals holding private insurance with that of individuals holding either public insurance (for those aged over 65 years) or no insurance (aged under 65 years). In five out of six comparisons, individuals with private insurance were more likely to take prescribed drugs than those without. Raw differences in the percentage of patients taking medicines ranged from 0.1 to 8.1%. Ontarians with chronic conditions holding private drug insurance are more likely to use prescription drugs than those who do not. Whether these inequities result in health outcome differences remains unknown. PMID:26142359

  4. The impact of expanding Medicaid on health insurance coverage and labor market outcomes.

    Science.gov (United States)

    Frisvold, David E; Jung, Younsoo

    2017-09-22

    Expansions of public health insurance have the potential to reduce the uninsured rate, but also to reduce coverage through employer-sponsored insurance (ESI), reduce labor supply, and increase job mobility. In January 2014, twenty-five states expanded Medicaid as part of the Affordable Care Act to low-income parents and childless adults. Using data from the 2011-2015 March Current Population Survey Supplements, we compare the changes in insurance coverage and labor market outcomes over time of adults in states that expanded Medicaid and in states that did not. Our estimates suggest that the recent expansion significantly increased Medicaid coverage with little decrease in ESI. Overall, the expansion did not impact labor market outcomes, including labor force participation, employment, and hours worked.

  5. [Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

    Science.gov (United States)

    Boidin, B

    2015-02-01

    This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

  6. Another health insurance gap: gaining and losing coverage among natives and immigrants at older ages.

    Science.gov (United States)

    Reyes, Adriana M; Hardy, Melissa

    2014-01-01

    As the immigrant population grows older and larger, limitations on access to health insurance may create a new subgroup of people who remain outside or on the margin of coverage. Using the Survey of Income and Program Participation (SIPP) data from the 2004 and 2008 panels, we address the health insurance gap between foreign-born and native-born adults among those aged 50-64 and the 65 and older, two sub-populations that have received relatively little attention in past research. We argue that current practices leave a significant minority of older foreign-born residents inconsistently covered or without any insurance. We find that health insurance coverage for older immigrants is both less likely and more episodic even when compositional differences in SES and assimilation are controlled. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Determinants for employer-paid health insurance coverage: a population-based study of the Danish labour force

    DEFF Research Database (Denmark)

    Christensen, Ann Demant; Søgaard, Rikke

    2013-01-01

    AIM: In 2002, the Danish tax law was changed, giving employees a tax exemption on supplemental, employer-paid health insurance. This might have conflicted with one of the key foundations of the healthcare system, namely equal access for equal needs. The aim of this study was to investigate...... determinants for employer-paid health insurance coverage. Because the policy change affected only people who were part of the labour force and because the public sector at that time had no tradition of providing fringe benefits, the analysis was restricted to the private labour force. METHOD: The analysis...

  8. A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

    Science.gov (United States)

    DeVoe, Jennifer; Angier, Heather; Hoopes, Megan; Gold, Rachel

    2017-01-01

    Maintaining continuous health insurance coverage is important. With recent expansions in access to coverage in the United States after “Obamacare,” primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients. We describe efforts to longitudinally track health insurance rates using data from the electronic health record (EHR) of a primary care network and to use these data to support practice-based insurance outreach and assistance. Although we highlight a few examples from one network, we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care. By partnering with researchers through practice-based research networks and other similar collaboratives, primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care. PMID:28966926

  9. A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

    Directory of Open Access Journals (Sweden)

    Jennifer DeVoe

    2016-12-01

    Full Text Available Maintaining continuous health insurance coverage is important. With recent expansions in access to coverage in the United States after “Obamacare,” primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients. We describe efforts to longitudinally track health insurance rates using data from the electronic health record (EHR of a primary care network and to use these data to support practice-based insurance outreach and assistance. Although we highlight a few examples from one network, we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care. By partnering with researchers through practice-based research networks and other similar collaboratives, primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care.

  10. The effect of parental immigration authorization on health insurance coverage for migrant Latino children.

    Science.gov (United States)

    Weathers, Andrea C; Minkovitz, Cynthia S; Diener-West, Marie; O'Campo, Patricia

    2008-06-01

    To examine if immigration authorization among parents is associated with health insurance coverage for migrant Latino children. A cross-sectional household survey of 300 migrant families for which one child, aged <13 years, was randomly selected. Most children lacked insurance (73%) and had unauthorized parents (77%). Having an authorized parent or parental stay of more than 5 years in the US were each positively associated with children's health insurance coverage [OR: 4.9; 95% CI: (2.7-8.7) and [OR = 6.7; 95% CI: (3.8-12.0), respectively]. The effect of parental authorization did not persist in multivariable logistic regression analysis; however, more than 5 years of parental stay in the US remained associated with children's insurance coverage [OR = 4.8; 95% CI (1.8-12.2)], regardless of parental authorization. Increased parental familiarity with US health and/or social services agencies, rather than parental authorization status, is important to obtaining health insurance for migrant children. Efforts to insure eligible migrant children should focus on recently arrived families.

  11. Employer-sponsored health insurance coverage continues to decline in a new decade.

    Science.gov (United States)

    Gould, Elise

    2013-01-01

    Most Americans, particularly those under age 65, rely on health insurance offered through the workplace. Given continuing high unemployment, it comes as no surprise that the share of Americans under age 65 covered by employer-sponsored health insurance (ESI) eroded for the 11th year in a row in 2011, falling from 58.6 percent in 2010 to 58.3 percent. The situation started deteriorating long before the Great Recession: the share of Americans under age 65 covered by ESI eroded every year from 2000 to 2011, decreasing by a total of 10.9 percentage points. As many as 29 million more people under age 65 would have had ESI in 2011 if the coverage rate had remained at the 2000 level. The decline in ESI coverage has been accompanied by an overall decline in health insurance coverage. The number of uninsured non-elderly Americans was 47.9 million in 2011--11.7 million higher than in 2000. Increasing public insurance coverage, particularly among children, is the only reason the uninsured rate did not rise one-for-one with losses in ESI. In addition, key components in the Patient Protection and Affordable Care Act took effect in 2010, shielding young adults from further coverage losses.

  12. Assessment of levels of hospice care coverage offered to commercial managed care plan members in California: implications for the California Health Insurance Exchange.

    Science.gov (United States)

    Chung, Kyusuk; Jahng, Joelle; Petrosyan, Syuzanna; Kim, Soo In; Yim, Victoria

    2015-06-01

    The implementation of the Affordable Care Act that provides for the expansion of affordable insurance to uninsured individuals and small businesses, coupled with the provision of mandated hospice coverage, is expected to increase the enrollment of the terminally ill younger population in hospice care. We surveyed health insurance companies that offer managed care plans in the 2014 California health insurance exchange and large hospice agencies that provided hospice care to privately insured patients in 2011. Compared with Medicare and Medicaid hospice benefits, hospice benefits for privately insured patients, particularly those enrolled in managed care plans, varied widely. Mandating hospice care alone may not be sufficient to ensure that individuals enrolled in different managed care plans receive the same level of coverage. © The Author(s) 2014.

  13. Korean medicine coverage in the National Health Insurance in Korea: present situation and critical issues

    Directory of Open Access Journals (Sweden)

    Byungmook Lim

    2013-09-01

    Full Text Available National Health Insurance (NHI in Korea has covered Korean medicine (KM services including acupuncture, moxibustion, cupping, and herbal preparations since 1987, which represents the first time that an entire traditional medicine system was insured by an NHI scheme anywhere in the world. This nationwide insurance coverage led to a rapid increase in the use of KM, and the KM community became one of the main interest groups in the Korean healthcare system. However, due to the public's safety concern of and the stagnancy in demand for KM services, KM has been facing new challenges. This paper presents a brief history and the current structure of KM health insurance, and describes the critical issues related to KM insurance for in-depth understanding of the present situation.

  14. Federal Old-Age, Survivors, and Disability Insurance; coverage of employees of private nonprofit organizations--SSA. Proposed rules.

    Science.gov (United States)

    1984-04-06

    These proposed rules implement sections 102, 321, 322 and 323 of Pub. L. 98-21 (the Social Security Amendments of 1983). Generally, these provisions: (1) Mandatorily cover for Social Security purposes employees of private nonprofit organizations; (2) Provide additional Social Security coverage for certain work performed outside the United States (U.S.); (3) Provide coverage under the Social Security program for certain foreign earned income; (4) Provide special Social Security insured status requirements for certain nonprofit organization employees covered as a result of these amendments; and (5) Provide Social Security coverage for employment and self-employment that is identified as "covered" for purposes of title II of the Social Security Act (the Act) by the provisions of a totalization agreement between the U.S. and another country.

  15. Boosting health insurance coverage in developing countries: do conditional cash transfer programmes matter in Mexico?

    Science.gov (United States)

    Biosca, Olga; Brown, Heather

    2015-03-01

    Achieving universal health insurance coverage is a goal for many developing countries. Even when universal health insurance programmes are in place, there are significant barriers to reaching the lowest socio-economic groups such as a lack of awareness of the programmes or knowledge of the benefits to participating in the insurance market. Conditional cash transfer (CCT) programmes can encourage participation through mandatory health education classes, increased contact with the health care system and cash payments to reduce costs of participating in the insurance market. To explore if participation in a CCT programme in Mexico, Oportunidades, is significantly associated with self-reported enrolment in a public health insurance programme. Cross-sectional data from 2007 collected on 29 595 Mexican households where the household head is aged between ages 15 and 60 were analysed. A logit model was used to estimate the association between Oportunidades participation and awareness of enrolment in a public health insurance programme. Participation in the Oportunidades programme is associated with a 25% higher likelihood of being actively aware of enrolment in Seguro Popular, a public health insurance scheme for the lowest socio-economic groups. Participation in the Oportunidades CCT programme is positively associated with awareness of enrolment in public health insurance. CCT programmes may be used to promote participation of the lowest socio-economic groups in universal public health insurance systems. This is crucial to achieving universal health insurance coverage in developing countries. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  16. The demand for health insurance coverage by low-income workers: can reduced premiums achieve full coverage?

    Science.gov (United States)

    Chernew, M; Frick, K; McLaughlin, C G

    1997-10-01

    To assess the degree to which premium reductions will increase the participation in employer-sponsored health plans by low-income workers who are employed in small businesses. Sample of workers in small business (25 or fewer employees) in seven metropolitan areas. The data were gathered as part of the Small Business Benefits Survey, a telephone survey of small business conducted between October 1992 and February 1993. Probit regressions were used to estimate the demand for health insurance coverage by low-income workers. Predictions based on these findings were made to assess the extent to which premium reductions might increase coverage rates. Workers included in the sample were selected, at random, from a randomly generated set of firms drawn from Dun and Bradstreet's DMI (Dun's Market Inclusion). The response rate was 81 percent. Participation in employer-sponsored plans is high when coverage is offered. However, even when coverage is offered to employees who have no other source of insurance, participation is not universal. Although premium reductions will increase participation in employer-sponsored plans, even large subsidies will not induce all workers to participate in employer-sponsored plans. For workers eligible to participate, subsidies as high as 75 percent of premiums are estimated to increase participation rates from 89.0 percent to 92.6 percent. For workers in firms that do not sponsor plans, similar subsidies are projected to achieve only modest increases in coverage above that which would be observed if the workers had access to plans at unsubsidized, group market rates. Policies that rely on voluntary purchase of coverage to reduce the number of uninsured will have only modest success.

  17. 75 FR 49363 - Deposit Insurance Regulations; Permanent Increase in Standard Coverage Amount; Advertisement of...

    Science.gov (United States)

    2010-08-13

    ... Standard Coverage Amount; Advertisement of Membership; International Banking; Foreign Banks August 10, 2010... conforming changes to its insurance regulations (12 CFR part 330), international banking regulations (12 CFR..., this inflation adjustment will not affect the level of the SMDIA in the foreseeable future because it...

  18. Trends in employer-sponsored health insurance coverage for tobacco-dependence treatments.

    Science.gov (United States)

    McMenamin, Sara B; Halpin, Helen A; Shade, Starley B

    2008-10-01

    Nearly 1.8 million smokers in California receive their health insurance benefits through their employer. The extent to which these workers have coverage for tobacco-dependence treatments (TDTs) through their employer-sponsored health care is unknown. This research used the 2000 and 2005 data from the California Employer Health Benefits Surveys to determine coverage for TDTs by private firms. The overall response rates of firms to the survey were 41% and 36%, respectively. The samples used in this analysis are limited to private firms in California that offered employee health benefits in 2000 (n=729) or in 2005 (n=745). This research found that among private firms offering health insurance coverage, there was a significant increase from 2000 to 2005 in the percentage of workers covered for any TDTs (44% to 57%). Rates of coverage for all three forms of TDTs (nicotine replacement therapy, Zyban, counseling) doubled from 11% to 22% over the 5-year time period. Although coverage levels have improved, they still fall short of the recommendations made in the U.S. Public Health Service guidelines as well as in the Healthy People 2010 objectives. Given the effectiveness, cost effectiveness, public demand for coverage, and relatively low cost of covering TDTs--estimated to be $3-$6 per member per year--it is difficult to understand why such coverage is not more widely available in California.

  19. Employer-provided health insurance and hospital mergers.

    Science.gov (United States)

    Garmon, Christopher

    2013-07-01

    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.

  20. Health insurance instability among older immigrants: region of origin disparities in coverage.

    Science.gov (United States)

    Reyes, Adriana M; Hardy, Melissa

    2015-03-01

    We provide a detailed analysis of how the dynamics of health insurance coverage (HIC) at older ages differs among Latino, Asian, and European immigrants in the United States. Using Survey of Income and Program Participation data from the 2004 and 2008 panels, we estimate discrete-time event history models to examine first and second transitions into and out of HIC, highlighting substantial differences in hazard rates among immigrants aged 50-64 from Asia, Latin America, and Europe. We find that the likelihood of having HIC at first observation and the rates of gaining and losing coverage within a relatively short time frame are least favorable for older Latino immigrants, although immigrants from all three regions are at a disadvantage relative to native-born non-Hispanic Whites. This disparity among immigrant groups persists even when lower rates of citizenship, greater difficulty with English, and low-skill job placements are taken into account. Factors that have contributed to the lower rates and shorter durations of HIC among older immigrants, particularly those from Latin America, may not be easily resolved by the Affordable Care Act. The importance of region of origin and assimilation characteristics for the risk of being uninsured in later life argues that immigration and health care policy should be jointly addressed. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Health Insurance Instability Among Older Immigrants: Region of Origin Disparities in Coverage

    Science.gov (United States)

    Hardy, Melissa

    2015-01-01

    Objectives. We provide a detailed analysis of how the dynamics of health insurance coverage (HIC) at older ages differs among Latino, Asian, and European immigrants in the United States. Method. Using Survey of Income and Program Participation data from the 2004 and 2008 panels, we estimate discrete-time event history models to examine first and second transitions into and out of HIC, highlighting substantial differences in hazard rates among immigrants aged 50–64 from Asia, Latin America, and Europe. Results. We find that the likelihood of having HIC at first observation and the rates of gaining and losing coverage within a relatively short time frame are least favorable for older Latino immigrants, although immigrants from all three regions are at a disadvantage relative to native-born non-Hispanic Whites. This disparity among immigrant groups persists even when lower rates of citizenship, greater difficulty with English, and low-skill job placements are taken into account. Discussion. Factors that have contributed to the lower rates and shorter durations of HIC among older immigrants, particularly those from Latin America, may not be easily resolved by the Affordable Care Act. The importance of region of origin and assimilation characteristics for the risk of being uninsured in later life argues that immigration and health care policy should be jointly addressed. PMID:25637934

  2. A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few?

    Science.gov (United States)

    Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

    2017-03-01

    The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access. Health insurance is a financial mechanism for paying for health care, while access refers to the process of actually obtaining that health care. The ACA has widened the gap between providing patients the mechanism of paying for healthcare and actually receiving it. The ACA is applauded for increasing the number of insured, quite appropriately as that has occurred for over 20 million people. Less frequently mentioned are the 6 million who have lost their insurance. Further, in terms of how health insurance is been provided, the majority the expansion was based on Medicaid expansion, with an increase of 13 million. Consequently, the ACA hasn't worked well for the working and middle class who receive much less support, particularly those who earn more than 400% of the federal poverty level, who constitute 40% of the population and don't receive any help. As a result, exchange enrollment has been a disappointment and the percentage of workers obtaining their health benefits from their employer has decreased steadily. Access to health care has been uneven, with those on Medicaid hampered by narrow networks, while those on the exchanges or getting employer benefits have faced high out-of-pocket costs.The second category relates to cost containment. President Obama claimed that the ACA provided significant cost containment, in that costs would have been even much higher if the ACA was not enacted. Further, he attributed

  3. Public views of health insurance in Japan during the era of attaining universal health coverage: a secondary analysis of an opinion poll on health insurance in 1967

    Directory of Open Access Journals (Sweden)

    Ikuma Nozaki

    2017-07-01

    Full Text Available While Japan’s success in achieving universal health insurance over a short period with controlled healthcare costs has been studied from various perspectives, that of beneficiaries have been overlooked. We conducted a secondary analysis of an opinion poll on health insurance in 1967, immediately after reaching universal coverage. We found that people continued to face a slight barrier to healthcare access (26.8% felt medical expenses were a heavy burden and had high expectations for health insurance (60.5% were satisfied with insured medical services and 82.4% were willing to pay a premium. In our study, younger age, having children before school age, lower living standards, and the health insurance scheme were factors that were associated with a willingness to pay premiums. Involving high-income groups in public insurance is considered to be the key to ensuring universal coverage of social insurance.

  4. The Children's Health Insurance Program Reauthorization Act Evaluation Findings on Children's Health Insurance Coverage in an Evolving Health Care Landscape.

    Science.gov (United States)

    Harrington, Mary E

    2015-01-01

    The Children's Health Insurance Program (CHIP) Reauthorization Act (CHIPRA) reauthorized CHIP through federal fiscal year 2019 and, together with provisions in the Affordable Care Act, federal funding for the program was extended through federal fiscal year 2015. Congressional action is required or federal funding for the program will end in September 2015. This supplement to Academic Pediatrics is intended to inform discussions about CHIP's future. Most of the new research presented comes from a large evaluation of CHIP mandated by Congress in the CHIPRA. Since CHIP started in 1997, millions of lower-income children have secured health insurance coverage and needed care, reducing the financial burdens and stress on their families. States made substantial progress in simplifying enrollment and retention. When implemented optimally, Express Lane Eligibility has the potential to help cover more of the millions of eligible children who remain uninsured. Children move frequently between Medicaid and CHIP, and many experienced a gap in coverage with this transition. CHIP enrollees had good access to care. For nearly every health care access, use, care, and cost measure examined, CHIP enrollees fared better than uninsured children. Access in CHIP was similar to private coverage for most measures, but financial burdens were substantially lower and access to weekend and nighttime care was not as good. The Affordable Care Act coverage options have the potential to reduce uninsured rates among children, but complex transition issues must first be resolved to ensure families have access to affordable coverage, leading many stakeholders to recommend funding for CHIP be continued. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  5. Insurance Coverage, Access to Care, and Medical Debt Since the ACA: a Look at California, Florida, New York, and Texas.

    Science.gov (United States)

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle McEvoy; Beutel, Sophie

    2017-03-01

    ISSUE: The Affordable Care Act has significantly increased health insurance coverage and access to care among U.S. adults nationwide. However, the law gives states flexibility in implementing certain provisions, leading to wide variations between states in consumers’ experiences. GOAL: To examine the differences in insurance coverage, access to care, and medical bill problems in the four largest states—California, Florida, New York, and Texas—all of which have made different choices in implementing the law. METHODS: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. FINDINGS AND CONCLUSIONS: In 2016, uninsured rates among adults ages 19 to 64 across the four states varied from 7 percent in New York and 10 percent in California to 16 percent in Florida and 25 percent in Texas. This variation was also apparent in the proportions of residents reporting problems getting needed care because of the cost—significantly lower in California and New York than in Florida and Texas. Lower percentages of Californians and New Yorkers reported having a medical bill problem in the past 12 months or having accrued medical debt compared to Floridians and Texans. These variations might be explained by several factors: whether the state expanded Medicaid eligibility; whether it ran its own health insurance marketplace; what the uninsured rate was prior to the Affordable Care Act; differences in the cost protections provided by private health plans; and demographic differences.

  6. How did welfare reform affect the health insurance coverage of women and children?

    Science.gov (United States)

    Cawley, John; Schroeder, Mathis; Simon, Kosali I

    2006-04-01

    To measure the change in U.S. women and children's health insurance coverage as a result of welfare reform (i.e. the creation of Temporary Assistance for Needy Families or TANF) in 1996. 1992-1999 longitudinal data from the Survey of Income and Program Participation (SIPP) merged with data on the timing of state implementation of welfare reform after 1996. Two key advantages of the SIPP data are that they permit matching type of insurance coverage to the welfare policy environment in each state in each month, and permit controlling for individual-level fixed effects. We measure how much insurance coverage changed after welfare reform using a difference in differences method that eliminates the influence of time-invariant unobserved individual heterogeneity and of statewide trends in insurance coverage. Models also control for individual, state, and year fixed effects, individual-level characteristics such as education, age, and number of children, plus state-level variables such as real per capita income, real minimum wage, and Medicaid eligibility. We limit our analysis to the SIPP data specific to the month just completed prior to the interview; as a result, we have up to twelve observations for each individual in the SIPP. This paper uses pooled data from the 1992-1996 panels of the SIPP covering the period 1992-1999. Publicly available state identifiers permit the merger of state policies and macroeconomic variables with the SIPP. TANF implementation is associated with an 8.1 percent increase in the probability that a welfare-eligible woman was uninsured. Welfare reform had less of an impact on the health insurance coverage of children. For example, TANF implementation was associated with a 3.0 percent increase in the probability that a welfare-eligible child lacked health insurance. An unintended consequence of welfare reform was to adversely impact the health insurance coverage of economically vulnerable women and children, and that this impact was several

  7. Health Insurance Coverage among Puerto Rican Adults in Same-Sex Relationships.

    Science.gov (United States)

    Gonzales, Gilbert

    2017-01-01

    The primary objectives of this study were to measure and compare health insurance coverage between nonelderly Puerto Rican adults in cohabiting same-sex relationships and their counterparts in cohabiting different-sex relationships. This study used data from the 2008-2014 Puerto Rican Community Survey on nonelderly adults (18-64 years) in cohabiting same-sex (n=274) and different-sex (n=58,128) relationships. Multinomial logistic regression models estimated differences in primary source of health insurance while controlling for key demographic and socioeconomic characteristics. Compared with men in different-sex relationships, men in same-sex relationships were less likely to have employer-sponsored insurance (ESI). Women in same-sex relationships were less likely than others to have ESI, insurance purchased directly from an insurer, and public health insurance after controlling for socio-demographic factors. Employment-based discrimination and policy barriers may have prevented same-sex couples from enjoying the full benefits associated with marriage and cohabitation in Puerto Rico, including employer-sponsored health insurance.

  8. Are Americans finding affordable coverage in the health insurance marketplaces? Results from the Commonwealth Fund Affordable Care Act Tracking Survey.

    Science.gov (United States)

    Rasmussen, Petra W; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2014-09-01

    By the end of the first open enrollment period for coverage offered through the Affordable Care Act's marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund's Affordable Care Act Tracking Survey, April-June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick.

  9. Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage.

    Science.gov (United States)

    Eibner, Christine; Saltzman, Evan

    2015-03-20

    The goals of the Affordable Care Act (ACA) are to enable all legal U.S. residents to have access to affordable health insurance and to prevent sicker individuals (such as those with preexisting conditions) from being priced out of the market. The ACA also instituted several policies to stabilize premiums and to encourage enrollment among healthy individuals of all ages. The law's tax credits and cost-sharing subsidies offer a "carrot" that may encourage enrollment among some young and healthy individuals who would otherwise remain uninsured, while the individual mandate acts as a "stick" by imposing penalties on individuals who choose not to enroll. In this article, the authors use the COMPARE microsimulation model, an analytic tool that uses economic theory and data to predict the effects of health policy reforms, to estimate how eliminating the ACA's individual mandate, eliminating the law's tax credits, and combined scenarios that change these and other provisions of the act might affect 2015 individual market premiums and overall insurance coverage. Underlying these estimates is a COMPARE-based analysis of how premiums and insurance coverage outcomes depend on young adults' propensity to enroll in insurance coverage. The authors find that eliminating the ACA's tax credits and eliminating the individual mandate both increase premiums and reduce enrollment on the individual market. They also find that these key features of the ACA help to protect against adverse selection and stabilize the market by encouraging healthy people to enroll and, in the case of the tax credit, shielding subsidized enrollees from premium increases. Further, they find that individual market premiums are only modestly sensitive to young adults' propensity to enroll in insurance coverage, and ensuring market stability does not require that young adults make up a particular share of enrollees.

  10. 76 FR 16422 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2011-03-23

    ... Health Insurance Programs; Provider Enrollment Application Fee Amount for 2011 AGENCY: Centers for... with comment period entitled: ``Medicare, Medicaid, and Children's Health Insurance Programs... Health Insurance Program (CHIP) provider enrollment processes. Specifically, and as stated in 42 CFR 424...

  11. User experience with a health insurance coverage and benefit-package access: implications for policy implementation towards expansion in Nigeria.

    Science.gov (United States)

    Mohammed, Shafiu; Aji, Budi; Bermejo, Justo Lorenzo; Souares, Aurelia; Dong, Hengjin; Sauerborn, Rainer

    2016-04-01

    Developing countries are devising strategies and mechanisms to expand coverage and benefit-package access for their citizens through national health insurance schemes (NHIS). In Nigeria, the scheme aims to provide affordable healthcare services to insured-persons and their dependants. However, inclusion of dependants is restricted to four biological children and a spouse per user. This study assesses the progress of implementation of the NHIS in Nigeria, relating to coverage and benefit-package access, and examines individual factors associated with the implementation, according to users' perspectives. A retrospective, cross-sectional survey was done between October 2010 and March 2011 in Kaduna state and 796 users were randomly interviewed. Questions regarding coverage of immediate-family members and access to benefit-package for treatment were analysed. Indicators of coverage and benefit-package access were each further aggregated and assessed by unit-weighted composite. The additive-ordinary least square regression model was used to identify user factors that may influence coverage and benefit-package access. With respect to coverage, immediate-dependants were included for 62.3% of the users, and 49.6 rated this inclusion 'good' (49.6%). In contrast, 60.2% supported the abolishment of the policy restriction for non-inclusion of enrolees' additional children and spouses. With respect to benefit-package access, 82.7% of users had received full treatments, and 77.6% of them rated this as 'good'. Also, 14.4% of users had been refused treatments because they could not afford them. The coverage of immediate-dependants was associated with age, sex, educational status, children and enrolment duration. The benefit-package access was associated with types of providers, marital status and duration of enrolment. This study revealed that coverage of family members was relatively poor, while benefit-package access was more adequate. Non-inclusion of family members could

  12. One-fifth of nonelderly Californians do not have access to job-based health insurance coverage.

    Science.gov (United States)

    Lavarreda, Shana Alex; Cabezas, Livier

    2010-11-01

    Lack of job-based health insurance does not affect just workers, but entire families who depend on job-based coverage for their health care. This policy brief shows that in 2007 one-fifth of all Californians ages 0-64 who lived in households where at least one family member was employed did not have access to job-based coverage. Among adults with no access to job-based coverage through their own or a spouse's job, nearly two-thirds remained uninsured. In contrast, the majority of children with no access to health insurance through a parent obtained public health insurance, highlighting the importance of such programs. Low-income, Latino and small business employees were more likely to have no access to job-based insurance. Provisions enacted under national health care reform (the Patient Protection and Affordable Care Act of 2010) will aid some of these populations in accessing health insurance coverage.

  13. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    Science.gov (United States)

    Lan, Jesse Yu-Chen

    2017-12-01

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

  14. Equity in private insurance coverage for substance abuse: a perspective on parity.

    Science.gov (United States)

    Barry, Colleen L; Sindelar, Jody L

    2007-01-01

    Congress is considering enactment of comprehensive parity legislation. The intent of parity is to equalize private coverage of behavioral and general medical care, thereby improving efficiency and fairness in insurance markets. One issue is whether to extend parity to substance abuse (SA) benefits. In the past, inclusion of substance abuse has been a hurdle to passage of parity. We examine the politics of SA parity, compare coverage trends for substance abuse and mental health, and assess the rationale for equalizing benefits. We conclude that the justification for SA parity is as compelling as it is for mental health parity.

  15. Mitigating India's health woes: Can health insurance be a remedy to achieve universal health coverage?

    Directory of Open Access Journals (Sweden)

    B Savitha

    2016-01-01

    Full Text Available A low level of public investments in preventive health facilities and medical care facilities and health professionals has given rise to poor health status for an average Indian. Insufficient government funding for health care, inadequate and ineffective health financing mechanisms, poor delivery of health care, especially in public facilities, and excessive reliance on unregulated high-cost private providers have contributed to the poor accomplishment of Millennium Development Goals, especially in the informal sector. Sustainable Development Goals (SDGs consider health to be one of the important objectives to be achieved by all the nations in the world. This paper reappraises the current status, unmet needs, challenges, and the way forward to implement and achieve universal health coverage (UHC in India by thrusting the focus on three elements (pillars of universal access to health services. Despite seven decades of independence, India does still face the formidable challenge of providing health services to its population at an affordable cost. One of the major obstacles in reaching universal coverage and universal health entitlement of every Indian citizen has been the absence of effective health financing mechanism that promotes affordable access to weaker and vulnerable sections of the society. In this respect, health insurance certainly does have the potential to expedite the process of UHC if various stakeholders work in cohesion under the government stewardship. In rural India, the health infrastructure and workforce are inadequate to serve the unserved and underserved population. Hence, the government should invest in public health facilities while promoting pan-India health insurance to ensure and guarantee easy access and affordability for its citizens. The way forward should not only be centered on financial protection, but also to have renewed emphasis on restructuring the health-care system, ensuring the adequate availability of

  16. Hospital Utilization and Universal Health Insurance Coverage: Evidence from the Massachusetts Health Care Reform Act.

    Science.gov (United States)

    Cseh, Attila; Koford, Brandon C; Phelps, Ryan T

    2015-12-01

    The Affordable Care Act is currently in the roll-out phase. To gauge the likely implications of the national policy we analyze how the Massachusetts Health Care Reform Act impacted various hospitalization outcomes in each of the 25 major diagnostic categories (MDC). We utilize a difference-in-difference approach to identify the impact of the Massachusetts reform on insurance coverage and patient outcomes. This identification is achieved using six years of data from the Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project. We report MDC-specific estimates of the impact of the reform on insurance coverage and type as well as length of stay, number of diagnoses, and number of procedures. The requirement of universal insurance coverage increased the probability of being covered by insurance. This increase was in part a result of an increase in the probability of being covered by Medicaid. The percentage of admissions covered by private insurance fell. The number of diagnoses rose as a result of the law in the vast majority of diagnostic categories. Our results related to length of stay suggest that looking at aggregate results hides a wealth of information. The most disparate outcomes were pregnancy related. The length of stay for new-born babies and neonates rose dramatically. In aggregate, this increase serves to mute decreases across other diagnoses. Also, the number of procedures fell within the MDCs for pregnancy and child birth and that for new-born babies and neonates. The Massachusetts Health Care Reform appears to have been effective at increasing insurance take-up rates. These increases may have come at the cost of lower private insurance coverage. The number of diagnoses per admission was increased by the policy across nearly all MDCs. Understanding the changes in length of stay as a result of the Massachusetts reform, and perhaps the Affordable Care Act, requires MDC-specific analysis. It appears that the most important distinction

  17. Coverage of the emergency health care law and the compulsory insurance against Road Traffic Crashes (SOAT)

    OpenAIRE

    Miranda, J. Jaime; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. CRONICAS, Centro de Excelencia en Enfermedades Crónicas, Universidad Peruana Cayetano Heredia. Lima, Perú. EDHUCASALUD, Asociación Civil para la Educación en Derechos Humanos con Aplicación en Salud. Lima, Perú. Médico, Magíster y Doctor en Epidemiología.; Rosales-Mayor, Edmundo; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Centro de Trastornos Respiratorios del Sueño (CENTRES), Clínica Anglo Americana. Lima, Perú. Grupo de Investigación en Sueño (GIS). Lima, Perú. Médico, Magíster en Medicina y Magíster en Sueño: fisiología y Medicina.; Gianella, Camila; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. EDHUCASALUD, Asociación Civil para la Educación en Derechos Humanos con Aplicación en Salud. Lima, Perú. Licenciada en Psicología Social, Magíster en Salud Internacional.; Paca-Palao, Ada; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Obstetriz, Magíster en Población y Salud.; Luna, Diego; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Departamento de Ciencias Sociales y Políticas, Universidad del Pacífico. Lima, Perú. Asociación Civil “Gobierno Coherente”. Lima, Perú. Sociólogo.; Lopez, Luis; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Dirección de formación Profesional y los Recursos Humanos, Ministerio del Trabajo y Promoción del Empleo. Lima, Perú. Economista.; Huicho, Luis; Programa de Investigación en Accidentes de Tránsito, Salud Sin Límites Perú. Lima, Perú. Departamento de Pediatría, Instituto Nacional de Salud del Niño. Lima, Perú. Facultad de Medicina, “San fernando” Universidad Nacional Mayor de San Marcos. Lima, Perú.; PIAT, Equipo

    2010-01-01

    Objective. The aim of this study was to ascertain, from patients’ perspective, the degree of knowledge and the actual coverage of the Emergency Health Care Law and the Compulsory Insurance against Road Traffic Crashes (SOAT). Material and methods. A cross-sectional, active surveillance of emergency wards of selected health facilities in three Peruvian cities (Lima, Pucallpa y Ayacucho) was conducted. Results. Out of 644 surveyed victims, 77% did not know about the law about provision of e...

  18. Vaccination coverage among children in Germany estimated by analysis of health insurance claims data

    Science.gov (United States)

    Rieck, Thorsten; Feig, Marcel; Eckmanns, Tim; Benzler, Justus; Siedler, Anette; Wichmann, Ole

    2014-01-01

    In Germany, the national routine childhood immunization schedule comprises 12 vaccinations. Primary immunizations should be completed by 24 mo of age. However, nationwide monitoring of vaccination coverage (VC) is performed only at school entry. We utilized health insurance claims data covering ~85% of the total population with the objectives to (1) assess VC of all recommended childhood vaccinations in birth-cohorts 2004–2009, (2) analyze cross-sectional (at 24 and 36 mo) and longitudinal trends, and (3) validate the method internally and externally. Counting vaccine doses in a retrospective cohort fashion, we assembled individual vaccination histories and summarized VC to nationwide figures. For most long-established vaccinations, VC at 24 mo was at moderate levels (~73–80%) and increased slightly across birth-cohorts. One dose measles VC was high (94%), but low (69%) for the second dose. VC with a full course of recently introduced varicella, pneumococcal, and meningococcal C vaccines increased across birth-cohorts from below 10% above 60%, 70%, and 80%, respectively. At 36 mo, VC had increased further by up to 15 percentage points depending on vaccination. Longitudinal analysis suggested a continued VC increase until school entry. Validation of VC figures with primary data showed an overall good agreement. In conclusion, analysis of health insurance claims data allows for the estimation of VC among children in Germany considering completeness and timeliness of vaccination series. This approach provides valid nationwide VC figures for all currently recommended pediatric vaccinations and fills the information gap between early infancy and late assessment at school entry. PMID:24192604

  19. 75 FR 60341 - Deposit Insurance Regulations; Unlimited Coverage for Noninterest-bearing Transaction Accounts

    Science.gov (United States)

    2010-09-30

    ... Act Section 343 of the Dodd-Frank Act amends the Federal Deposit Insurance Act (``FDI Act'') to...-Frank Act amends the deposit insurance provisions of the FDI Act (12 U.S.C. 1821(a)(1)) to provide... issued by IDIs, are ``deposits'' as defined under the FDI Act (12 U.S.C. 1813(l)) and Part 330 of the...

  20. The impact of maternity length-of-stay mandates on the labor market and insurance coverage.

    Science.gov (United States)

    Sabik, Lindsay M; Laugesen, Miriam J

    2012-01-01

    To understand the effects of insurance regulation on the labor market and insurance coverage, this study uses a difference-in-difference-in-differences analysis to compare five states that passed minimum maternity length-of-stay laws with states that waited until after a federal law was passed. On average, we do not find statistically significant effects on labor market outcomes such as hours of work and wages. However, we find that employees of small firms in states with maternity length-of-stay mandates experienced a 6.2-percentage-point decline in the likelihood of having employer-sponsored insurance. Implementation of federal health reform that requires minimum benefit standards should consider the implications for firms of differing sizes.

  1. 76 FR 67743 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2011-11-02

    ... Medicare or Medicaid programs or Children's Health Insurance Program (CHIP); revalidating their Medicare... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment..., Medicaid, and Children's Health Insurance Program (CHIP) provider enrollment processes. Specifically, and...

  2. The Effects of Health Shocks on Employment and Health Insurance: The Role of Employer-Provided Health Insurance

    Science.gov (United States)

    Bradley, Cathy J.; Neumark, David; Motika, Meryl

    2012-01-01

    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

  3. SCHIP's impact on dependent coverage in the small-group health insurance market.

    Science.gov (United States)

    Seiber, Eric E; Florence, Curtis S

    2010-02-01

    To estimate the impact of State Children's Health Insurance Program (SCHIP) expansions on public and private coverage of dependents at small firms compared with large firms. 1996-2007 Annual Demographic Survey of the Current Population Survey (CPS). This study estimates a two-stage least squares (2SLS) model for four insurance outcomes that instruments for SCHIP and Medicaid eligibility. Separate models are estimated for small group markets (firms with fewer than 25 employees), small businesses (firms under 500 employees), and large firms (firms 500 employees and above). We extracted data from the 1996-2007 CPS for children in households with at least one worker. The SCHIP expansions decreased the percentage of uninsured dependents in the small group market by 7.6 percentage points with negligible crowd-out in the small group and no significant effect on private coverage across the 11-year-period. The SCHIP expansions have increased coverage for households in the small group market with no significant crowd-out of private coverage. In contrast, the estimates for large firms are consistent with the substantial crowd-out observed in the literature.

  4. 78 FR 19949 - The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers

    Science.gov (United States)

    2013-04-02

    ... Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers; Proposed Rule #0;#0... Remuneration Provided by Certain Health Insurance Providers AGENCY: Internal Revenue Service (IRS), Treasury... application of the $500,000 deduction limitation for remuneration provided by certain health insurance...

  5. “Mind the Gap” in Children’s Health Insurance Coverage: Does the Length of a Child’s Coverage Gap Matter?

    Science.gov (United States)

    DeVoe, Jennifer E.; Graham, Alan; Krois, Lisa; Smith, Jeanene; Fairbrother, Gerry L.

    2016-01-01

    Objective Gaps in health insurance coverage compromise access to health care services, but it is unclear whether the length of time without coverage is an important factor. This article examines how coverage gaps of different lengths affect access to health care among low-income children. Methods We conducted a multivariable, cross-sectional analysis of statewide primary data from families in Oregon’s food stamp population with children presumed eligible for publicly funded health insurance. The key independent variable was length of a child’s insurance coverage gap; outcome variables were 6 measures of health care access. Results More than 25% of children reported a coverage gap during the 12-month study period. Children most likely to have a gap were older, Hispanic, lived in households earning between 133% and 185% of the federal poverty level, and/or had an employed parent. After adjusting for these characteristics, in comparison with continuously insured children, a child with a gap of any length had a higher likelihood of unmet medical, prescription, and dental needs; no usual source of care; no doctor visits in the past year; and delayed urgent care. When comparing coverage gaps, children without coverage for longer than 6 months had a higher likelihood of unmet needs compared with children with a gap shorter than 6 months. In some cases, children with gaps longer than 6 months were similar to, or worse off than, children who had never been insured. Conclusions State policies should be designed to minimize gaps in public health insurance coverage in order to ensure children’s continuous access to necessary services. PMID:18355742

  6. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria.

    Science.gov (United States)

    Onoka, Chima A; Hanson, Kara; Hanefeld, Johanna

    2015-11-01

    This article examines why and how a national health insurance (NHI) proposal targeting universal health coverage (UHC) in Nigeria developed over time. The study involved document reviews, in-depth interviews, a further review of preliminary analysis by relevant actors and use of a stakeholder analysis approach. The need for strategies to improve healthcare funding during the economic recession of the 1980s stimulated the proposal. The inclusion of Health Maintenance Organizations (HMOs) as financing organizations for national health insurance at the expense of sub-national (state) government mechanisms increased credibility of policy implementation but resulted in loss of support from states. The most successful period of the policy process occurred when a new minister of health (strongly supported by the president that displayed interest in UHC) provided leadership through the Federal Ministry of Health (FMOH), and effectively managed stakeholders' interests and galvanized their support to advance the policy. Later, the National Health Insurance Scheme (the federal government's implementing/regulatory agency) assumed this leadership role but has been unable to extend coverage in a significant way. Nigeria's experience shows that where political leaders are interested in a UHC-related proposal, the strong political leadership they provide considerably enhances the pace of the policy process. However, public officials should carefully guide policymaking processes that involve private sector actors, to ensure that strategies that compromise the chance of achieving UHC are not introduced. In contexts where authority is shared between federal and state governments, securing federal level commitment does not guarantee that a national health insurance proposal has become a 'national' proposal. States need to be provided with an active role in the process and governance structure. Finally, the article underscores the utility of retrospective stakeholder analysis in

  7. Dropped out or pushed out? Insurance market exit and provider market power in Medicare Advantage.

    Science.gov (United States)

    Pelech, Daria

    2017-01-01

    This paper explores how provider and insurer market power affect which markets an insurer chooses to operate in. A 2011 policy change required that certain private insurance plans in Medicare form provider networks de novo; in response, insurers cancelled two-thirds of the affected plans. Using detailed data on pre-policy provider and insurer market structure, I compare markets where insurers built networks to those they exited. Overall, insurers in the most concentrated hospital and physician markets were 9 and 13 percentage points more likely to exit, respectively, than those in the least concentrated markets. Conversely, insurers with more market power were less likely to exit than those with less, and an insurer's market power had the largest effect on exit in concentrated hospital markets. These findings suggest that concentrated provider markets contribute to insurer exit and that insurers with less market power have more difficulty surviving in concentrated provider markets. Published by Elsevier B.V.

  8. Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria

    National Research Council Canada - National Science Library

    Onoka, Chima A; Onwujekwe, Obinna E; Uzochukwu, Benjamin S; Ezumah, Nkoli N

    2013-01-01

    The National Health Insurance Scheme (NHIS) in Nigeria was launched in 2005 as part of efforts by the federal government to achieve universal coverage using financial risk protection mechanisms. However, only 4...

  9. Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003

    Directory of Open Access Journals (Sweden)

    Collins Charles D

    2007-03-01

    Full Text Available Abstract Background In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS and Labour Insurance Scheme (LIS to the new Urban Employee Basic Health Insurance Scheme (BHIS. Methods This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. Results An examination of the data reveals a number of key points: a The overall coverage of the newly established scheme has decreased from 1998 to 2003. b The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. Conclusion The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in

  10. U.S. physicians' views on financing options to expand health insurance coverage: a national survey.

    Science.gov (United States)

    McCormick, Danny; Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H; Himmelstein, David U

    2009-04-01

    Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. To assess physician views on financing options for expanding health care coverage and on access to health care. Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians.

  11. STATUS AND PROSPECTS OF DEVELOPMENT OF INSURANCE COVERAGE ORGANIZATIONS BUSINESS INFRASTRUCTURE OF REAL ESTATE MARKET

    Directory of Open Access Journals (Sweden)

    A. N. Jampol'skij

    2014-01-01

    Full Text Available This paper presents an analysis of the current state of the Russian market of insurance services provided by appraisers and notaries working in the real estate market. According to the results of analysis of the real estate market infrastructure organizations highlighted the company business and intermediary market infrastructure. It is possible to identify the specifi c risks and to compare them to exist in the Russian insurance. Liability insurance organizations – representatives of the business infrastructure of the real estate market serves to increase the economic security of transactions, and in this context deserves regular monitoring for the purpose of correction of legislation in relation to modern economic realities. The paper presents an analysis of the legislation governing the liability insurance of notaries and appraisers, recommendations are made to improve the practice of insurance.

  12. Holding back the tide: policies to preserve and reconstruct health insurance coverage in Maryland.

    Science.gov (United States)

    Oliver, Thomas R

    2004-04-01

    Over the past decade, state officials have pursued a variety of strategies to protect and expand health insurance coverage for their residents. This article examines the course of action in Maryland, where new initiatives were shaped around the state's unique hospital payment system and its reimbursement of uncompensated care, an evolving Medicaid and children's health program, and regulation of the small group health insurance market. Several important patterns emerge from the Maryland experience. First, even the most incremental initiatives--programs intended to aid a few thousand beneficiaries--bring into play the very issues that hamper comprehensive reforms: who is deserving of mutual aid and what is the proper role of government versus private entities in administering that aid. In Maryland, these issues generate conflict not only between Democrats and Republicans but also urban and rural interests. Second, all of the important reforms of the past decade were undertaken primarily in reaction to federal policy initiatives. Contrary to rhetoric lauding states as the "laboratories of democracy," the political impetus for reform and basic policy options emerge from interaction between federal and state debates. Third, even with budget surpluses and Democrats in control of the governorship and legislature, Maryland did not move aggressively toward universal health insurance. Now, with a much weaker economy and a new, Republican governor, the primary challenge will be to prevent further erosion of insurance coverage. The Maryland experience reiterates that each step toward greater health security, no matter how small, is a major technical and political challenge and that it will be difficult if not impossible to rely on states to secure coverage for all Americans in the foreseeable future.

  13. Administrative and clinical denials by a large dental insurance provider

    Directory of Open Access Journals (Sweden)

    Geraldo Elias MIRANDA

    2015-01-01

    Full Text Available The objective of this study was to assess the prevalence and the type of claim denials (administrative, clinical or both made by a large dental insurance plan. This was a cross-sectional, observational study, which retrospectively collected data from the claims and denial reports of a dental insurance company. The sample consisted of the payment claims submitted by network dentists, based on their procedure reports, reviewed in the third trimester of 2012. The denials were classified and grouped into ‘administrative’, ‘clinical’ or ‘both’. The data were tabulated and submitted to uni- and bivariate analyses. The confidence intervals were 95% and the level of significance was set at 5%. The overall frequency of denials was 8.2% of the total number of procedures performed. The frequency of administrative denials was 72.88%, whereas that of technical denials was 25.95% and that of both, 1.17% (p < 0.05. It was concluded that the overall prevalence of denials in the studied sample was low. Administrative denials were the most prevalent. This type of denial could be reduced if all dental insurance providers had unified clinical and administrative protocols, and if dentists submitted all of the required documentation in accordance with these protocols.

  14. Health insurance coverage, neonatal mortality and caesarean section deliveries: an analysis of vital registration data in Colombia.

    NARCIS (Netherlands)

    Houweling, T.A. (Tanja); I. Arroyave (Ivan); A. Burdorf (Alex); M. Avendano Pabon (Mauricio)

    2017-01-01

    markdownabstractLow-income and middle-income countries have introduced different health insurance schemes over the past decades, but whether different schemes are associated with different neonatal outcomes is yet unknown. We examined the association between the health insurance coverage scheme and

  15. Income, Poverty, and Health Insurance Coverage in the United States: 2012. Current Population Reports P60-245

    Science.gov (United States)

    DeNavas-Walt, Carmen; Proctor, Bernadette D.; Smith, Jessica C.

    2013-01-01

    This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2013 and earlier Current Population Survey Annual Social and Economic Supplements (CPS ASEC) conducted by the U.S. Census Bureau. For most groups, the 2012 income, poverty, and health insurance estimates were not…

  16. The effects of health shocks on employment and health insurance: the role of employer-provided health insurance.

    Science.gov (United States)

    Bradley, Cathy J; Neumark, David; Motika, Meryl

    2012-12-01

    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. We study how men's dependence on their own employer for health insurance affects labor supply responses and health insurance coverage following a health shock. We use the Health and Retirement Study (HRS) surveys from 1996 through 2008 to observe employment and health insurance status at interviews 2 years apart, and whether a health shock occurred in the intervening period between the interviews. 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 are included in the study sample. We then limited the sample to men who were initially healthy. 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. 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 limit continued employment. Men with ECHI who have a self

  17. Life Insurance Basics: A Self-Help Workbook for Consumers.

    Science.gov (United States)

    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…

  18. The utilization of dental care services according to health insurance coverage in Catalonia (Spain).

    Science.gov (United States)

    Pizarro, Vladimir; Ferrer, Montse; Domingo-Salvany, Antonia; Benach, Joan; Borrell, Carme; Pont, Angels; Schiaffino, Anna; Almansa, Josue; Tresserras, Ricard; Alonso, Jordi

    2009-02-01

    The aim of this study was to assess the relationship of dental care service use with health insurance and its evolution. The Catalan Health Interview Survey is a cross-sectional study conducted in 1994 (n = 15 000) and 2001-2 (n = 8400) by interviews at home to a representative sample of Catalonia (Spain). All the estimates were obtained by applying weights to restore the representativeness of the Catalonia general population. In the bivariate analysis, age, gender, social class and health insurance coverage were statistically associated with a dental visit in the previous year (P social class). However, the falling trend of differences by health insurance coverage is of note (adjusted OR = 2.2 and 1.5 at 1994 and 2002, respectively); as well as the positive evolution of the overall rate of dental service care use in the previous year, from 26.7% in 1994 to 34.3% in 2002. Future studies will be needed to monitor this tendency.

  19. Prevalence of chronic disease and insurance coverage among refugees in the United States.

    Science.gov (United States)

    Yun, Katherine; Fuentes-Afflick, Elena; Desai, Mayur M

    2012-12-01

    Little is known about the health status of refugees beyond the immediate post-arrival period in the US. Using data from the 2003 New Immigrant Survey, a nationally representative survey of immigrants who had recently become legal permanent residents, we determined the prevalence of chronic conditions and health insurance coverage among adult refugees who had lived in the US for at least 1 year (n = 490). We compared their health status with that of other immigrants (n = 3,715) using multivariable logistic regression. The median duration of US residency was 5.6 and 8.0 years among refugees and other immigrants, respectively. Refugees were more likely than other immigrants to report at least one chronic condition (24.7 vs. 15.6 %, P refugees: arthritis (adjusted odds ratio [AOR] = 1.67, 95 % confidence interval [CI] = 1.07, 2.61), heart disease (AOR = 2.49, 95 % CI = 1.30, 4.74), stroke (AOR = 5.87, 95 % CI = 1.27, 27.25), activity-limitation due to pain (AOR = 1.96, 95 % CI = 1.31, 2.93), and any chronic condition (AOR = 1.37, 95 % CI = 1.03, 1.81). Although similar percentages of refugees (49.0 %) and other immigrants (47.4 %) were uninsured, 46.5 % of refugees with chronic conditions lacked health insurance. Refugees have a high burden of chronic disease and would benefit from expanded insurance coverage for adults with preexisting conditions.

  20. Volume matters: physician practice characteristics and immunization coverage among young children insured through a universal health plan.

    Science.gov (United States)

    Guttmann, Astrid; Manuel, Doug; Dick, Paul T; To, Teresa; Lam, Kelvin; Stukel, Therese A

    2006-03-01

    We studied the association between immunization coverage for a cohort of 2-year-old children covered by a universal health insurance plan and pediatric provider and other health services characteristics. We assembled a cohort of 101,570 infants born in urban areas in Ontario, Canada, between July 1, 1997, and June 31, 1998. Children were considered to have up-to-date (UTD) immunization coverage if they had > or =5 immunizations by 2 years of age, ie, the recommended 3 doses and 1 booster of diphtheria-polio-tetanus-pertussis/Haemophilus influenzae type b vaccine and 1 dose of measles-mumps-rubella vaccine. Provider practice characteristics were derived from outpatient billing records, and 1996 census data were used to derive neighborhood income quintiles. The association between UTD immunization status and provider characteristics was assessed with multilevel regression models, controlling for patient characteristics. Overall, the rate of complete UTD immunization coverage was low (66.3%) despite a large number of primary care visits (median: 19 visits). Children whose usual provider had a low volume of pediatric primary care were less than one half as likely to be UTD. Other factors associated with not being UTD included very low continuity of care, low continuity of care, and usual provider in practice for Ontario are low. Because visit rates are high, primary care reform should include interventions directed at provider immunization practices to reduce missed opportunities.

  1. Comparing impact on the family and insurance coverage in children with cerebral palsy and children with another special healthcare need.

    Science.gov (United States)

    Schaible, B; Colquitt, G; Caciula, M C; Carnes, A; Li, L; Moreau, N

    2018-01-12

    Families and caregivers of children with special healthcare needs (CSHCN) often experience financial difficulties, have unmet physical and mental health needs, and are at increased risk of marital problems due to the stress caused by carrying for their child. Within the larger population of CHSCN, young people with cerebral palsy (CP) have more unmet needs due to the complexity and potential severity of the disability. The purpose of this study was to identify factors associated with differences in insurance coverage and impact on the family of children with CP and other CHSCN. The data were taken from the National Survey of Children with Special Health Care Needs, which was designed to examine state- and national-level estimates of CSHCN. Three variables examined differences in insurance coverage between those children diagnosed with CP versus all other CSHCN: insurance coverage for the previous year, current insurance coverage, and adequacy of insurance coverage. Four variables representing different indicators of family impact were used to assess differences between children with CP versus all other CSHCN: out-of-pocket expenses for healthcare, family financial burden, hours per week that family members spent caring for the child, and impact on family work life. The results of this study showed significant differences between households with a child with CP and a child with another health special need in terms of insurance coverage, indicating a tendency of children with CP to be insured the entire year. As for the impact on the family in households with children with CP versus other CSHCN, there were significant differences in all four variables that were analysed. There is limited evidence highlighting differences between the impact of caring for a child with CP and caring for other CSHCN. Caring for a child with CP has a significant impact on the family, despite insurance coverage. © 2018 John Wiley & Sons Ltd.

  2. Health Insurance Coverage and Hypertension Control in China: Results from the China Health and Nutrition Survey.

    Science.gov (United States)

    Liao, Yi; Gilmour, Stuart; Shibuya, Kenji

    2016-01-01

    China has rapidly expanded health insurance coverage over the past decade but its impact on hypertension control is not well known. We analyzed factors associated with hypertension and the impact of health insurance on the management of hypertension in China from 1991 to 2009. We used individual-level data from the China Health and Nutrition Survey (CHNS) for blood pressure, BMI, and other socio-economic variables. We employed multi-level logistic regression models to estimate the factors associated with prevalence and management of hypertension. We also estimated the effects of health insurance on management of hypertension using propensity score matching. We found that prevalence of hypertension increased from 23.8% (95% CI: 22.5-25.1%) in 1991 to 31.5% (28.5-34.7%) in 2009. The proportion of hypertensive patients aware of their condition increased from 31.7% (28.7-34.9%) to 51.1% (45.1-57.0%). The proportion of diagnosed hypertensive patients in treatment increased by 35.5% in the 19 years, while the proportion of those in treatment with controlled blood pressure remained low. Among diagnosed hypertensives, health insurance increased the probability of receiving treatment by 28.7% (95% CI: 10.6-46.7%) compared to propensity-matched individuals not covered by health insurance. Hypertension continues to be a major health threat in China and effective control has not improved over time despite large improvements in awareness and treatment access. This suggests problems in treatment quality, medication adherence and patient understanding of the condition. Improvements in hypertension management, quality of medical care for those at high risk, and better health insurance packages are needed.

  3. Health Insurance Coverage and Hypertension Control in China: Results from the China Health and Nutrition Survey.

    Directory of Open Access Journals (Sweden)

    Yi Liao

    Full Text Available China has rapidly expanded health insurance coverage over the past decade but its impact on hypertension control is not well known. We analyzed factors associated with hypertension and the impact of health insurance on the management of hypertension in China from 1991 to 2009.We used individual-level data from the China Health and Nutrition Survey (CHNS for blood pressure, BMI, and other socio-economic variables. We employed multi-level logistic regression models to estimate the factors associated with prevalence and management of hypertension. We also estimated the effects of health insurance on management of hypertension using propensity score matching. We found that prevalence of hypertension increased from 23.8% (95% CI: 22.5-25.1% in 1991 to 31.5% (28.5-34.7% in 2009. The proportion of hypertensive patients aware of their condition increased from 31.7% (28.7-34.9% to 51.1% (45.1-57.0%. The proportion of diagnosed hypertensive patients in treatment increased by 35.5% in the 19 years, while the proportion of those in treatment with controlled blood pressure remained low. Among diagnosed hypertensives, health insurance increased the probability of receiving treatment by 28.7% (95% CI: 10.6-46.7% compared to propensity-matched individuals not covered by health insurance.Hypertension continues to be a major health threat in China and effective control has not improved over time despite large improvements in awareness and treatment access. This suggests problems in treatment quality, medication adherence and patient understanding of the condition. Improvements in hypertension management, quality of medical care for those at high risk, and better health insurance packages are needed.

  4. 76 FR 7740 - Amendments to Deposit Insurance Regulations: Deposit Insurance Coverage Training; SMDIA Notification

    Science.gov (United States)

    2011-02-11

    ... Internet or other technology. Third, the rule would require IDIs to provide a link to the FDIC's Electronic... Internet or by means of other technology, these inquiries can be included in the paper or electronic... deposit accounts opened by mail or via the Internet or other technology, the publication can be provided...

  5. Trends in Disparities in Low-Income Children's Health Insurance Coverage and Access to Care by Family Immigration Status.

    Science.gov (United States)

    Jarlenski, Marian; Baller, Julia; Borrero, Sonya; Bennett, Wendy L

    2016-03-01

    To examine time trends in disparities in low-income children's health insurance coverage and access to care by family immigration status. We used data from the National Survey of Children's Health in 2003 to 2011-2012, including 83,612 children aged 0 to 17 years with family incomes immigration status categories: citizen children with nonimmigrant parents; citizen children with immigrant parents; and immigrant children. We used multivariable regression analyses to obtain adjusted trends in health insurance coverage and access to care. All low-income children experienced gains in health insurance coverage and access to care from 2003 to 2011-2012, regardless of family immigration status. Relative to citizen children with nonimmigrant parents, citizen children with immigrant parents had a 5 percentage point greater increase in health insurance coverage (P = .06), a 9 percentage point greater increase in having a personal doctor or nurse (P Immigrant children had significantly lower health insurance coverage than other groups. However, the group had a 14 percentage point greater increase in having a personal doctor or nurse (P immigration status have lessened over time among children in low-income families, although large disparities still exist. Policy efforts are needed to ensure that children of immigrant parents and immigrant children are able to access health insurance and health care. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. “Aging Out” of Dependent Coverage and the Effects on US Labor Market and Health Insurance Choices

    Science.gov (United States)

    2015-01-01

    Objectives. I examined how labor market and health insurance outcomes were affected by the loss of dependent coverage eligibility under the Patient Protection and Affordable Care Act (ACA). Methods. I used National Health Interview Survey (NHIS) data and regression discontinuity models to measure the percentage-point change in labor market and health insurance outcomes at age 26 years. My sample was restricted to unmarried individuals aged 24 to 28 years and to a period of time before the ACA’s individual mandate (2011–2013). I ran models separately for men and women to determine if there were differences based on gender. Results. Aging out of this provision increased employment among men, employer-sponsored health insurance offers for women, and reports that health insurance coverage was worse than it was 1 year previously (overall and for young women). Uninsured rates did not increase at age 26 years, but there was an increase in the purchase of non–group health coverage, indicating interest in remaining insured after age 26 years. Conclusions. Many young adults will turn to state and federal health insurance marketplaces for information about health coverage. Because young adults (aged 18–29 years) regularly use social media sites, these sites could be used to advertise insurance to individuals reaching their 26th birthdays. PMID:26447916

  7. Welfare reform and elderly immigrants' health insurance coverage: the roles of federal and state medicaid eligibility rules.

    Science.gov (United States)

    Nam, Yunju

    2011-11-01

    Immigrants' access to federally-funded Medicaid became limited after welfare reform imposed restrictive noncitizen eligibility rules. This study used a representative sample from the Current Population Survey (N = 105,873) and state-level data to examine the effects of these policy changes on elderly immigrants. Triple difference-in-differences analyses show that federal restriction of eligibility had a significantly negative association with elderly immigrants' Medicaid coverage, and generous state eligibility had significantly positive relationships with Medicaid and any health insurance coverage. Findings indicate the important role of eligibility on elderly immigrants' health insurance coverage. Results call for social workers' actions to expand elderly immigrants' Medicaid eligibility.

  8. Public Views of Health Insurance in Japan During the Era of Attaining Universal Health Coverage: A Secondary Analysis of an Opinion Poll on Health Insurance in 1967

    OpenAIRE

    Ikuma Nozaki; Koji Wada; Osamu Utsunomiya

    2017-01-01

    While Japan's success in achieving universal health insurance over a short period with controlled healthcare costs has been studied from various perspectives, that of beneficiaries have been overlooked. We conducted a secondary analysis of an opinion poll on health insurance in 1967, immediately after reaching universal coverage. We found that people continued to face a slight barrier to healthcare access (26.8% felt medical expenses were a heavy burden) and had high expectations for health i...

  9. Employer-provided health insurance and the incidence of job lock: a literature review and empirical test.

    Science.gov (United States)

    Rashad, Inas; Sarpong, Eric

    2008-12-01

    The incidence of 'job lock' in the health insurance context has long been viewed as a potential problem with employer-provided health insurance, a concept that was instrumental in the passage of the United States Consolidated Omnibus Budget Reconciliation Act of 1986, and later, the Health Insurance Portability and Accountability Act in 1996. Several recent developments in healthcare in the USA include declining healthcare coverage and a noticeable shift in the burden of medical care costs to employees. If these developments cause employees with employer-provided health insurance to feel locked into their jobs, optimal job matches in the labor force may not take place. A summary of the seminal papers in the current literature on the topic of job lock is given, followed by an empirical exercise using single individuals from the National Health Interview Survey (1997-2003) and the 1979 cohort of the National Longitudinal Survey of Youth (1989-2000). Econometric methods used include difference in differences, ordinary least squares and individual fixed effects models, in gauging the potential effect that employer-provided health insurance may have on job tenure and voluntary job departure. Our findings are consistent with recent assertions that there is some evidence of job lock. Individuals with employer-provided health insurance stay on the job 16% longer and are 60% less likely to voluntarily leave their jobs than those with insurance that is not provided by their employers. Productivity may not be optimal if incentives are altered owing to the existence of fringe benefits, such as health insurance. Further research in this area should determine whether legislation beyond the Consolidated Omnibus Budget Reconciliation Act and Health Insurance Portability and Accountability Act laws is needed.

  10. Medicaid and CHIP Provide Coverage to More than Half of All Children in D.C. Policy Snapshot

    Science.gov (United States)

    DC Action for Children, 2011

    2011-01-01

    Medicaid and CHIP are crucial parts of the social safety net, providing health insurance coverage to more than half of all children ages 0-21 in D.C. and a third of children nationally. Without these two programs, more than 97,000 children in the District would have been uninsured in 2010. New research indicates that compared with the uninsured,…

  11. A race against time: can CO-OPs and provider start-ups survive in the health insurance marketplaces?

    Science.gov (United States)

    Eggbeer, Bill

    2015-12-01

    > The Affordable Care Act's state and federal health insurance marketplaces, designed to provide affordable insurance coverage to individuals and small groups, are proving hostile territory to new market entrants. Efforts to inject competition into the marketplaces are being challenged by the wide-scale withdrawal o consumer-operated and oriented plans (CO-OPs). Meanwhile, premiums appear likely to increase for consumers as plans seek to balance medical losses. Flaws in the "Three R's" (reinsurance, risk corridors, and risk-adjustment) program are viewed as a threat to the survival of CO-OPs and start-ups.

  12. Limited provider panels: their promise and problems in an individual health insurance market.

    Science.gov (United States)

    Pitsenberger, William H

    2008-07-01

    The cost of healthcare, and consequently of health insurance, continues to increase dramatically. A growing chorus calls for replacing the fundamental method by which people purchase insurance today--through their employers--with a system of individually acquired insurance. This article argues that changing how Americans purchase health insurance could change the dynamics between insurers and healthcare providers in a way that could favorably impact costs, primarily through reliance on highly limited provider networks. It examines the bases of legal obstacles to limited provider networks embedded in both statutory and case law and urges re-examination of those bases in light of changes in the distribution system of health insurance.

  13. Supplementary contribution payable to the health insurance scheme for the spouse's coverage

    CERN Multimedia

    HR Department

    2007-01-01

    Staff Members, Fellows and Pensioners are reminded that any change in their marital status, as well as any change in the spouse or registered partner's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Articles III 6.01 to 6.03 of the Rules of the CERN Health Insurance Scheme. Such changes may have consequences on the conditions of the spouse or registered partner's affiliation to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse or registered partner. From 1.1.2007, for the following monthly income brackets, the indexed amounts in Swiss francs of the monthly supplementary contribution are: more than 2'500 CHF and up to 4'250 CHF: 134.- more than 4'250 CHF and up to 7'500 CHF: 234.- more than 7'500 CHF and up to 10'000 CHF: 369.- more than 10'000 CHF: 461.- It is in the member of the personnel's interest to declare a change in the annual ...

  14. The impact of medical insurance coverage and molecular monitoring frequency on outcomes in chronic myeloid leukemia: real-world evidence in China.

    Science.gov (United States)

    Sheng, Guangying; Chen, Suning; Zhang, Ri; Miao, Miao; Wu, Depei; Tan, Seng Chuen; Liu, Chao; Xiong, Tengbin

    2017-04-01

    Imatinib (Glivec) has been covered by critical disease insurance for treatment of chronic myeloid leukemia (CML) in Jiangsu province of China since 2013. Further, free molecular monitoring has been provided to patients at top clinical centers as part of a pilot study that has changed the local treatment pattern and outcomes of patients with CML. This study evaluates the impact of medical insurance coverage and the molecular monitoring frequency on outcomes of patients with CML treated at a central hospital in Jiangsu, China, according to patient-level data. The study investigated 335 CML patients receiving medical treatment in a central hospital between January 1, 2011 and December 31, 2014. Demographic and clinical characteristics were extracted from the patients' clinical records. Univariate and multivariate analyses using the logistic regression model were performed to identify the differences in outcomes of major molecular response (MMR) or complete cytogenetic response (CCyR) between patients who were insured vs uninsured, or between patients with frequency of PCR monitoring ≤2 times vs ≥3 times per year. Both the achievement of MMR (BCR-ABLIS ≤0.1%) (50.4% vs 37.5%) and CCyR (80.7% vs 62.8%) at 12 months have shown significant differences that favored patients with insurance coverage of imatinib, while there was no significant difference in the outcome of BCR-ABLIS ≤1% between insured and non-insured groups (56.0% vs 51.3%) at 6 months. The long-term results at 24 months demonstrated that there was a statistically significant difference in MMR rates between the group with 3 or more PCR monitoring tests per year and the group of patients with 2 or less PCR tests per year (76.9% vs 52.2%). The study findings suggest that CML patients benefit from insurance coverage of imatinib and higher frequency (≥3) of regularly scheduled molecular monitoring PCR in China.

  15. Racial gaps in child health insurance coverage in four South American countries: the role of wealth, human capital, and other household characteristics.

    Science.gov (United States)

    Wehby, George L; Murray, Jeffrey C; McCarthy, Ann Marie; Castilla, Eduardo E

    2011-12-01

    OBJECTIVE. To evaluate the extent of racial gaps in child health insurance coverage in South America and study the contribution of wealth, human capital, and other household characteristics to accounting for racial disparities in insurance coverage. DATA SOURCES/STUDY SETTING. Primary data collected between 2005 and 2006 in 30 pediatric practices in Argentina, Brazil, Ecuador, and Chile. DESIGN. Country-specific regression models are used to assess differences in insurance coverage by race. A decomposition model is used to quantify the extent to which wealth, human capital, and other household characteristics account for racial disparities in insurance coverage. DATA COLLECTION/EXTRACTION METHODS. In-person interviews were conducted with the mothers of 2,365 children. PRINCIPAL FINDINGS. The majority of children have no insurance coverage except in Chile. Large racial disparities in insurance coverage are observed. Household wealth is the single most important household-level factor accounting for racial disparities in coverage and is significantly and positively associated with coverage, followed by maternal education and employment/occupational status. Geographic differences account for the largest part of racial disparities in insurance coverage in Argentina and Ecuador. CONCLUSIONS. Increasing the coverage of children in less affluent families is important for reducing racial gaps in health insurance coverage in the study countries. © Health Research and Educational Trust.

  16. State budget transfers to Health Insurance to expand coverage to people outside formal sector work in Latin America.

    Science.gov (United States)

    Mathauer, Inke; Behrendt, Thorsten

    2017-02-16

    Contributory social health insurance for formal sector employees only has proven challenging for moving towards universal health coverage (UHC). This is because the informally employed and the poor usually remain excluded. One way to expand UHC is to fully or partially subsidize health insurance contributions for excluded population groups through government budget transfers. This paper analyses the institutional design features of such government subsidization arrangements in Latin America and assesses their performance with respect to UHC progress. The aim is to identify UHC conducive institutional design features of such arrangements. A literature search provided the information to analyse institutional design features, with a focus on the following aspects: eligibility/enrolment rules, financing and pooling arrangements, and purchasing and benefit package design. Based on secondary data analysis, UHC progress is assessed in terms of improved population coverage, financial protection and access to needed health care services. Such government subsidization arrangements currently exist in eight countries of Latin America (Bolivia, Chile, Colombia, Costa Rica, Dominican Republic, Mexico, Peru, Uruguay). Institutional design features and UHC related performance vary significantly. Notably, countries with a universalist approach or indirect targeting have higher population coverage rates. Separate pools for the subsidized maintain inequitable access. The relatively large scopes of the benefit packages had a positive impact on financial protection and access to care. In the long term, merging different schemes into one integrated health financing system without opt-out options for the better-off is desirable, while equally expanding eligibility to cover those so far excluded. In the short and medium term, the harmonization of benefit packages could be a priority. UHC progress also depends on substantial supply side investments to ensure the availability of quality

  17. [Fair health financing and catastrophic health expenditures: potential impact of the coverage extension of the popular health insurance in Mexico].

    Science.gov (United States)

    Knaul, Felicia; Arreola-Ornelas, Héctor; Méndez, Oscar; Martínez, Alejandra

    2005-01-01

    To assess the impact on fair health financing and household catastrophic health expenditures of the implementation of the Popular Health Insurance (Seguro Popular de Salud). Data analyzed in this study come from the National Income and Expenditure Household Survey (Encuesta Nacional de Ingresos y Gastos de los Hogares, ENIGH), 2000, and the National Health Insurance and Expenditure Survey, (Encuesta Nacional de Aseguramiento y Gasto en Salud, ENAGS), 2001. Estimations are based on projections of extension of the Popular Health Insurance under different conditions of coverage and out-of-pocket expenditure reductions in the uninsured population. The mathematic simulation model assumes applying the new Popular Health Insurance financial structure to the 2000 expenditure values reported by ENIGH, given the probability of affiliation by households. The model of determinants of affiliation to the Popular Health Insurance yielded three significant variables: being in income quintiles I and II, being a female head of household, and that a household member had a medical visit in the past year. Simulation results show that important impacts on the performance of the Mexican Health System will occur in terms of fair financing and catastrophic expenditures, even before achieving the universal coverage goal in 2010. A reduction of 40% in out-of-pocket expenditures and a Popular Health Insurance coverage of 100% will decrease catastrophic health expenditures from 3.4% to 1.6%. Our results show that the reduction of out-of-pocket expenditures generated by the new financing and health provision Popular Health Insurance model, will improve the financial fairness index and the financial contribution to the health system, and will decrease the percentage of households with catastrophic expenditures, even before reaching universal coverage. A greater impact may be expected due to coverage extension initiating in the poorest communities that have a very restricted and progressive

  18. Therapy Caps and Variation in Cost of Outpatient Occupational Therapy by Provider, Insurance Status, and Geographic Region.

    Science.gov (United States)

    Pergolotti, Mackenzi; Lavery, Jessica; Reeve, Bryce B; Dusetzina, Stacie B

    This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12-14 visits. . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium.

  19. 77 FR 70374 - Servicemembers' Group Life Insurance-Stillborn Child Coverage

    Science.gov (United States)

    2012-11-26

    ... relevant to this discussion. The term ``natural child'' refers to a biological child. Black's Law... father who provided the semen that fertilized the ovum. Black's Law Dictionary 1222 (defining... payment can be made on account of the member's insurable dependent's death, the SGLI proceeds payable on...

  20. DIGITAL FLOOD INSURANCE RATE MAP DATABASE, PROVIDENCE COUNTY, RI

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk...

  1. The association between acculturation and health insurance coverage for immigrant children from socioeconomically disadvantaged regions of origin.

    Science.gov (United States)

    Hernandez, Daphne C; Kimbro, Rachel Tolbert

    2013-06-01

    Among immigrant children whose parents have historically had lower education, the study explored which immigrant children were most likely to have coverage based on maternal region of origin. The direct and indirect relationship of acculturation on immigrant children's coverage was also assessed. A subsample of US-born children with foreign-born mothers from the Early Childhood Longitudinal Survey-Kindergarten Cohort was analyzed using multinomial logistic regressions (n = 1,686). Children whose mothers emigrated from the Caribbean or Indochina had greater odds of being insured compared to children whose mothers emigrated from Mexico. Moreover, Latin American children did not statistically differ from Mexican children in being uninsured. Maternal citizenship was positively associated with children's coverage; while living in a household with a mother who migrated as a child was negatively associated with private insurance. To increase immigrant children's coverage, Latin American and Mexican families may benefit from additional financial assistance, rather than cultural assistance.

  2. National trends in the cost of employer health insurance coverage, 2003-2013.

    Science.gov (United States)

    Collins, Sara R; Radley, David C; Schoen, Cathy; Beutel, Sophie

    2014-12-01

    Looking at trends in private employer-based health insurance from 2003 to 2013, this issue brief finds that premiums for family coverage increased 73 percent over the past decade--faster than median family income. Employees' contributions to their premiums climbed by 93 percent over that time frame. At the same time, deductibles more than doubled in both large and small firms. Workers are thus paying more but getting less protective benefits. However, the study also finds that while premiums continued to rise through 2013, the rate of growth slowed between 2010 and 2013, following implementation of the Affordable Care Act. While families experienced slower growth in premium contributions and deductibles over this period, sluggish growth in median family income means families are paying more in premiums and deductibles as a share of their income than ever before.

  3. Insurance for Your EDP Operation

    Science.gov (United States)

    Zaiden, Dennis J.

    1973-01-01

    Describes EDP (electronic data processing) insurance, which provides coverage for such things as the loss of computer programs and accumulated transaction data, and the consequences of an interruption in processing. Discusses what is and is not covered by EDP insurance, how to plan for EDP insurance, the amount of coverage to get, and how to avoid…

  4. Willigness to pay for long-term care coverage: the role of private information and self-insurance

    OpenAIRE

    Costa i Font, Joan; Rovira Forns, Joan

    2004-01-01

    Both public and private insurance for long-term care is undeveloped in some European countries such as in Spain and empirical evidence is still limited. This paper aims at exmining the determinants of the demand for Long Term Care (LTC) coverage in Spain using contingent valuation techniques. Our findings indicate that only one-fifth of the population is willing to pay to assure coverage decisions are significantly affected by private information asymmetry and housing tenure in giving rise to...

  5. Child health security in China: a survey of child health insurance coverage in diverse areas of the country.

    Science.gov (United States)

    Xiong, Juyang; Hipgrave, David; Myklebust, Karoline; Guo, Sufang; Scherpbier, Robert W; Tong, Xuetao; Yao, Lan; Moran, Andrew E

    2013-11-01

    China embarked on an ambitious health system reform in 2009, and pledged to achieve universal health insurance coverage by 2020. However, there are gaps in access to healthcare for some children in China. We assessed health insurance status and associated variables among children under five in twelve communities in 2010: two urban community health centers and two rural township health centers in each of three municipalities located in China's distinctly different East, Central and Western regions. Information on demographic and socio-economic variables and children's insurance status was gathered from parents or caregivers of all children enrolled in local health programs, and others recruited from the local communities. Only 62% of 1131 children assessed were insured. This figure did not vary across geographic regions, but urban children were less likely to be insured than rural children. In multivariate analysis, infants were 2.44 times more likely to be uninsured than older children and children having at least one migrant parent were 1.90 times more likely to be uninsured than those living with non-migrant parents. Low maternal education was also associated with being uninsured. Gaps in China's child health insurance coverage might be bridged if newborns are automatically covered from birth, and if insurance is extended to all urban migrant children, regardless of the family's residential registration status and size. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Policy Changes and Improvements in Health Insurance Coverage Among MSM: 20 U.S. Cities, 2008-2014.

    Science.gov (United States)

    Cooley, Laura A; Hoots, Brooke; Wejnert, Cyprian; Lewis, Rashunda; Paz-Bailey, Gabriela

    2017-03-01

    Recent policy changes have improved the ability of gay, bisexual, and other men who have sex with men (MSM) to secure health insurance. We wanted to assess changes over time in self-reported health insurance status among MSM participating in CDC's National HIV Behavioral Surveillance (NHBS) in 2008, 2011, and 2014. We analyzed NHBS data from sexually active MSM interviewed at venues in 20 U.S. cities. To determine if interview year was associated with health insurance status, we used a Poisson model with robust standard errors. Among included MSM, the overall percentage of MSM with health insurance rose 16 % from 2008 (68 %) to 2014 (79 %) (p value for trend health insurance coverage all three interview years, by age, education, and income. Corresponding with recent policy changes, health insurance improved among MSM participating in NHBS, with greater improvements in historically underinsured demographic segments. Despite these increases, improved coverage is still needed. Improved access to health insurance could lead to a reduction in health disparities among MSM over time.

  7. Supplementary contribution payable to the health insurance scheme for the spouse's coverage

    CERN Multimedia

    Human Resources Department

    2005-01-01

    Staff Members, Fellows and Pensioners are reminded that any change in the marital status of members of the personnel, as well as any change in the spouse's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Article R IV 1.17 of the Staff Regulations. Such changes may have consequences on the conditions of the spouse's affiliation to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse. Changes to the rules and simplification to the system are currently being prepared and should be operational by mid-2005. Meanwhile from 1.1.2005, for the following income brackets, the indexed amounts in Swiss francs of the monthly supplementary contribution are: more than 30'000 CHF and up to 50'000 CHF: 134.- more than 50'000 CHF and up to 90'000 CHF: 234.- more than 90'000 CHF and up to 130'000 CHF: 369.- more than 130'000 CHF: 459.- It is in the member o...

  8. REMINDER CONCERNING THE SUPPLEMENTARY CONTRIBUTION PAYABLE TO THE HEALT INSURANCE SCHEME FOR SPOUSE COVERAGE

    CERN Multimedia

    Human Resources Division

    2002-01-01

    Staff members, fellows and pensioners are reminded that any change in the marital status of members of the personnel, as well as any change in the spouse's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Article R IV 1.17 of the Staff Regulations. Such changes may have consequences on the affiliation of the spouse to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse. In 2002, for the following income brackets, the indexed amounts in Swiss francs of the supplementary contribution are:   more than 30'000 CHF and up to 50'000 CHF: 134.- more than 50'000 CHF and up to 90'000 CHF: 234.- more than 90'000 CHF and up to 130'000 CHF: 369.- more than 130'000 CHF: 461.- It is in the member of the personnel's interest to declare a change in the annual income of his/her spouse as soon as possible in order to adjust contributions with the m...

  9. REMINDER THE SUPPLEMENTARY CONTRIBUTION PAYABLE TO THE HEALTH INSURANCE SCHEME FOR THE SPOUSE'S COVERAGE

    CERN Multimedia

    Human Resources Division

    2001-01-01

    Staff Members and Fellows are reminded that any change in the marital status of members of the personnel, as well as any change in the spouse's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Article R IV 1.17 of the Staff Regulations. Such changes may have consequences on the affiliation of the spouse to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse. In the latter case, it is in the member of the personnel's interest to declare such a change as soon as possible in order that the contribution is adjusted with a minimum of backdating. To notify a change, staff members and fellows are required to fill in the form 'confidential declaration of family situation' and to send it to Mrs. Patricia Cattan (HR-SOC), indicating the effective date of the change. This form is available from divisional secretariats or from the web at the following address:...

  10. REMINDER: SUPPLEMENTARY CONTRIBUTION PAYABLE TO THE HEALTH INSURANCE SCHEME FOR THE SPOUSE'S COVERAGE

    CERN Multimedia

    2003-01-01

    Staff Members, Fellows and Pensioners are reminded that any change in the marital status of members of the personnel, as well as any change in the spouse's income or health insurance cover, shall be notified in writing to CERN, within 30 calendar days of the change, in accordance with Article R IV 1.17 of the Staff Regulations. Such changes may have consequences on the conditions of the spouse's affiliation to the CERN Health Insurance Scheme (CHIS) or on the payment of the supplementary contribution to the CHIS for the coverage of the spouse. In 2003, for the following income brackets, the indexed amounts in Swiss francs of the supplementary contribution are : - more than 30'000 CHF and up to 50'000 CHF: 134.- - more than 50'000 CHF and up to 90'000 CHF: 234.- - more than 90'000 CHF and up to 130'000 CHF: 369.- - more than 130'000 CHF: 468.- It is in the member of the personnel's interest to declare as soon as possible a change in the annual income of his spouse in order that the contribution is adjusted w...

  11. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Science.gov (United States)

    2011-08-03

    ...-AQ07 Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under... the Patient Protection and Affordable Care Act regarding preventive health services. DATES: Effective... effect a rating of A or B in the current recommendations of the United States Preventive Services Task...

  12. The impact of increasing health insurance coverage on disparities in mortality: Health care reform in Colombia, 1998-2007

    NARCIS (Netherlands)

    I. Arroyave (Ivan); D. Cardona (Doris); A. Burdorf (Alex); M. Avendano Pabon (Mauricio)

    2013-01-01

    textabstractObjectives. We examined the impact of expanding health insurance coverage on socioeconomic disparities in total and cardiovascular disease mortality from 1998 to 2007 in Colombia. Methods. We used Poisson regression to analyze data from mortality registries (633 905 deaths) linked to

  13. Health insurance coverage, neonatal mortality and caesarean section deliveries: an analysis of vital registration data in Colombia.

    Science.gov (United States)

    Houweling, Tanja A J; Arroyave, Ivan; Burdorf, Alex; Avendano, Mauricio

    2017-05-01

    Low-income and middle-income countries have introduced different health insurance schemes over the past decades, but whether different schemes are associated with different neonatal outcomes is yet unknown. We examined the association between the health insurance coverage scheme and neonatal mortality in Colombia. We used Colombian national vital registration data, including all live births (2 506 920) and neonatal deaths (17 712) between 2008 and 2011. We used Poisson regression models to examine the association between health insurance coverage and the neonatal mortality rate (NMR), distinguishing between women insured via the contributory scheme (40% of births, financed through payroll and employer's contributions), government subsidised insurance (47%) and the uninsured (11%). NMR was lower among babies born to mothers in the contributory scheme (6.13/1000) than in the subsidised scheme (7.69/1000) or the uninsured (8.38/1000). Controlling for socioeconomic and demographic factors, NMRs remained higher for those in the subsidised scheme (OR 1.09, 95% CI 1.05 to 1.14) and the uninsured (OR 1.16, 95% CI 1.10 to 1.23) compared to those in the contributory scheme. These differences increased in models that additionally controlled for caesarean section (C-section) delivery. This increase was due to the higher fraction of C-section deliveries among women in the contributory scheme (49%, compared to 34% for the subsidised scheme and 28% for the uninsured). Health insurance through the contributory system is associated with lower neonatal mortality than insurance through the subsidised system or lack of insurance. Universal health insurance may not be sufficient to close the gap in newborn mortality between socioeconomic groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. The impact of increasing health insurance coverage on disparities in mortality: health care reform in Colombia, 1998-2007.

    Science.gov (United States)

    Arroyave, Ivan; Cardona, Doris; Burdorf, Alex; Avendano, Mauricio

    2013-03-01

    We examined the impact of expanding health insurance coverage on socioeconomic disparities in total and cardiovascular disease mortality from 1998 to 2007 in Colombia. We used Poisson regression to analyze data from mortality registries (633 905 deaths) linked to population census data. We used the relative index of inequality to compare disparities in mortality by education between periods of moderate increase (1998-2002) and accelerated increase (2003-2007) in health insurance coverage. Disparities in mortality by education widened over time. Among men, the relative index of inequality increased from 2.59 (95% confidence interval [CI] = 2.52, 2.67) in 1998-2002 to 3.07 (95% CI = 2.99, 3.15) in 2003-2007, and among women, from 2.86 (95% CI = 2.77, 2.95) to 3.12 (95% CI = 3.03, 3.21), respectively. Disparities increased yearly by 11% in men and 4% in women in 1998-2002, whereas they increased by 1% in men per year and remained stable among women in 2003-2007. Mortality disparities widened significantly less during the period of increased health insurance coverage than the period of no coverage change. Although expanding coverage did not eliminate disparities, it may contribute to curbing future widening of disparities.

  15. Community Rating in Health Insurance : Trade-Off Between Coverage and Selection

    NARCIS (Netherlands)

    Bijlsma, M.; Boone, Jan; Zwart, G.T.J.

    2015-01-01

    We analyze the role of community rating in the optimal design of a risk adjustment scheme in competitive health insurance markets when insurers have better information on their customers’ risk profiles than the sponsor of health insurance. The sponsor offers insurers a menu of risk adjustment

  16. Small group employer participation in New Mexico's State Coverage Insurance program: lessons for federal reform.

    Science.gov (United States)

    Sommers, Anna S; Abraham, Jean Marie; Spicer, Laura; Mikow, Asher; Spaulding-Bynon, Mari

    2011-02-01

    To identify factors associated with small group employer participation in New Mexico's State Coverage Insurance (SCI) program. Telephone surveys of employers participating in SCI (N=269) and small employers who inquired about SCI (N=148) were fielded September 2008-January 2009. Descriptive and multivariate analyses investigated differences between employer samples, including employer characteristics, concerns that applied to the business when deciding whether to participate in SCI, prior offerings of insurance to workers, and perceived affordability of the program. Unweighted employer samples yielded 88 and 75 percent response rates for the participating and inquiring employers, respectively. The administrative issue most commonly selected by inquiring employers as applying to their business was difficulty understanding how eligibility requirements applied to their business and its employees (53.5 percent). Inquiring businesses were significantly more likely to report concern about affording to pay the premiums in the first month (35.6 versus 18.7 percent) and the cost to the business over the long run (46.5 versus 26.6 percent) relative to participating employers. From the model results, businesses with the fewest full-time employees (zero to two) were 19 percentage points less likely to participate relative to businesses with six or more full-time employees. Administrative and cost barriers to participation in SCI reported by employers suggest that the tax credit offered to small businesses under new federal provisions, which merely offsets the employer portion of premium, could be more effective if accompanied by additional supports to businesses. © Health Research and Educational Trust.

  17. The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy.

    Science.gov (United States)

    Hsu, Minchung; Huang, Xianguo; Yupho, Somrasri

    2015-11-01

    This paper quantitatively investigates the sustainability of the universal health insurance coverage (UHI) system in Thailand while taking into account the country's rapidly aging population and large informal labor sector. We examine the effects of population aging and informal employment across three tax options for financing the UHI. A modern dynamic general equilibrium framework is utilized to conduct policy experiments and welfare analysis. In the case of labor income tax being used to finance the cost of UHI, an additional 11-15% of labor tax will be required with the 2050 population age structure, compared with the 2005 benchmark economy. We also find that an expansion of income tax base to the informal sector can substantially alleviate the tax burden. Based on welfare comparisons across the alternative tax options, the labor income tax is the most preferred because the inequality between formal/informal sectors is large. If the informal sector cannot avoid labor income tax, capital tax will be preferred over labor and consumption taxes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. FY11_EOM_Oct_Face Amount of Life Insurance Coverage by Program by State

    Data.gov (United States)

    Department of Veterans Affairs — Face value of insurance for each administered life insurance program listed by state. Data is current as of 10-31-11. All programs are closed to new issues except...

  19. FY11_EOM_August_Face Amount of Life Insurance Coverage by Program by State

    Data.gov (United States)

    Department of Veterans Affairs — Face value of insurance for each administered life insurance program listed by state. Data is current as of 8-31-11. All programs are closed to new issues except for...

  20. EOM July FY2011 - Face Amount of Life Insurance Coverage by Program by State

    Data.gov (United States)

    Department of Veterans Affairs — Face value of insurance for each administered life insurance program listed by state. Data is current as of 7-31-11. All programs are closed to new issues except for...

  1. Expensive but worth it: older parents' attitudes and opinions about the costs and insurance coverage for in vitro fertilization.

    Science.gov (United States)

    Nachtigall, Robert D; MacDougall, Kirstin; Davis, Anne C; Beyene, Yewoubdar

    2012-01-01

    To describe older parents' attitudes and opinions about the costs and insurance coverage for IVF. Qualitative interview study. Two Northern California IVF practices. Sixty women and 35 male partners in which the woman had delivered her first child after the age of 40 years using IVF. Two in-depth interviews over 3 months. Thematic analysis of interview transcripts. We found that although the costs of IVF were perceived as high, even by those with insurance or who could afford them, the cost of IVF relative to other expenses in life was dwarfed by the value attributed to having a child. Women were twice as likely as men to support insurance coverage for IVF. Both men and women with complete or partial IVF insurance coverage were more likely to support insurance than those without coverage. There was a broad range of attitudes and opinions about the appropriateness of IVF insurance coverage, which addressed questions of age, gender equality, reproductive choice, whether infertility is a medical illness, and the role of personal and societal economic equity and responsibility. Despite a generally favorable opinion about the appropriateness of insurance coverage by those who have successfully undergone IVF treatment, the affordability of IVF remains an unresolved dilemma in the United States. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Determinants of employment-based private health insurance coverage in Denmark

    Directory of Open Access Journals (Sweden)

    Astrid Kiil

    2011-10-01

    Full Text Available This study estimates the determinants of having employment-based private health insurance (EPHI based on data from a survey of the Danish workforce conducted in 2009. The study contributes to the literature by exploring the role of satisfaction with the tax-financed health care system as a potential determinant of EPHI ownership and by taking into account that some employees receive EPHI free of charge, while others pay the premium out of their pre-tax income and thus make an actual choice. The results indicate that the probability of having EPHI is positively affected by private sector employment, size of the workplace, whether the workplace has a health scheme, income, being employed as a white-collar worker, and age until the age of 49, while the presence of subordinates, gender, education level, membership of 'denmark' and living in the capital region are not significantly associated with EPHI coverage. As expected, the characteristics related to the workplace are by far the quantitatively most important determinants. The association between EPHI and self-assessed health is found to be quadratic such that individuals in good self-assessed health are more likely to be covered by EPHI than those in excellent and fair, poor or very poor self-assessed health, respectively. Finally, the probability of having EPHI is found to be negatively related to the level of satisfaction with the tax-financed health care system. The findings of the study are not affected notably by distinguishing empirically between employees who receive EPHI free of charge and those who pay the premium out of their pre-tax income. Link to Appendix

  3. Supplemental security income and social security disability insurance coverage among long-term childhood cancer survivors.

    Science.gov (United States)

    Kirchhoff, Anne C; Parsons, Helen M; Kuhlthau, Karen A; Leisenring, Wendy; Donelan, Karen; Warner, Echo L; Armstrong, Gregory T; Robison, Leslie L; Oeffinger, Kevin C; Park, Elyse R

    2015-06-01

    Supplemental security income (SSI) and social security disability insurance (DI) are federal programs that provide disability benefits. We report on SSI/DI enrollment in a random sample of adult, long-term survivors of childhood cancer (n = 698) vs a comparison group without cancer (n = 210) from the Childhood Cancer Survivor Study who completed a health insurance survey. A total of 13.5% and 10.0% of survivors had ever been enrolled on SSI or DI, respectively, compared with 2.6% and 5.4% of the comparison group. Cranial radiation doses of 25 Gy or more were associated with a higher risk of current SSI (relative risk [RR] = 3.93, 95% confidence interval [CI] = 2.05 to 7.56) and DI (RR = 3.65, 95% CI = 1.65 to 8.06) enrollment. Survivors with severe/life-threatening conditions were more often enrolled on SSI (RR = 3.77, 95% CI = 2.04 to 6.96) and DI (RR = 2.73, 95% CI = 1.45 to 5.14) compared with those with mild/moderate or no health conditions. Further research is needed on disability-related financial challenges after childhood cancer. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Los seguros de salud mexicanos: cobertura universal incierta Mexican health insurance: uncertain universal coverage

    Directory of Open Access Journals (Sweden)

    Asa Cristina Laurell

    2011-06-01

    Full Text Available El sistema de salud mexicano se compone de la Secretaría de Salud (rectora del sector y prestador de algunos servicios, la seguridad social laboral pública, y el sector privado. Transita por un proceso de reforma iniciado en 1995 para universalizar la cobertura y separar las funciones regulación-financiamiento-prestación de servicios; reforma que después de quince años sigue inacabada y problemática. Este texto analiza crítica- y propositivamente la problemática surgida a raíz de las sucesivas reformas. El énfasis se pone en su última etapa con la introducción del "Seguro Popular" para la población sin seguridad social laboral. El análisis concibe la reforma de salud como parte de la Reforma del Estado en el marco de la reorganización neoliberal de la sociedad. A diferencia de otros países latinoamericanos este proceso no pasó por una nueva Constitución. El análisis se basa en documentos oficiales y un seguimiento sistemático de la instrumentación del Sistema de Protección Social en Salud y su impacto sobre la cobertura y acceso a los servicios. Se concluye que es improbable que se universalice la cobertura poblacional y menos el acceso a los servicios. Empero las reformas están forzando la mercantilización del sistema aún en presencia de un sector privado débil.The Mexican health system is comprised of the Department of Health, state labor social security and the private sector. It is undergoing a reform process initiated in 1995 to achieve universal coverage and separate the regulation, financing and service functions; a reform that after fifteen years is incomplete and problematic. The scope of this paper is to assess the problems that underlie the successive reforms. Special emphasis is given to the last reform stage with the introduction of the "Insurance of the People" aimed at the population without labor social security. In the analysis, health reform is seen as part of the Reform of the State in the context of

  5. Who really pays for health insurance? The incidence of employer-provided health insurance with sticky nominal wages.

    Science.gov (United States)

    Sommers, Benjamin D

    2005-03-01

    This paper addresses two seeming paradoxes in the realm of employer-provided health insurance: First, businesses consistently claim that they bear the burden of the insurance they provide for employees, despite theory and empirical evidence indicating that workers bear the full incidence. Second, benefit generosity and the percentage of premiums paid by employers have decreased in recent decades, despite the preferential tax treatment of employer-paid benefits relative to wages-trends unexplained by the standard incidence model. This paper offers a revised incidence model based on nominal wage rigidity, in an attempt to explain these paradoxes. The model predicts that when the nominal wage constraint binds, some of the burden of increasing insurance premiums will fall on firms, particularly small companies with low-wage employees. In response, firms will reduce employment, decrease benefit generosity, and require larger employee premium contributions. Using Current Population Survey data from 2000-2001, I find evidence for this kind of wage rigidity and its associated impact on the employment and premium contributions of low-wage insured workers during a period of rapid premium growth.

  6. Mapping the coverage of security controls in cyber insurance proposal forms

    OpenAIRE

    Woods, D.; Agrafiotis, I; Nurse, JRC; Creese, S

    2017-01-01

    Policy discussions often assume that wider adoption of cyber insurance will promote information security best practice. However, this depends on the process that applicants need to go through to apply for cyber insurance. A typical process would require an applicant to fill out a proposal form, which is a self-assessed questionnaire. In this paper, we examine 24 proposal forms, offered by insurers based in the UK and the US, to determine which security controls are present in the ...

  7. Estimation of insurance premiums for coverage against natural disaster risk: an application of Bayesian Inference

    Directory of Open Access Journals (Sweden)

    Y. Paudel

    2013-03-01

    Full Text Available This study applies Bayesian Inference to estimate flood risk for 53 dyke ring areas in the Netherlands, and focuses particularly on the data scarcity and extreme behaviour of catastrophe risk. The probability density curves of flood damage are estimated through Monte Carlo simulations. Based on these results, flood insurance premiums are estimated using two different practical methods that each account in different ways for an insurer's risk aversion and the dispersion rate of loss data. This study is of practical relevance because insurers have been considering the introduction of flood insurance in the Netherlands, which is currently not generally available.

  8. Health insurance system and provider payment reform in the Republic of Macedonia

    Directory of Open Access Journals (Sweden)

    Doncho M. Donev

    2009-03-01

    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

  9. Effects of the health insurance coverage extension on the use of outpatient services among small children in rural China.

    Science.gov (United States)

    Kawazoe, Nobuo; Liu, Guoxiang; Chiang, Chifa; Zhang, Yan; Aoyama, Atsuko

    2015-08-01

    A new public health insurance scheme has been gradually introduced in rural provinces in China since 2003. This would likely cause an increment in the use of health services. It is known that the association between health insurance coverage and health service utilization varies among different age groups. This study aims to examine the association between extending health insurance coverage and increment in outpatient service utilization of small children in rural China, and to identify other factors associated with the outpatient service utilization. A household survey was conducted in 2 counties in north China in August 2010, targeting 107 selected households with a child aged 12-59 months. The questionnaire included modules on demographic information such as ages of children and parents, enrollment status of health insurance, the number of episodes of illness as perceived by parents, month of incidence of episode and outpatient service utilization at each episode. Based on the utilization at each episode of illness, a random effects logistic regression model was employed to analyze the association. It was found that eligibility for the reimbursement of outpatient medical expenses was not significantly associated with decision to seek care or choice of health facility. This might be in part due to the low level of reimbursement which could discourage the use of insured, and to the close relationship with village clinic workers which would encourage the use of uninsured. Three other factors were significantly associated with increment in the outpatient service utilization; age of children, mother's education, and number of children in a household.

  10. Analysis of inpatient payments of breast cancer patients with different medical insurance coverages in China (mainland) in 2011-2015.

    Science.gov (United States)

    Li, Rui; Zhang, Liang; Yang, Jinxia; Cai, Yue; Chen, Wanqing; Lan, Lan; Xue, Ming; Meng, Qun

    2017-10-01

    An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China (mainland), in an attempt to offer a clue to further control the costs. The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011-2015 were collected from the inpatient medical record home page (IMRHP) dataset. The data were then processed with SAS (Version 9.3; SAS Institute, Cary, NC, USA). Indicators like means, increase (decrease) percentages were used to descriptively analyze the average hospitalization expense of each time (AHEET) and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades. In 2011-2015, the AHEET borne by breast cancer patients in China had been constantly increasing. Specifically, the self-pay inpatients had the largest increase, inpatients covered by Urban Employee Basic Medical Insurance (UEBMI) and Urban Resident Basic Medical Insurance (URBMI) were the next, and those covered by New Rural Cooperative Medical System (NRCMS) had the least increase. Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals. The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals. The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients, taking advantage of restriction mechanism of the medical insurances, and promoting healthy competition between private hospitals and public hospitals. The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI- and URBMI-covered breast cancer patients and of Grade 3 hospitals.

  11. Community perceptions of health insurance and their preferred design features: implications for the design of universal health coverage reforms in Kenya.

    Science.gov (United States)

    Mulupi, Stephen; Kirigia, Doris; Chuma, Jane

    2013-11-12

    Health insurance is currently being considered as a mechanism for promoting progress to universal health coverage (UHC) in many African countries. The concept of health insurance is relatively new in Africa, it is hardly well understood and remains unclear how it will function in countries where the majority of the population work outside the formal sector. Kenya has been considering introducing a national health insurance scheme (NHIS) since 2004. Progress has been slow, but commitment to achieve UHC through a NHIS remains. This study contributes to this process by exploring communities' understanding and perceptions of health insurance and their preferred designs features. Communities are the major beneficiaries of UHC reforms. Kenyans should understand the implications of health financing reforms and their preferred design features considered to ensure acceptability and sustainability. Data presented in this paper are part of a study that explored feasibility of health insurance in Kenya. Data collection methods included a cross-sectional household survey (n = 594 households) and focus group discussions (n = 16). About half of the household survey respondents had at least one member in a health insurance scheme. There was high awareness of health insurance schemes but limited knowledge of how health insurance functions as well as understanding of key concepts related to income and risk cross-subsidization. Wide dissatisfaction with the public health system was reported. However, the government was the most preferred and trusted agency for collecting revenue as part of a NHIS. People preferred a comprehensive benefit package that included inpatient and outpatient care with no co-payments. Affordability of premiums, timing of contributions and the extent to which population needs would be met under a contributory scheme were major issues of concern for a NHIS design. Possibilities of funding health care through tax instead of NHIS were raised and preferred

  12. Winners and losers in health insurance: access and type of coverage for women in same-sex and opposite-sex partnerships.

    Science.gov (United States)

    Pals, Heili; Waren, Warren

    2014-01-01

    Using data from the American Community Survey, 2009 (N=580,754), we compared rates of health insurance coverage and types of coverage used between women in same-sex and opposite-sex partnerships. This large, national dataset also allowed us to investigate regional variation in insurance coverage for women in same-sex partnerships by comparing "gay-tolerant" states versus other states. Multivariate analyses revealed that women in same-sex partnerships consistently had lower rates of health insurance coverage than married women in opposite-sex partnerships, but always more than unmarried women in opposite-sex partnerships. We also found that state-level variation in gay tolerance did not contribute to the access or type of coverage used by women in same-sex partnerships.

  13. 76 FR 4813 - Deposit Insurance Regulations; Unlimited Coverage for Noninterest-Bearing Transaction Accounts...

    Science.gov (United States)

    2011-01-27

    ... Insurance Act (FDI Act), as added by section 343 of the Dodd-Frank Wall Street Reform and Consumer... 343'').\\2\\ Section 343 amended the deposit insurance provisions of the FDI Act (12 U.S.C. 1821(a)(1...)(iii) of the FDI Act. The Act replaced the Section 343 definition with one that explicitly includes...

  14. Moderate Effects of Same-Sex Legislation on Dependent Employer-Based Insurance Coverage Among Sexual Minorities.

    Science.gov (United States)

    Tran, Linda Diem

    2016-12-01

    A difference-in-difference approach was used to compare the effects of same-sex domestic partnership, civil union, and marriage policies on same- and different-sex partners who could have benefitted from their partners' employer-based insurance (EBI) coverage. Same-sex partners had 78% lower odds (Marginal Effect = -21%) of having EBI compared with different-sex partners, adjusting for socioeconomic and health-related factors. Same-sex partners living in states that recognized same-sex marriage or domestic partnership had 89% greater odds of having EBI compared with those in states that did not recognize same-sex unions (ME = 5%). The impact of same-sex legislation on increasing take-up of dependent EBI coverage among lesbians, gay men, and bisexual individuals was modest, and domestic partnership legislation was equally as effective as same-sex marriage in increasing same-sex partner EBI coverage. Extending dependent EBI coverage to same-sex partners can mitigate gaps in coverage for a segment of the lesbians, gay men, and bisexual population but will not eliminate them. © The Author(s) 2016.

  15. Twelve-year trends in health insurance coverage among Latinos, by subgroup and immigration status.

    Science.gov (United States)

    Shah, N Sarita; Carrasquillo, Olveen

    2006-01-01

    We examine twelve-year trends in the Latino uninsured population by ethnic subgroup and immigration status. From 1993 to 1999, most Latino subgroups, particularly Puerto Ricans, had large decreases in Medicaid coverage. For some subgroups these were offset by increases in employer coverage, but not for Mexicans, resulting in a four-percentage-point increase in their uninsured population. During 2000-2004, Medicaid/SCHIP expansions benefited most subgroups and mitigated smaller losses in employer coverage. However, during 1993-2004, the percentage of noncitizen Latinos lacking coverage increased by several percentage points. This was attributable to Medicaid losses during 1993-1999 and losses in employer coverage during 2000-2004.

  16. Cost-Utility Analysis of Extending Public Health Insurance Coverage to Include Diabetic Retinopathy Screening by Optometrists.

    Science.gov (United States)

    van Katwyk, Sasha; Jin, Ya-Ping; Trope, Graham E; Buys, Yvonne; Masucci, Lisa; Wedge, Richard; Flanagan, John; Brent, Michael H; El-Defrawy, Sherif; Tu, Hong Anh; Thavorn, Kednapa

    2017-09-01

    Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness in Canada. Eye examinations play an important role in early detection. However, DR screening by optometrists is not always universally covered by public or private health insurance plans. This study assessed whether expanding public health coverage to include diabetic eye examinations for retinopathy by optometrists is cost-effective from the perspective of the health care system. We conducted a cost-utility analysis of extended coverage for diabetic eye examinations in Prince Edward Island to include examinations by optometrists, not currently publicly covered. We used a Markov chain to simulate disease burden based on eye examination rates and DR progression over a 30-year time horizon. Results were presented as an incremental cost per quality-adjusted life year (QALY) gained. A series of one-way and probabilistic sensitivity analyses were performed. Extending public health coverage to eye examinations by optometrists was associated with higher costs ($9,908,543.32) and improved QALYs (156,862.44), over 30 years, resulting in an incremental cost-effectiveness ratio of $1668.43/QALY gained. Sensitivity analysis showed that the most influential determinants of the results were the cost of optometric screening and selected utility scores. At the commonly used threshold of $50,000/QALY, the probability that the new policy was cost-effective was 99.99%. Extending public health coverage to eye examinations by optometrists is cost-effective based on a commonly used threshold of $50,000/QALY. Findings from this study can inform the decision to expand public-insured optometric services for patients with diabetes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. A cross-jurisdictional evaluation of insurance coverage among HIV care patients following the Affordable Care Act.

    Science.gov (United States)

    Hood, Julia E; Buskin, Susan E; Anderson, Bridget J; Gagner, Alexandra; Kienzle, Jennifer; Maggio, David; Markey, Katie; Reuer, Jennifer; Benbow, Nanette; Wortley, Pascale

    2017-04-01

    The impact of the Affordable Care Act (ACA) on HIV care patients, aged 18-64, was evaluated in three jurisdictions with Medicaid expansion (Chicago, New York State, and Washington) and three jurisdictions without Medicaid expansion (Georgia, Texas, and Virginia) using data from the Medical Monitoring Project. Multivariate regression models were used to evaluate insurance status that was reported pre- and post-ACA; self-reported impact of ACA on HIV care was explored with descriptive statistics. The likelihood of having insurance was significantly greater post-ACA compared to pre-ACA in Chicago (aRR = 1.33, 95%CI = 1.20, 1.47), Washington (aRR = 1.15, 95%CI = 1.08, 1.22), and Virginia (aRR = 1.14, 95%CI = 1.00, 1.29). In Washington and Chicago, the likelihood of being Medicaid-insured was greater post-ACA compared to pre-ACA implementation (Chicago: aRR = 1.25, 95%CI = 1.03,1.53; Washington: aRR = 1.66 95% CI = 1.30, 2.13). No other significant differences were observed. Only a subset of HIV care patients (range: 15-35%) reported a change in insurance that would have coincided with the implementation of ACA; and within this subset, a change in medical care costs was the most commonly noted issue. In conclusion, the influence of ACA on insurance coverage and other factors affecting HIV care likely varies by jurisdiction.

  18. Social health insurance coverage and financial protection among rural-to-urban internal migrants in China: evidence from a nationally representative cross-sectional study.

    Science.gov (United States)

    Chen, Wen; Zhang, Qi; Renzaho, Andre M N; Zhou, Fangjing; Zhang, Hui; Ling, Li

    2017-01-01

    Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China. Data from the '2014 National Internal Migrant Dynamic Monitoring Survey' were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban resident-based basic medical insurance (URBMI)), and doubly insured (enrolled in both rural and urban schemes). Financial protection was defined as 'the percentage of out-of-pocket (OOP) payments for the latest inpatient service during the past 12 months in the total household expenditure'. The uninsured rate of SHI and the NCMS, UEBMI/URBMI and double insurance coverage in rural-to-urban IMs was 17.3% (95% CI 16.9% to 17.7%), 66.6% (66.0% to 67.1%), 22.6% (22.2% to 23.0%) and 5.5% (5.3% to 5.7%), respectively. On average, financial protection indicator among uninsured, only NCMS insured, only URBMI/UEBMI insured and doubly insured participants was 13.3%, 9.2%, 6.2% and 5.8%, respectively (p=0.004). After controlling for confounding factors and adjusting the protection effect of private health insurance, compared with no SHI, the UEBMI/URBMI, the NCMS and double insurance could reduce the average percentage share of OOP payments by 33.9% (95% CI 25.5% to 41.4%), 14.1% (6.6% to 20.9%) and 26.8% (11.0% to 39.7%), respectively. Although rural-to-urban IMs face barriers to accessing SHI schemes, our findings confirm the positive financial protection effect of SHI. Improving availability and portability of health insurance would promote financial protection for IMs, and further

  19. The role of insurance in the achievement of universal coverage within a developing country context: South Africa as a case study.

    Science.gov (United States)

    van den Heever, Alex M

    2012-01-01

    this point took the form of non-commercial occupational (employer-based) schemes. During the 1980s government acquiesced to industry lobbies arguing for the deregulation of health insurance from 1989, with an extreme deregulation occurring in 1994, evidently in anticipation of the change of government associated with the democratic dispensation. Dramatic unintended consequences followed, with substantial increases in provider and funder costs coinciding with uncontrolled discrimination against poor health risks.Against significant industry opposition, including legal challenges, partial re-regulation took effect from 2000 which removed the discretion of schemes to discriminate against poor health risks. This included: the implementation of a strong regulator of health insurance; the establishment of one allowable vehicle able to provide health insurance; open enrolment, whereby schemes could not refuse membership applications; mandatory minimum benefit requirements; and a prohibition on setting contributions or premiums on the basis of health status. After a two-year lag, dramatically reduced cost trends and contributions became evident. Aside from generally tighter regulation across a range of fronts, this appears related to the need for schemes to compete more on the basis of healthcare provider costs than demographic risk profiles. Despite an incomplete reform improved equitable coverage and cost-containment was nevertheless achieved.A more complete regulatory regime is consequently likely to deepen coverage by: further stabilising and even decreasing costs; enhanced risk pooling; and access for low income groups. This would occur if South Africa: improved the quality of free public services, thereby creating competitive constraints for medical schemes; introduced risk-equalisation, increasing the pressure on schemes to compete on the cost and quality of coverage rather than their risk profile; and through the establishment of improved price regulation. The

  20. Skin in the game: Does paying for obesity treatment out of pocket lead to better outcomes compared to insurance coverage?

    Science.gov (United States)

    Ard, Jamy D; Emery, Matt; Cook, Miranda; Hale, Erica; Frain, Annette; Lewis, Kristina H; Song, Eunyoung

    2017-06-01

    To determine whether insurance coverage for medical weight loss treatment was associated with different program engagement and weight loss outcomes compared to those who paid out of pocket. One-year outcomes from an academic medical weight management program were used to compare two groups: employees (n = 480) with insurance coverage ("covered") versus nonemployees (n = 463) who paid out of pocket ("self-pay"). Demographics and weight were abstracted from medical records. Socioeconomic status was estimated using neighborhood demographics. Group differences in weight were analyzed using generalized linear modeling adjusted for age, baseline BMI, sex, program type, and neighborhood socioeconomic status. Covered patients were younger (46.5 ± 10.6 vs. 51.6 ± 12.5) with a lower BMI (38.5 ± 7.5 vs. 41.3 ± 9.9) compared to self-pay (P obesity treatment have lower levels of attrition and similar levels of participation and outcomes as those who pay out of pocket. © 2017 The Obesity Society.

  1. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    Directory of Open Access Journals (Sweden)

    Andrew J Barnes

    Full Text Available The Affordable Care Act's marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool--plan recommendations--in improving marketplace decisions.Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia.We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended.Primary data were gathered using an online choice experiment and questionnaire.Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made.As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers' decisions.

  2. An introduction to Chuna manual medicine in Korea: History, insurance coverage, education, and clinical research in Korean literature.

    Science.gov (United States)

    Park, Tae-Yong; Moon, Tae-Woong; Cho, Dong-Chan; Lee, Jung-Han; Ko, Youn-Seok; Hwang, Eui-Hyung; Heo, Kwang-Ho; Choi, Tae-Young; Shin, Byung-Cheul

    2014-06-01

    The objectives of this study were to summarize the curriculum, history, and clinical researches of Chuna in Korea and to ultimately introduce Chuna to Western medicine. Information about the history and insurance coverage of Chuna was collected from Chuna-related institutions and papers. Data on Chuna education in all 12 Korean medicine (KM) colleges in Korea were reconstructed based on previously published papers. All available randomized controlled trials (RCTs) of Chuna in clinical research were searched using seven Korean databases and six KM journals. As a result, during the modern Chuna era, one of the three periods of Chuna, which also include the traditional Chuna era and the suppressed Chuna era, Chuna developed considerably because of a solid Korean academic system, partial insurance coverage, and the establishment of a Chuna association in Korea. All of the KM colleges offered courses on Chuna-related subjects (CRSs); however, the total number of hours dedicated to lectures on CRSs was insufficient to master Chuna completely. Overall, 17 RCTs were reviewed. Of the 14 RCTs of Chuna in musculoskeletal diseases, six reported Chuna was more effective than a control condition, and another six RCTs proposed Chuna had the same effect as a control condition. One of these 14 RCTs made the comparison impossible because of unreported statistical difference; the last RCT reported Chuna was less effective than a control condition. In addition, three RCTs of Chuna in neurological diseases reported Chuna was superior to a control condition. In conclusion, Chuna was not included in the regular curriculum in KM colleges until the modern Chuna era; Chuna became more popular as the result of it being covered by Korean insurance carriers and after the establishment of a Chuna association. Meanwhile, the currently available evidence is insufficient to characterize the effectiveness of Chuna in musculoskeletal and neurological diseases.

  3. An introduction to Chuna manual medicine in Korea: History, insurance coverage, education, and clinical research in Korean literature

    Directory of Open Access Journals (Sweden)

    Tae-Yong Park

    2014-06-01

    Full Text Available The objectives of this study were to summarize the curriculum, history, and clinical researches of Chuna in Korea and to ultimately introduce Chuna to Western medicine. Information about the history and insurance coverage of Chuna was collected from Chuna-related institutions and papers. Data on Chuna education in all 12 Korean medicine (KM colleges in Korea were reconstructed based on previously published papers. All available randomized controlled trials (RCTs of Chuna in clinical research were searched using seven Korean databases and six KM journals. As a result, during the modern Chuna era, one of the three periods of Chuna, which also include the traditional Chuna era and the suppressed Chuna era, Chuna developed considerably because of a solid Korean academic system, partial insurance coverage, and the establishment of a Chuna association in Korea. All of the KM colleges offered courses on Chuna-related subjects (CRSs; however, the total number of hours dedicated to lectures on CRSs was insufficient to master Chuna completely. Overall, 17 RCTs were reviewed. Of the 14 RCTs of Chuna in musculoskeletal diseases, six reported Chuna was more effective than a control condition, and another six RCTs proposed Chuna had the same effect as a control condition. One of these 14 RCTs made the comparison impossible because of unreported statistical difference; the last RCT reported Chuna was less effective than a control condition. In addition, three RCTs of Chuna in neurological diseases reported Chuna was superior to a control condition. In conclusion, Chuna was not included in the regular curriculum in KM colleges until the modern Chuna era; Chuna became more popular as the result of it being covered by Korean insurance carriers and after the establishment of a Chuna association. Meanwhile, the currently available evidence is insufficient to characterize the effectiveness of Chuna in musculoskeletal and neurological diseases.

  4. Identifying barriers to move to better health coverage: preferences for health insurance benefits among the rural poor population in La Guajira, Colombia.

    Science.gov (United States)

    Amaya, Jeannette Liliana; Ruiz, Fernando; Trujillo, Antonio J; Buttorff, Christine

    2016-01-01

    Even though access to health insurance in Colombia has improved since the implementation of the 1993 health reforms (Law 100), universal coverage has not yet been accomplished. There is still a segment of the population under the low-income (subsidized) health insurance policy or without health insurance altogether. The purpose of this research was to identify preferences and behavior regarding health insurance among the subsidized rural population in La Guajira, Colombia, and to understand why that population remains under the subsidized health insurance policy. The field experiment gathered information from 400 households regarding their socioeconomic situation, health conditions, and preferences for health insurance characteristics. Results suggest that the surveyed population gives priority to expanded family coverage, physician and hospital choice, and access to specialists, rather than to attributes associated with co-payments or premiums. That indicates that people value healthcare benefits and family coverage more than health insurance expenses, and policy makers could use these preferences to enroll subsidized population into the contributory regime. Copyright © 2014 John Wiley & Sons, Ltd.

  5. 77 FR 4734 - Servicemembers' Group Life Insurance-Stillborn Child Coverage

    Science.gov (United States)

    2012-01-31

    ... Veterans' Benefits Improvement Act of 2008, Public Law 110-389, expanded the definition of ``insurable... in a rule that may: (1) Have an annual effect on the economy of $100 million or more or adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the...

  6. Societal implications of medical insurance coverage for imatinib as first-line treatment of chronic myeloid leukemia in China: a cost-effectiveness analysis.

    Science.gov (United States)

    Sheng, Guangying; Chen, Suning; Dong, Chaohui; Zhang, Ri; Miao, Miao; Wu, Depei; Tan, Seng Chuen; Liu, Chao; Xiong, Tengbin

    2017-04-01

    Imatinib (Glivec) and nilotinib (Tasigna) have been covered by critical disease insurance in Jiangsu province of China since 2013, which changed local treatment patterns and outcomes of patients with chronic myeloid leukemia (CML). This study evaluated the long-term cost-effectiveness of insurance coverage with imatinib as the first-line treatment for patients with CML in China from a societal perspective. A decision-analytic model based on previously published and real-world evidence was applied to simulate and evaluate the lifetime clinical and economic outcomes associated with CML treatments before and after imatinib was covered by medical insurance. Incremental cost-effectiveness ratio (ICER) was calculated with both costs and quality-adjusted life years (QALYs) discounted at 3% annually. Different assumptions of treatment benefits and costs were taken to address uncertainties and were tested with sensitivity analyses. In base case analysis, both cost and effectiveness of CML treatments increased after imatinib was covered by the medical insurance; on average, the incremental QALY and cost were 5.5 and ¥277,030 per patient in lifetime, respectively. The ICER of insurance coverage with imatinib was ¥50,641, which is less than the GDP per capita of China. Monte Carlo simulation resulted in the estimate of 100% probability that the insurance coverage of imatinib is cost-effective. Total cost was substantially saved at 5 years after patients initiated imatinib treatment with insurance coverage compared to no insurance coverage, the saved cost at 5 years was ¥99,565, which included the cost savings from both direct (e.g. cost of bone marrow or stem cell transplant) and indirect costs (e.g. productivity loss of patients and care-givers). The insurance coverage of imatinib is very cost-effective in China, according to the local cost and clinical data in Jiangsu province. More importantly, the insurance coverage of imatinib and nilotinib have changed the treatment

  7. 75 FR 69577 - Deposit Insurance Regulations; Unlimited Coverage for Noninterest-Bearing Transaction Accounts

    Science.gov (United States)

    2010-11-15

    ... such coverage for these accounts promotes moral hazard. Four commenters suggested charging a separate..., whether held by a business, an individual or other type of depositor. Unlike the definition of noninterest... as a noninterest-bearing transaction account. One issue raised during the comment period is how the...

  8. State budget transfers to Health Insurance Funds for universal health coverage: institutional design patterns and challenges of covering those outside the formal sector in Eastern European high-income countries.

    Science.gov (United States)

    Vilcu, Ileana; Mathauer, Inke

    2016-01-15

    Many countries from the European region, which moved from a government financed and provided health system to social health insurance, would have had the risk of moving away from universal health coverage if they had followed a "traditional" approach. The Eastern European high-income countries studied in this paper managed to avoid this potential pitfall by using state budget revenues to explicitly pay health insurance contributions on behalf of certain (vulnerable) population groups who have difficulties to pay these contributions themselves. The institutional design aspects of their government revenue transfer arrangements are analysed, as well as their impact on universal health coverage progress. This regional study is based on literature review and review of databases for the performance assessment. The analytical framework focuses on the following institutional design features: rules on eligibility for contribution exemption, financing and pooling arrangements, and purchasing arrangements and benefit package design. More commonalities than differences can be identified across countries: a broad range of groups eligible for exemption from payment of health insurance contributions, full state contributions on behalf of the exempted groups, mostly mandatory participation, integrated pools for both the exempted and contributors, and relatively comprehensive benefit packages. In terms of performance, all countries have high total population coverage rates, but there are still challenges regarding financial protection and access to and utilization of health care services, especially for low income people. Overall, government revenue transfer arrangements to exempt vulnerable groups from contributions are one option to progress towards universal health coverage.

  9. Health care coverage and access in the nation's four largest states. Results from the Commonwealth Fund Biennial Health Insurance Survey, 2014.

    Science.gov (United States)

    Rasmussen, Petra W; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2015-04-01

    Across the country's four largest states, uninsured rates vary for adults ages 19 to 64: 12 percent of New Yorkers, 17 percent of Californians, 21 percent of Floridians, and 30 percent of Texans lacked health coverage in 2014. Differences also extend to the proportion of residents reporting problems getting needed care because of cost, which was significantly lower in New York and California compared with Florida and Texas. Similarly, lower percentages of New Yorkers and Californians reported having a medical bill problem in the past 12 months or having accrued medical debt compared with Floridians and Texans. These differences stem from a variety of factors, including whether states have expanded eligibility for Medicaid, the state's uninsured rate prior to the Affordable Care Act taking effect, differences in the cost protections provided by private health insurance, and demographics.

  10. National health insurance coverage and socio-economic status in a rural district of Ghana.

    Science.gov (United States)

    Sarpong, N; Loag, W; Fobil, J; Meyer, C G; Adu-Sarkodie, Y; May, J; Schwarz, N G

    2010-02-01

    To explore the association between socio-economic status (SES) and health insurance subscription to the Ghanaian National Health Insurance Scheme (NHIS) of residents of the Asante Akim North district of the Ashanti Region, Ghana. In the course of a community survey, data on asset variables (e.g. electricity, housing conditions and other variables) and on NHIS subscription were collected on the household level in 99 villages. Using principal components analysis, households were classified into three categories of SES (20% high, 40% middle and 40% low SES). Odds ratios of NHIS subscription were calculated for all SES categories, using the low category as the reference group and adjusting for travelling time to health facilities by public transport. Of the 7223 households surveyed, 38% subscribed to the NHIS, of these 21% were low, 43% middle and 60% high SES households. SES was significantly associated with NHIS subscription (high SES: OR 4.9, 95% CI 4.3-5.7; middle SES: OR 2.5, 95% CI 2.2-2.9; low SES: OR 1, reference group). Four years after its introduction, the NHIS has reached subscription rates of 38% in the district surveyed. However, to achieve the aim of assuring universal access to health care facilities for all residents of Ghana, in particular for individuals living under socio-economic constraints, increasing subscription rates are necessary.

  11. The association between state mandates of colorectal cancer screening coverage and colorectal cancer screening utilization among US adults aged 50 to 64 years with health insurance

    Directory of Open Access Journals (Sweden)

    Virgo Katherine

    2011-01-01

    Full Text Available Abstract Background Several states in the US have passed laws mandating coverage of colorectal cancer (CRC screening tests by health insurance plans. The impact of these state mandates on the use of colorectal cancer screening has not been evaluated among an age-eligible target population with access to care (i.e., health care insurance coverage. Methods We collected information on state mandates implemented by December 31, 2008 and used data on insured adults aged 50 and 64 years from the Behavioral Risk Factor Surveillance System between 2002 and 2008 to classify individual-level exposure to state mandates for at least 1 year. Multivariate logistic regression models (with state- and year- fixed effects, and patient demographic and socioeconomic characteristics were used to estimate the effect of state mandates on recent endoscopy screening (either flexible sigmoidoscopy or colonoscopy during the past year. Results From 1999-2008, twenty-two states in the US, including the District of Columbia passed comprehensive laws requiring health insurance coverage of CRC screening including endoscopy tests. Residence in states with CRC screening coverage mandates in place for at least 1 year was associated with a 1.4 percentage point increase in the probability of utilization of recent endoscopy (i.e., 17.5% screening rates in those with mandates versus 16.1% in those without, Adjusted OR = 1.10, 95% CI: 1.02 - 1.20, p = 0.02. Conclusions The findings suggest a positive, albeit small, impact of state mandates on the use of recent CRC screening endoscopy among the target eligible population with health insurance. However, more research is needed to evaluate potential effects of mandates across health insurance types while including controls for other system-level factors (e.g. endoscopy and primary care capacity. National health insurance reform should strive towards a system that expands access to recommended CRC screening tests.

  12. State trends in the cost of employer health insurance coverage, 2003-2013.

    Science.gov (United States)

    Schoen, Cathy; Radley, David; Collins, Sara R

    2015-01-01

    From 2010 to 2013--the years following the implementation of the Affordable Care Act--there has been a marked slowdown in premium growth in 31 states and the District of Columbia. Yet, the costs employees and their families pay out-of-pocket for deductibles and their share of premiums continued to rise, consuming a greater share of incomes across the country. In all but a handful of states, average deductibles more than doubled over the past decade for employees working in large and small firms. Workers are paying more but getting less protective benefits. Costs are particularly high, compared with median income, in Southern and South Central states, where incomes are below the national average. Based on recent forecasts that predict an uptick in private insurance growth rates starting in 2015, securing slow cost growth for workers, families, and employers will likely require action to address rising costs of medical care services.

  13. Defining the essential anatomical coverage provided by military body armour against high energy projectiles.

    Science.gov (United States)

    Breeze, John; Lewis, E A; Fryer, R; Hepper, A E; Mahoney, Peter F; Clasper, Jon C

    2016-08-01

    Body armour is a type of equipment worn by military personnel that aims to prevent or reduce the damage caused by ballistic projectiles to structures within the thorax and abdomen. Such injuries remain the leading cause of potentially survivable deaths on the modern battlefield. Recent developments in computer modelling in conjunction with a programme to procure the next generation of UK military body armour has provided the impetus to re-evaluate the optimal anatomical coverage provided by military body armour against high energy projectiles. A systematic review of the literature was undertaken to identify those anatomical structures within the thorax and abdomen that if damaged were highly likely to result in death or significant long-term morbidity. These structures were superimposed upon two designs of ceramic plate used within representative body armour systems using a computerised representation of human anatomy. Those structures requiring essential medical coverage by a plate were demonstrated to be the heart, great vessels, liver and spleen. For the 50th centile male anthropometric model used in this study, the front and rear plates from the Enhanced Combat Body Armour system only provide limited coverage, but do fulfil their original requirement. The plates from the current Mark 4a OSPREY system cover all of the structures identified in this study as requiring coverage except for the abdominal sections of the aorta and inferior vena cava. Further work on sizing of plates is recommended due to its potential to optimise essential medical coverage. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. The Impact of Increased Tax Subsidies on the Insurance Coverage of Self-Employed Families: Evidence from the 1996-2004 Medical Expenditure Panel Survey

    Science.gov (United States)

    Selden, Thomas M.

    2009-01-01

    The share of health insurance premiums that self-employed workers can deduct when computing federal income taxes rose from 30 percent in 1996 to 100 percent in 2003. Data from the 1996-2004 Medical Expenditure Panel Survey are used to show that the increased tax subsidy was associated with substantial increases in private coverage among…

  15. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    Science.gov (United States)

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

  16. The Urban Resident Basic Medical Insurance: a landmark reform towards universal coverage in China.

    Science.gov (United States)

    Lin, Wanchuan; Liu, Gordon G; Chen, Gang

    2009-07-01

    As the latest government effort to reform China's health care system, Urban Resident Basic Medical Insurance (URBMI) was piloted in seventy-nine cities during the summer of 2007, following State Council Policy Document 2007 No. 20's guidelines. This study presents the first economic analysis of URBMI, following a national household survey in nine representative Chinese cities. The survey aimed to answer three questions: Who is covered by the plan? Who gains from the plan? Who is most satisfied with the plan? We have found that there is a U-shaped relationship between URBMI participation rate and income. That is, the extremely rich or poor are the most likely to participate. Those with any inpatient treatment last year or with any chronic disease are also more likely to enroll in URBMI, indicating adverse selection into participation. We have also found that in reducing financial barriers to care, URBMI most significantly benefits the poor and those with previous inpatient care. Finally, those participants in the bottom 20% of family incomes are happier with URBMI than are their more affluent counterparts.

  17. 3 CFR - State Children's Health Insurance Program

    Science.gov (United States)

    2010-01-01

    ... 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...

  18. “Will Employers Drop Health Insurance Coverage because of the Affordable Care Act?” Health Affairs 32(9): 1522–1530

    Science.gov (United States)

    Buchmueller, Thomas; Carey, Colleen; Levy, Helen G.

    2014-01-01

    Since the passage of the Affordable Care Act, there has been considerable speculation about how many employers will stop offering health insurance once the major coverage provisions of the Act take effect. While some observers predict little aggregate effect, others believe that 2014 marks the beginning of the end for our current system of employer- sponsored insurance. We address the question “how will employer health insurance offering respond to health reform?” using theoretical and empirical evidence. First, we describe economic models of why employers offer insurance. Second, we recap the relevant provisions of health reform and use our economic framework to consider how they may affect employer offers. Third, we review the various predictions that have been made on this subject. Finally, we offer some observations on interpreting early data from 2014. PMID:24019355

  19. 75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2010-07-23

    ... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in... health insurance issuers providing group health insurance coverage. The text of those temporary...

  20. Indian community health insurance schemes provide partial protection against catastrophic health expenditure

    Directory of Open Access Journals (Sweden)

    Ranson Kent

    2007-03-01

    Full Text Available Abstract Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE. We studied two Indian community health insurance (CHI schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit

  1. Understanding insurance coverage in the senior market: reimbursement and emerging trends.

    Science.gov (United States)

    Vogenberg, F Randy; Marcoux, Rita M; Larrat, E Paul

    2012-09-01

    Currently, Medicare Part D is the primary payer of pharmaceuticals and driver of formulary selection for most seniors, regardless of their care setting. This primer examines key issues in reimbursement for geriatric care from a historical perspective and how it has affected health care professionals in their clinical and distributive functions. Discussion on how reimbursement trends evolved for older adult patients across care settings such as nursing facilities, assisted living, hospice, and home health are included. Additionally, this primer identifies what is changing across the different care settings, the complexities of medication coverage today, and current trends that may have significant impact on medication cost in the near future if the Affordable Care Act is implemented as currently written. Finally, the primer identifies legislative and regulatory initiatives and reimbursement trends that will continue to pose a challenge in the coming years as Congress and the president address the number of individuals covered by publicly funded programs. This challenge will be amplified in part by a growing biotechnology pharmaceutical pipeline and a rapidly increasing genomics industry.

  2. The impact of stakeholder values and power relations on community-based health insurance coverage: qualitative evidence from three Senegalese case studies.

    Science.gov (United States)

    Mladovsky, Philipa; Ndiaye, Pascal; Ndiaye, Alfred; Criel, Bart

    2015-07-01

    Continued low rates of enrolment in community-based health insurance (CBHI) suggest that strategies proposed for scaling up are unsuccessfully implemented or inadequately address underlying limitations of CBHI. One reason may be a lack of incorporation of social and political context into CBHI policy. In this study, the hypothesis is proposed that values and power relations inherent in social networks of CBHI stakeholders can explain levels of CBHI coverage. To test this, three case studies constituting Senegalese CBHI schemes were studied. Transcripts of interviews with 64 CBHI stakeholders were analysed using inductive coding. The five most important themes pertaining to social values and power relations were: voluntarism, trust, solidarity, political engagement and social movements. Analysis of these themes raises a number of policy and implementation challenges for expanding CBHI coverage. First is the need to subsidize salaries for CBHI scheme staff. Second is the need to develop more sustainable internal and external governance structures through CBHI federations. Third is ensuring that CBHI resonates with local values concerning four dimensions of solidarity (health risk, vertical equity, scale and source). Government subsidies is one of the several potential strategies to achieve this. Fourth is the need for increased transparency in national policy. Fifth is the need for CBHI scheme leaders to increase their negotiating power vis-à-vis health service providers who control the resources needed for expanding CBHI coverage, through federations and a social movement dynamic. Systematically addressing all these challenges would represent a fundamental reform of the current CBHI model promoted in Senegal and in Africa more widely; this raises issues of feasibility in practice. From a theoretical perspective, the results suggest that studying values and power relations among stakeholders in multiple case studies is a useful complement to traditional health

  3. Determinants of Coverage Decisions in Health Insurance Marketplaces: Consumers' Decision-Making Abilities and the Amount of Information in Their Choice Environment

    Science.gov (United States)

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

    2015-01-01

    Objective To investigate the determinants and quality of coverage decisions among uninsured choosing plans in a hypothetical health insurance marketplace. Study Setting Two samples of uninsured individuals: one from an Internet-based sample comprised largely of young, healthy, tech-savvy individuals (n = 276), and the other from low-income, rural Virginians (n = 161). Study Design We assessed whether health insurance comprehension, numeracy, choice consistency, and the number of plan choices were associated with participants' ability to choose a cost-minimizing plan, given their expected health care needs (defined as choosing a plan costing no more than $500 in excess of the total estimated annual costs of the cheapest plan available). Data Collection Primary data were collected using an online questionnaire. Principal Findings Uninsured who were more numerate showed higher health insurance comprehension; those with more health insurance comprehension made choices of health insurance plans more consistent with their stated preferences; and those who made choices more concordant with their stated preferences were less likely to choose a plan that cost more than $500 in excess of the cheapest plan available. Conclusions Increasing health insurance comprehension and designing exchanges to facilitate plan comparison will be critical to ensuring the success of health insurance marketplaces. PMID:24779769

  4. The impact of welfare reform on the health insurance coverage, utilization and health of low education single mothers.

    Science.gov (United States)

    Narain, Kimberly; Bitler, Marianne; Ponce, Ninez; Kominski, Gerald; Ettner, Susan

    2017-05-01

    The Personal Responsibility Work Opportunity and Reconciliation Act (PRWORA) of 1996 imposed time limits on the receipt of welfare cash benefits and mandated cash benefit sanctions for failure to meet work requirements. Many studies examining the health implications of PRWORA have found associated declines in health insurance coverage and healthcare utilization among single mothers but no impact of PRWORA on health outcomes. A limitation of this literature is that most studies cover a time period before time limits were implemented in all states and also before individuals began actually timing out. This work builds on previous studies by exploring this research question using data from the Survey of Income and Program Participation that covers a time period after all states have implemented time limits (1991-2009). We use a difference-in-differences study design that exploits variability in eligibility for cash welfare benefits by marital status and state-level variation in timing of PRWORA implementation to identify the effect of PRWORA. Using ordinary least square regression models, controlling for state-level and federal policies, individual-level demographics and state and year fixed-effects, we find that PRWORA leads to 7 and 5 percentage point increases in self-reported poor health and self-reported disability among white single mothers without a diploma, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Does Employer-Provided Health Insurance Constrain Labor Supply Adjustments to Health Shocks? New Evidence on Women Diagnosed with Breast Cancer

    Science.gov (United States)

    Neumark, David; Barkowski, Scott

    2013-01-01

    Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse’s employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11 percent smaller. Women’s subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior. PMID:23891911

  6. Databases for estimating health insurance coverage for children: a workshop summary

    National Research Council Canada - National Science Library

    Plewes, Thomas J

    "This report summarizes the proceedings of a workshop convened in June 2010 to critically examine the various databases that could provide national and state-level estimates of low-income uninsured...

  7. 77 FR 71423 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2012-11-30

    ... or Medicaid program or the Children's Health Insurance Program (CHIP); revalidating their Medicare... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND...

  8. 78 FR 72089 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2013-12-02

    ... or Medicaid program or the Children's Health Insurance Program (CHIP); revalidating their Medicare... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND...

  9. [Health insurance in the contributive and subsidized regimes and its impact on the service providers].

    Science.gov (United States)

    Prada, Luis M

    2004-01-01

    The performance of 18 private Health-promoting (EPS) and Family Compensation (CCF) entities, as well as their general balances for 1997, 1998 and 1999, were studied to determine the profit margins achieved by EPS's in their work of administering health insurance. The average behavior of each EPS balance sheet was analyzed to reduce the effect produced by extreme cases; each EPS's value was thus weighted by the number of its affiliated people. The expected behavior of the costs and expenses of companies whose main business is providing health insurance could thus become determined. The main source of operational income for a private EPS is the contributive regime's per capita unit of payment (UPC). Subsidized regime participation and that of other sources of income has decreased year by year. By contrast, public EPS's have shown decreasing participation in income obtained from UPC (contributive and subsidized) and growing dependence on other sources of income; this can be interpreted as being a symptom of weak commercial management. According to the balance sheets provided by the SNS, the EPS (public, private and Family Compensation entities), including the Social Security Institute (ISS), together obtained a total of 4.18 billion pesos operational income in 1999, an increase of 21.7% as compared to 1998. Income received from the ISS amounted to 1.93 billion dollars in 1999 (46% of the total). At 2000 prices, the total amount of operational income was 4.54 billion pesos in 1999 (15.6% real increase). Taking the behavior of 4 EPS's as our reference point (Sanitas, Humana Vivir, Coomeva and Famisanar), it can be concluded that an EPS whose main business is health insurance needs a 17.2% gross margin to cover its operational and non-operational costs and a 1.1% margin before tax.

  10. Changes in out-of-pocket payments for contraception by privately insured women during implementation of the federal contraceptive coverage requirement.

    Science.gov (United States)

    Finer, Lawrence B; Sonfield, Adam; Jones, Rachel K

    2014-02-01

    As part of the Affordable Care Act, a federal requirement for private health plans to cover contraceptive methods, services and counseling, without any out-of-pocket costs to patients, took effect for millions of Americans in January 2013. Data for this study come from a subset of the 3207 women aged 18-39 years who responded to two waves of a national longitudinal survey. This analysis focused on the 889 women who were using hormonal contraceptive methods in both the fall 2012 and spring 2013 waves and the 343 women who used the intrauterine device at either wave. Women were asked about the amount they paid out of pocket in an average month for their method of choice. Between Wave 1 and Wave 2, the proportion of privately insured women paying zero dollars out of pocket for oral contraceptives increased substantially, from 15% to 40%; by contrast, there was no significant change among publicly insured or uninsured women (whose coverage was not affected by the new federal requirement). Similar changes were seen among privately insured women using the vaginal ring. The initial implementation of the federal contraceptive coverage requirement appears to have had a notable impact on the out-of-pocket costs paid by privately insured women. Additional progress is likely as the requirement phases in to apply to more private plans, but with evidence that not all methods are being treated equally, policymakers should consider stepped-up oversight and enforcement of the provision. This study measures the out-of-pocket costs for women with private, public and no insurance prior to the federal contraceptive coverage requirement and after it took effect; in doing so, it highlights areas of progress in eliminating these costs and areas that need further progress. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Research Needs Assessment in the Health Insurance Organization: Level of Health Care Provider

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2011-12-01

    Full Text Available Objective: Setting research priorities in the research management cycle is a key. It is important to set the research priorities to make optimal use of scarce resources. The aim of this research was to determine the research needs of Health Insurance Organization based on its health care centers research needs.Methods: This is a qualitative, descriptive and cross-sectional study that was conducted in 2011. A purposeful sample of 60 participants from 14 hospitals, seven dispensaries, five dental clinics, two rehabilitation centers, four radiology centers, six medical diagnostic laboratories, 12 pharmacies, and 20 medical offices that were contracted with the Health Insurance Organization in Iran was interviewed. The framework analysis method (a qualitative research method was used for analysis of interviews. Atlas-Ti software was used to analyze quantitative data, respectively. The topics were prioritized using the Analytical Hierarchy Process (AHP method through Expert Choice software.Results: Based on the problems extracted in our qualitative study, 12 research topics were proposed by the experts. Among these “Design of standard treatment protocols,” “Designing model of ranking the health care centers under contract,” and “Pathology of payment system” took the priority ranks of 1 to 3, earning the scores of 0.44, 0.42, and 0.37, respectively.Conclusion: Considering limited resources and unlimited needs and to prevent research resource wasting, conducting research related to health care providers in the Health Insurance Organization can help it achieve its goals.

  12. Abortion providers' experiences with Medicaid abortion coverage policies: a qualitative multistate study.

    Science.gov (United States)

    Dennis, Amanda; Blanchard, Kelly

    2013-02-01

    To evaluate the implementation of state Medicaid abortion policies and the impact of these policies on abortion clients and abortion providers. From 2007 to 2010, in-depth interviews were conducted with representatives of 70 abortion-providing facilities in 15 states. In-depth interviews focused on abortion providers' perceptions regarding Medicaid and their experiences working with Medicaid and securing reimbursement in cases that should receive federal funding: rape, incest, and life endangerment. Data were transcribed verbatim before being coded. In two study states, abortion providers reported that 97 percent of submitted claims for qualifying cases were funded. Success receiving reimbursement was attributed to streamlined electronic billing procedures, timely claims processing, and responsive Medicaid staff. Abortion providers in the other 13 states reported reimbursement for 36 percent of qualifying cases. Providers reported difficulties obtaining reimbursement due to unclear rejections of qualifying claims, complex billing procedures, lack of knowledgeable Medicaid staff with whom billing problems could be discussed, and low and slow reimbursement rates. Poor state-level implementation of Medicaid coverage of abortion policies creates barriers for women seeking abortion. Efforts to ensure policies are implemented appropriately would improve women's health. © Health Research and Educational Trust.

  13. Health insurance for "frontaliers"

    CERN Document Server

    2013-01-01

    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 “...

  14. Low income parents' reports of communication problems with health care providers: effects of language and insurance.

    Science.gov (United States)

    Clemans-Cope, Lisa; Kenney, Genevieve

    2007-01-01

    This study examines how parental reports of communication problems with health providers vary over a wider range of characteristics of low income children than considered in previous studies. Data were drawn from the 1999 and 2002 National Survey of America's Families. Communication problems, insurance type, socioeconomic characteristics, health factors, and provider type were examined. Data were analyzed using bivariate and multivariate techniques. Bivariate analysis identified that the parents of 24.4% of low income children and 36.4% of publicly covered low income children with a Spanish interview reported poor communication with health providers. Coefficients from regression analysis suggest that, controlling for covariates, foreign-born parents with a Spanish interview were 11.8 percentage points (pcommunication problems than U.S.-born parents with an English interview. Among low income publicly covered children with a Spanish interview, regression analysis suggests that parents of children who used clinics or hospital outpatient departments as their usual source of care were 9.5 percentage points (pcommunication problems compared with those whose usual source of care was a doctor's or HMO office. Implementing policies to improve communication barriers for low income children, particularly those with foreign-born parents whose native language is not English, may be necessary to reduce health disparities relative to higher income children across a variety of health domains including utilization, satisfaction, and outcomes. Focusing attention on the availability of professional translation services in clinics or hospital outpatient departments may be a cost-effective strategy for reducing communication problems for publicly insured children.

  15. [Who benefits from stepwise occupational reintegration provided under the statutory pension insurance scheme?].

    Science.gov (United States)

    Bürger, W; Streibelt, M

    2011-06-01

    Stepwise occupational reintegration (SOR) - since law amendments in April 2004 also provided under the German pension insurance scheme (Deutsche Rentenversicherung, DRV) - is an instrument intended to support insurants on sick-leave in reintegrating into work step by step after long-term illness. In 2008, the effectiveness of SOR regarding return to work was affirmed for the first time in a comprehensive study. However, in view of the growing amount of SOR, the question of differential effects of SOR in special subgroups is raised. This paper presents a re-analysis of data collected in the 2008 study. A total of 696 patients after medical rehabilitation were included in the analyses, 348 with SOR provided by the DRV, and a control group of 348 patients without SOR matched on a multitude of different variables using the Propensity Scores. Successful outcome was measured using a combined criterion "Return to work in good health", that is, patients returning to gainful activity and with sick leave of under 6 weeks and no intention to retire within a one-year follow-period after medical rehabilitation. Differentiating criteria are age gender, rehab indication, periods of sick leave in the year before medical rehabilitation, kind of and access to medical rehabilitation. The data indicate especially good results of SOR for patients with mental disorders (OR=2.49), patients who were requested to participate in medical rehabilitation by a health insurance fund because of long-term sick leave (OR=2.71), and patients with longer periods of sick leave before medical rehabilitation (3 to <6 months: OR=2.41, 6 months and more: OR=2.23). In contrast, there are only minimal effects (statistically not significant) of SOR in patients with medical rehabilitation directly after a hospital stay ("Anschlussheilbehandlung"), patients with cardiac or oncological diseases, and in younger (age 19-34) and older patients (age 55-60). In-depth analyses show that SOR success is more marked in

  16. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal: e0146798

    National Research Council Canada - National Science Library

    Mónica Ruiz-Casares; Janet Cleveland; Youssef Oulhote; Catherine Dunkley-Hickin; Cécile Rousseau

    2016-01-01

      Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec...

  17. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal

    National Research Council Canada - National Science Library

    Ruiz-Casares, Mónica; Cleveland, Janet; Oulhote, Youssef; Dunkley-Hickin, Catherine; Rousseau, Cécile

    2016-01-01

    Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec...

  18. Welfare reform and older immigrant adults' Medicaid and health insurance coverage: changes caused by chilling effects of welfare reform, protective citizenship, or distinct effects of labor market condition by citizenship?

    Science.gov (United States)

    Nam, Yunju

    2012-06-01

    To examine how federal noncitizen Medicaid eligibility restriction and generous state policy affect Medicaid and health insurance coverage among older adults with different citizenship status. This study uses an older adult sample (65 years or older) from the Current Population Survey (CPS) and state data and employed a triple difference-in-differences approach to incorporate variations in citizenship status, time, and state eligibility. Findings show that Medicaid coverage significantly declined among older noncitizens but increased among older naturalized citizens after Welfare Reform. Findings also show that the differences in older noncitizens' health insurance coverage changes were significant between generous and nongenerous states. Medicaid eligibility affects older immigrant adults' Medicaid and health insurance coverage. Findings support the "protective citizenship" hypothesis but not the "chilling effect" and "labor market condition" hypotheses. Opposite patterns of change in Medicaid coverage between naturalized citizens and noncitizens raise doubt about the effectiveness of eligibility restrictions in reducing government spending.

  19. Preferred Primary Healthcare Provider Choice Among Insured Persons in Ashanti Region, Ghana

    Directory of Open Access Journals (Sweden)

    Micheal Kofi Boachie

    2016-03-01

    Full Text Available Background In early 2012, National Health Insurance Scheme (NHIS members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs and direction of association of such factors with the choice of PPP. Methods Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63% and doctors (39.92%, distance or proximity (49.60%, provider reputation (39.52%, waiting time (39.92, additional charges (37.10%, and recommendations (48.79% were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027, availability of doctors (-1.82, additional charges (-2.14 and reputation (-2.09 were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59, waiting time (1.45, residence (-2.62, gender (-2.89, and reputation (-2.69 were statistically significant at 1% level. Presence of additional charges (-1.29 was statistically significant at 5% level. Conclusion Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by

  20. Preferred Primary Healthcare Provider Choice Among Insured Persons in Ashanti Region, Ghana.

    Science.gov (United States)

    Boachie, Micheal Kofi

    2015-10-20

    In early 2012, National Health Insurance Scheme (NHIS) members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs) and direction of association of such factors with the choice of PPP. Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63%) and doctors (39.92%), distance or proximity (49.60%), provider reputation (39.52%), waiting time (39.92), additional charges (37.10%), and recommendations (48.79%) were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027), availability of doctors (-1.82), additional charges (-2.14) and reputation (-2.09) were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59), waiting time (1.45), residence (-2.62), gender (-2.89), and reputation (-2.69) were statistically significant at 1% level. Presence of additional charges (-1.29) was statistically significant at 5% level. Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by ensuring constant availability of

  1. Premium copayments and the trade-off between wages and employer-provided health insurance.

    Science.gov (United States)

    Lubotsky, Darren; Olson, Craig A

    2015-12-01

    This paper estimates the trade-off between salary and health insurance costs using data on Illinois school teachers between 1991 and 2008 that allow us to address several common empirical challenges in this literature. Teachers paid about 17 percent of the cost of individual health insurance and about 46 percent of the cost of their family members' plans through premium contributions, but we find no evidence that teachers' salaries respond to changes in insurance costs. Consistent with a higher willingness to pay for insurance, we find that premium contributions are higher in districts that employ a higher-tenured workforce. We find no evidence that school districts respond to higher health insurance costs by reducing the number of teachers. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Rotational electrical impedance tomography using electrodes with limited surface coverage provides window for multimodal sensing

    Science.gov (United States)

    Lehti-Polojärvi, Mari; Koskela, Olli; Seppänen, Aku; Figueiras, Edite; Hyttinen, Jari

    2018-02-01

    Electrical impedance tomography (EIT) is an imaging method that could become a valuable tool in multimodal applications. One challenge in simultaneous multimodal imaging is that typically the EIT electrodes cover a large portion of the object surface. This paper investigates the feasibility of rotational EIT (rEIT) in applications where electrodes cover only a limited angle of the surface of the object. In the studied rEIT, the object is rotated a full 360° during a set of measurements to increase the information content of the data. We call this approach limited angle full revolution rEIT (LAFR-rEIT). We test LAFR-rEIT setups in two-dimensional geometries with computational and experimental data. We use up to 256 rotational measurement positions, which requires a new way to solve the forward and inverse problem of rEIT. For this, we provide a modification, available for EIDORS, in the supplementary material. The computational results demonstrate that LAFR-rEIT with eight electrodes produce the same image quality as conventional 16-electrode rEIT, when data from an adequate number of rotational measurement positions are used. Both computational and experimental results indicate that the novel LAFR-rEIT provides good EIT with setups with limited surface coverage and a small number of electrodes.

  3. Beyond insurance coverage: usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Spatz, Erica S; Ross, Joseph S; Desai, Mayur M; Canavan, Maureen E; Krumholz, Harlan M

    2010-07-01

    Expanding insurance coverage, while necessary, may not be sufficient to ensure high-quality care for adults with cardiovascular disease. We sought to examine the association between having a usual source of care (USOC) and receiving medication treatment of hypertension and hypercholesterolemia. Using the 2003-2006 National Health and Nutrition Examination Survey, we categorized USOC (a place to go when sick or need medical advice) and insurance status in adults >or=35 years old with an indication for medication treatment of hypertension (n = 3,142) and hypercholesterolemia (n = 1,134), determined using the Joint National Committee 7 and Adult Treatment Panel III recommendations, respectively. Multivariable logistic regression modeling was used to determine the independent effect of USOC on receiving treatment of hypertension and hypercholesterolemia, controlling for age, sex, race/ethnicity, insurance status, and comorbidities. Separate multivariable models were examined stratified by insurance status. Among subjects with an indication for treatment of hypertension and hypercholesterolemia, 32.4% and 42.0% were untreated, respectively. When compared with adults with a USOC, adults without a USOC were more likely to be untreated for hypertension (adjusted prevalence ratio [aPR] 2.43, 95% CI 1.88-2.85) and hypercholesterolemia (aPR 1.79, 95% CI 1.31-2.13). In stratified analyses among subjects with insurance, no USOC remained associated with being untreated (hypertension, aPR 2.58, 95% CI 1.88-3.08; hypercholesterolemia, aPR 1.65, 95% CI 0.97-2.18). Absence of a USOC was associated with being untreated for hypertension and hypercholesterolemia, even among individuals with insurance, suggesting that efforts to improve chronic disease management should also facilitate access to a regular source of care. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  4. The Volume Of TV Advertisements During The ACA's First Enrollment Period Was Associated With Increased Insurance Coverage.

    Science.gov (United States)

    Karaca-Mandic, Pinar; Wilcock, Andrew; Baum, Laura; Barry, Colleen L; Fowler, Erika Franklin; Niederdeppe, Jeff; Gollust, Sarah E

    2017-04-01

    The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. These results support the importance of strategic investment in advertising to increase uptake of health insurance but suggest that not all types of advertisements will have the same effect on the public. Project HOPE—The People-to-People Health Foundation, Inc.

  5. Information reporting by applicable large employers on health insurance coverage offered under employer-sponsored plans. Final regulations.

    Science.gov (United States)

    2014-03-10

    This document contains final regulations providing guidance toemployers that are subject to the information reporting requirements under section 6056 of the Internal Revenue Code (Code), enacted by the Affordable Care Act (generally employers with at least 50 full-time employees, including full-time equivalent employees). Section 6056 requires those employers to report to the IRS information about the health care coverage, if any, they offered to full-time employees, in order to administer the employer shared responsibility provisions of section 4980H of the Code. Section 6056 also requires those employers to furnish related statements to employees that employees may use to determine whether, for each month of the calendar year, they may claim on their individual tax returns a premium tax credit under section 36B (premium tax credit). The regulations provide for a general reporting method and alternative reporting methods designed to simplify and reduce the cost of reporting for employers subject to the information reporting requirements under section 6056. The regulations affect those employers, employees and other individuals.

  6. Nanospray FAIMS Fractionation Provides Significant Increases in Proteome Coverage of Unfractionated Complex Protein Digests*

    Science.gov (United States)

    Swearingen, Kristian E.; Hoopmann, Michael R.; Johnson, Richard S.; Saleem, Ramsey A.; Aitchison, John D.; Moritz, Robert L.

    2012-01-01

    High-field asymmetric waveform ion mobility spectrometry (FAIMS) is an atmospheric pressure ion mobility technique that can be used to reduce sample complexity and increase dynamic range in tandem mass spectrometry experiments. FAIMS fractionates ions in the gas-phase according to characteristic differences in mobilities in electric fields of different strengths. Undesired ion species such as solvated clusters and singly charged chemical background ions can be prevented from reaching the mass analyzer, thus decreasing chemical noise. To date, there has been limited success using the commercially available Thermo Fisher FAIMS device with both standard ESI and nanoLC-MS. We have modified a Thermo Fisher electrospray source to accommodate a fused silica pulled tip capillary column for nanospray ionization, which will enable standard laboratories access to FAIMS technology. Our modified source allows easily obtainable stable spray at flow rates of 300 nL/min when coupled with FAIMS. The modified electrospray source allows the use of sheath gas, which provides a fivefold increase in signal obtained when nanoLC is coupled to FAIMS. In this work, nanoLC-FAIMS-MS and nanoLC-MS were compared by analyzing a tryptic digest of a 1:1 mixture of SILAC-labeled haploid and diploid yeast to demonstrate the performance of nanoLC-FAIMS-MS, at different compensation voltages, for post-column fractionation of complex protein digests. The effective dynamic range more than doubled when FAIMS was used. In total, 10,377 unique stripped peptides and 1649 unique proteins with SILAC ratios were identified from the combined nanoLC-FAIMS-MS experiments, compared with 6908 unique stripped peptides and 1003 unique proteins with SILAC ratios identified from the combined nanoLC-MS experiments. This work demonstrates how a commercially available FAIMS device can be combined with nanoLC to improve proteome coverage in shotgun and targeted type proteomics experiments. PMID:22186714

  7. [Increased financial risks for health insurers: a challenge for providers of mental health care in the Netherlands].

    Science.gov (United States)

    Daansen, P J; van Schilt, J

    2014-01-01

    As from 2014 Dutch health insurance companies will bear the full financial risk for their clients in mental health care. Over the next years the existing risk settlement shared between insurance companies will gradually be brought to a close. Municipalities and the Ministry of Justice are already responsible for or will soon become responsible for financing health care for adolescents, patients with severe psychiatric disorders and forensic psychiatric patients. As a result, the health insurance companies are beginning to impose ever stricter conditions regarding the care 'product' they are 'buying'. To study the possible consequences, for mental health care institutions, of the increased risk to be borne by health care insurers. Use was made of relevant marketing literature and literature relating to mental health care. Studies of Dutch mental health care literature indicate that in the future the purchasing procedure will no longer consider the immediate treatment outcome as the sole performance indicator but will also take into account additional factors such as long-term improvements in patients' health, customer satisfaction and degree of patient participation, patient empowerment and autonomy. In formulating the details of their health products and business strategies, health care providers will now have to take into account not only the efficacy of the treatment they provide but also the purchasing policy and strategy of the health insurance companies.

  8. Captive insurance companies.

    Science.gov (United States)

    Strauss, Peter

    2014-01-01

    The landscape of the business world is changing; and now, more than ever, business owners are recognizing that life is filled with risks: known risk, calculated risk, and unexpected risk. Every day, businesses thrive or fail based on understanding the risk of owning and operating their business, and business owners are recognizing that there are alternative risk financing mechanisms other than simply taking out a basket of standard coverage as recommended by your friendly neighborhood agent. A captive insurance company is an insurance company established to provide a broad range of risk management capabilities to affiliated companies. The captive is owned by the business owner and can provide insurance to the business for potential future losses, whether or not the losses are already covered by a commercial carrier or are "self-insured." The premiums paid by your business are tax deductible. Meanwhile, the premiums that your captive collects are tax-free up to $1.2 million annually.

  9. 25 CFR 900.193 - Does FTCA coverage extend to individuals who provide health care services under a personal...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Does FTCA coverage extend to individuals who provide health care services under a personal services contract providing services in a facility that is owned, operated, or constructed under the jurisdiction of the IHS? 900.193 Section 900.193 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND...

  10. DRIVE AT YOUR OWN RISK: UBER VIOLATES UNFAIR COMPETITION LAWS BY MISLEADING UBERX DRIVERS ABOUT THEIR INSURANCE COVERAGE

    National Research Council Canada - National Science Library

    Jennie Davis

    2015-01-01

    .... This Note asserts that Uber misleads uberX drivers about the type and amount of coverage available to them, as uberX drivers have no first-party protections in place while they drive around searching for fares...

  11. Health Insurance: Most College Students Are Covered through Employer-Sponsored Plans, and Some Colleges and States Are Taking Steps to Increase Coverage. Report to the Committee on Health, Education, Labor, and Pensions, U.S. Senate. GAO-08-389

    Science.gov (United States)

    Dicken, John E.

    2008-01-01

    College students face challenges obtaining health insurance: they may not have access to insurance through an employer, and as they get older, they may lose dependent coverage obtained through a parent's plan. Federal law ensures continued access to health insurance for some, but not all, such students. Without health insurance, college students…

  12. Children's Health in Washington, D.C.: Access and Health Challenges despite High Insurance Coverage Rates. Research Highlights

    Science.gov (United States)

    Adamson, David M.

    2009-01-01

    In Washington, D.C., the vast majority of children have health insurance. Yet District children often lack sufficient access to medical care and face significant health threats from chronic conditions and risk factors such as exposure to violence in schools and neighborhoods. These findings emerged from an assessment of children's health in…

  13. Impact of universal health insurance coverage in Thailand on sales and market share of medicines for non-communicable diseases: an interrupted time series study.

    Science.gov (United States)

    Garabedian, Laura Faden; Ross-Degnan, Dennis; Ratanawijitrasin, Sauwakon; Stephens, Peter; Wagner, Anita Katharina

    2012-01-01

    In 2001, Thailand implemented the Universal Coverage Scheme (UCS), a public insurance system that aimed to achieve universal access to healthcare, including essential medicines, and to influence primary care centres and hospitals to use resources efficiently, via capitated payment for outpatient services and other payment policies for inpatient care. Our objective was to evaluate the impact of the UCS on utilisation of medicines in Thailand for three non-communicable diseases: cancer, cardiovascular disease and diabetes. Interrupted time-series design, with a non-equivalent comparison group. Thailand, 1998-2006. Quarterly purchases of medicines from hospital and retail pharmacies collected by IMS Health between 1998 and 2006. UCS implementation, April-October 2001. Total pharmaceutical sales volume and percent market share by licensing status and National Essential Medicine List status. The UCS was associated with long-term increases in sales of medicines for conditions that are typically treated in outpatient primary care settings, such as diabetes, high cholesterol and high blood pressure, but not for medicines for diseases that are typically treated in secondary or tertiary care settings, such as heart failure, arrhythmias and cancer. Although the majority of increases in sales were for essential medicines, there were also postpolicy increases in sales of non-essential medicines. Immediately following the reform, there was a significant shift in hospital sector market share by licensing status for most classes of medicines. Government-produced products often replaced branded generic or generic competitors. Our results suggest that expanding health insurance coverage with a medicine benefit to the entire Thai population increased access to medicines in primary care. However, our study also suggests that the UCS may have had potentially undesirable effects. Evaluations of the long-term impacts of universal health coverage on medicine utilisation are urgently

  14. Impact of universal health insurance coverage in Thailand on sales and market share of medicines for non-communicable diseases: an interrupted time series study

    Science.gov (United States)

    Garabedian, Laura Faden; Ross-Degnan, Dennis; Ratanawijitrasin, Sauwakon; Stephens, Peter; Wagner, Anita Katharina

    2012-01-01

    Objective In 2001, Thailand implemented the Universal Coverage Scheme (UCS), a public insurance system that aimed to achieve universal access to healthcare, including essential medicines, and to influence primary care centres and hospitals to use resources efficiently, via capitated payment for outpatient services and other payment policies for inpatient care. Our objective was to evaluate the impact of the UCS on utilisation of medicines in Thailand for three non-communicable diseases: cancer, cardiovascular disease and diabetes. Design Interrupted time-series design, with a non-equivalent comparison group. Setting Thailand, 1998–2006. Data Quarterly purchases of medicines from hospital and retail pharmacies collected by IMS Health between 1998 and 2006. Intervention UCS implementation, April–October 2001. Outcome measures Total pharmaceutical sales volume and percent market share by licensing status and National Essential Medicine List status. Results The UCS was associated with long-term increases in sales of medicines for conditions that are typically treated in outpatient primary care settings, such as diabetes, high cholesterol and high blood pressure, but not for medicines for diseases that are typically treated in secondary or tertiary care settings, such as heart failure, arrhythmias and cancer. Although the majority of increases in sales were for essential medicines, there were also postpolicy increases in sales of non-essential medicines. Immediately following the reform, there was a significant shift in hospital sector market share by licensing status for most classes of medicines. Government-produced products often replaced branded generic or generic competitors. Conclusions Our results suggest that expanding health insurance coverage with a medicine benefit to the entire Thai population increased access to medicines in primary care. However, our study also suggests that the UCS may have had potentially undesirable effects. Evaluations of the long

  15. Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme--a systems approach.

    Science.gov (United States)

    Agyepong, Irene A; Aryeetey, Geneieve C; Nonvignon, Justice; Asenso-Boadi, Francis; Dzikunu, Helen; Antwi, Edward; Ankrah, Daniel; Adjei-Acquah, Charles; Esena, Reuben; Aikins, Moses; Arhinful, Daniel K

    2014-08-05

    Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour. A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear

  16. The Commercialisation of Modern Islamic Insurance Providers: A Study of Takaful Business Frameworks in Malaysia

    Directory of Open Access Journals (Sweden)

    Kamaruzaman Noordin

    2014-06-01

    Full Text Available A commercial insurance contract is deemed invalid by many Muslim scholars due to the fact that it is a mu`awada (financial exchange contract, which is overwhelmed by prohibited elements such as gharar (uncertainty, riba (interest, and maysir (gambling. As an alternative, a Shari`acompliant insurance scheme (also known as takaful that supposedly run on the principles of mutual co-operation was proposed by the scholars and subsequently institutionalized in the late 1970s. Nevertheless, after more than 30 years, it appears that the majority of takaful operators currently exist worldwide were established as joint-stock or public limited companies (PLCs. As a result, it could be argued that the original concept of takaful was later overshadowed by the element of profit-making as observed in commercial insurance entities. This paper therefore sets out to examine those issues, which directly relate to this form of commercialisation. It argues that since the establishment of insurance companies based on commercial framework is impermissible, it could possibly affect the validity of present takaful arrangement. This study is mainly qualitative and relies greatly upon the documentation method. It is also based on afieldwork method, since the business models adopted by several takaful operators in Malaysia are carefully examined. In general, it is found that the characteristics of a commercial takaful entity may not necessarily be similar to that of its conventional counterpart.

  17. 25 CFR 900.195 - Does FTCA coverage extend to the contractor's health care practitioners providing services to...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Does FTCA coverage extend to the contractor's health care practitioners providing services to private patients on a fee-for-services basis when such personnel (not the self-determination contractor) receive the fee? 900.195 Section 900.195 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR, AND...

  18. Does employer-provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer.

    Science.gov (United States)

    Bradley, Cathy J; Neumark, David; Barkowski, Scott

    2013-09-01

    Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse's employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11% smaller. Women's subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Analyzing disparity trends for health care insurance coverage among non-elderly adults in the US: evidence from the Behavioral Risk Factor Surveillance System, 1993-2009.

    Science.gov (United States)

    Assaf, Shireen; Campostrini, Stefano; Di Novi, Cinzia; Xu, Fang; Gotway Crawford, Carol

    2017-04-01

    To explore the changing disparities in access to health care insurance in the United States using time-varying coefficient models. Secondary data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1993 to 2009 was used. A time-varying coefficient model was constructed using a binary outcome of no enrollment in health insurance plan versus enrolled. The independent variables included age, sex, education, income, work status, race, and number of health conditions. Smooth functions of odds ratios and time were used to produce odds ratio plots. Significant time-varying coefficients were found for all the independent variables with the odds ratio plots showing changing trends except for a constant line for the categories of male, student, and having three health conditions. Some categories showed decreasing disparities, such as the income categories. However, some categories had increasing disparities in health insurance enrollment such as the education and race categories. As the Affordable Care Act is being gradually implemented, studies are needed to provide baseline information about disparities in access to health insurance, in order to gauge any changes in health insurance access. The use of time-varying coefficient models with BRFSS data can be useful in accomplishing this task.

  20. Competing for consumers. Coming coordinated-care squeeze prompts providers to push into insurance market.

    Science.gov (United States)

    Evans, Melanie

    2013-04-29

    Squeezed by coordinated-care initiatives, a number of hospital systems are looking to help fill beds and reap more revenue by offering insurance plans on the state exchanges set to launch this fall. Some will use narrow networks, a strategy that allows systems to create a captive customer base. "I think it's going to be a huge growth area in the exchanges," says Jonathan Gruber, left, a professor of economics at MIT.

  1. The role of micro health insurance in providing financial risk protection in developing countries--a systematic review.

    Science.gov (United States)

    Habib, Shifa Salman; Perveen, Shagufta; Khuwaja, Hussain Maqbool Ahmed

    2016-03-22

    Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI) has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. We conducted a systematic search for published literature using the search terms "Community based health insurance AND developing countries", "Micro health insurance AND developing countries", "Mutual health insurance AND developing countries", "mutual OR micro OR community based health insurance" "Health insurance AND impact AND poor" "Health insurance AND financial protection" and "mutual health organizations" on three databases, Pubmed, Google Scholar and Science Direct (Elsevier). Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa). Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure, household borrowings and poverty. MHI also had a positive safeguarding effect on

  2. State budget transfers to health insurance funds: extending universal health coverage in low- and middle-income countries of the WHO European Region.

    Science.gov (United States)

    Mathauer, Inke; Theisling, Mareike; Mathivet, Benoit; Vilcu, Ileana

    2016-04-02

    Many low-and middle-income countries (LMIC) of the World Health Organization (WHO) European Region have introduced social health insurance payroll taxes after the political transition in the late 1980s, combined with budget transfers to allow for exempting specific population groups from paying contributions, such as those outside formal sector work and in particular vulnerable groups. This paper assesses the institutional design aspects of such financing arrangements and their performance with respect to universal health coverage progress in LMIC of the European region. The study is based on a literature review and review of secondary databases for the performance assessment. Such financing arrangements currently exist in 13 LMIC of that region, with strong commonalities in institutional design: This includes a wide range of different eligible population groups, mostly mandatory membership, integrated pools for both the exempted and contributors, and relatively comprehensive benefit packages. Performance is more varied. Enrolment rates range from about 65 % to above 95 %, and access to care and financial protection has improved in several countries. Yet, inequities between income quintiles persist. Budget transfers to health insurance arrangements have helped to deepen UHC or maintain achievements with respect to UHC in these European LMICs by covering those outside formal sector work, and in particular vulnerable population groups. However, challenges remain: a comprehensive benefit package on paper is not enough as long as supply side constraints and quality gaps as well as informal payments prevail. A key policy question is how to reach those so far uncovered.

  3. Increasing Access to Oral Anticancer Medicines in Middle-Income Countries: A Case Study of Private Health Insurance Coverage in Brazil.

    Science.gov (United States)

    Massard da Fonseca, Elize; Bastos, Francisco Inácio; Lopes, Gilberto

    2016-02-01

    The World Health Organization estimates that approximately 60% of the world's new annual cancer cases occur in Asia, Africa, and Central and South America, and that 70% of cancer deaths occur in these regions. Although oral chemotherapy is a promising intervention for cancer treatment, given its high cost, it is usually unavailable in middle-income countries. In 2013, after strong lobbying from civil society, Brazil's Congress passed legislation mandating that all private health insurance companies provide access to oral antineoplastic treatment. The decision to scale up the provision of oral chemotherapy was a watershed event in the regulation of private health insurance in Brazil. Until then, private insurers, which cover 25% of the population, were exempted from the provision of pharmaceutical drugs for home care treatments. This article explores the political process involved in regulating the provision of oral chemotherapy medicines by private health insurers. Elements of this successful advocacy case included investment in strategic communication, specialized knowledge of regulatory policy, and the ability to act via democratic channels of political representation. In turn, the receptiveness of government branches such as the Congress and regulating bodies, as well as the Cancer Awareness Month campaign, opened a window of opportunity. However, prospects for expanded access to such medicines in the public health system are bleak in the short term because of the ongoing political and economic crisis.

  4. The role of micro health insurance in providing financial risk protection in developing countries- a systematic review

    Directory of Open Access Journals (Sweden)

    Shifa Salman Habib

    2016-03-01

    Full Text Available Abstract Background Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting. Methods We conducted a systematic search for published literature using the search terms “Community based health insurance AND developing countries”, “Micro health insurance AND developing countries”, “Mutual health insurance AND developing countries”, “mutual OR micro OR community based health insurance” “Health insurance AND impact AND poor” “Health insurance AND financial protection” and “mutual health organizations” on three databases, Pubmed, Google Scholar and Science Direct (Elsevier. Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization. Results Twenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa. Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure

  5. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Employer-sponsored insurance health plans. 440.350... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may provide... health insurance. (b) The State must assure that employer sponsored plans meet the requirements of...

  6. 78 FR 52719 - Tax Credit for Employee Health Insurance Expenses of Small Employers

    Science.gov (United States)

    2013-08-26

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BL55 Tax Credit for Employee Health Insurance Expenses of... certain small employers that offer health insurance coverage to their employees under section 45R of the... ``Affordable Care Act''). I. Section 45R Section 45R(a) provides for a health insurance tax credit in the case...

  7. Study of Global Health Strategy Based on International Trends: -Promoting Universal Health Coverage Globally and Ensuring the Sustainability of Japan's Universal Coverage of Health Insurance System: Problems and Proposals.

    Science.gov (United States)

    Hatanaka, Takashi; Eguchi, Narumi; Deguchi, Mayumi; Yazawa, Manami; Ishii, Masami

    2015-09-01

    The Japanese government at present is implementing international health and medical growth strategies mainly from the viewpoint of business. However, the United Nations is set to resolve the Post-2015 Development Agenda in the fall of 2015; the agenda will likely include the achievement of universal health coverage (UHC) as a specific development goal. Japan's healthcare system, the foundation of which is its public, nationwide universal health insurance program, has been evaluated highly by the Lancet. The World Bank also praised it as a global model. This paper presents suggestions and problems for Japan regarding global health strategies, including in regard to several prerequisite domestic preparations that must be made. They are summarized as follows. (1) The UHC development should be promoted in coordination with the United Nations, World Bank, and Asian Development Bank. (2) The universal health insurance system of Japan can be a global model for UHC and ensuring its sustainability should be considered a national policy. (3) Trade agreements such as the Trans-Pacific Partnership (TPP) should not disrupt or interfere with UHC, the form of which is unique to each nation, including Japan. (4) Japan should disseminate information overseas, including to national governments, people, and physicians, regarding the course of events that led to the establishment of the Japan's universal health insurance system and should make efforts to develop international human resources to participate in UHC policymaking. (5) The development of separate healthcare programs and UHC preparation should be promoted by streamlining and centralizing maternity care, school health, infectious disease management such as for tuberculosis, and emergency medicine such as for traffic accidents. (6) Japan should disseminate information overseas about its primary care physicians (kakaritsuke physicians) and develop international human resources. (7) Global health should be developed in

  8. An Investigation of the Factors Affecting the Purchase of Comprehensive Car Insurance Policies of Vehicle Owners

    Directory of Open Access Journals (Sweden)

    Hakan EYGÜ

    2012-09-01

    Full Text Available Comprehensive insurance is the coverage purchased by the individuals in exchange for the premiums paid for insuring their movable properties against the damages caused by either their or others’ faults. Comprehensive insurance is generally rooted in the automotive sector and its applications are generally designed for this sector. Vehicle owners buy their vehicles according to their tastes using a considerable part of their savings. Purchasing of a comprehensive car insurance policy means that the purchaser is transferring the costs borne by the risks to be occurred related to his or her vehicle to the insurance company. Thus, the vehicle is insured against any costs arise in case of any damage. This study were examined to investigate the comprehensive car insurance policy ownership ratio of vehicle owners, factors that may be affecting the ownership of such policies, opinions of policy owners on the insurance company providing the coverage and the factors affecting the decision of not purchasing comprehensive car insurance policies.

  9. Immigrants and employer-sponsored health insurance.

    Science.gov (United States)

    Buchmueller, Thomas C; Lo Sasso, Anthony T; Lurie, Ithai; Dolfin, Sarah

    2007-02-01

    To investigate the factors underlying the lower rate of employer-sponsored health insurance coverage for foreign-born workers. 2001 Survey of Income and Program Participation. We estimate probit regressions to determine the effect of immigrant status on employer-sponsored health insurance coverage, including the probabilities of working for a firm that offers coverage, being eligible for coverage, and taking up coverage. We identified native born citizens, naturalized citizens, and noncitizen residents between the ages of 18 and 65, in the year 2002. First, we find that the large difference in coverage rates for immigrants and native-born Americans is driven by the very low rates of coverage for noncitizen immigrants. Differences between native-born and naturalized citizens are quite small and for some outcomes are statistically insignificant when we control for observable characteristics. Second, our results indicate that the gap between natives and noncitizens is explained mainly by differences in the probability of working for a firm that offers insurance. Conditional on working for such a firm, noncitizens are only slightly less likely to be eligible for coverage and, when eligible, are only slightly less likely to take up coverage. Third, roughly two-thirds of the native/noncitizen gap in coverage overall and in the probability of working for an insurance-providing employer is explained by characteristics of the individual and differences in the types of jobs they hold. The substantially higher rate of uninsurance among immigrants is driven by the lower rate of health insurance offers by the employers of immigrants.

  10. Toward Better Access to Health Insurance Coverage for U.S. Retirees in Mexico Mejor accesibilidad a los seguros de salud para jubilados estadunidenses residentes en México

    Directory of Open Access Journals (Sweden)

    David C. Warner

    2001-02-01

    Full Text Available Many retirees from the United States of America have limited health insurance coverage while living in Mexico. Medicare and Medicaid benefits are not portable to other countries and Medigap (private insurance that supplements Medicare is very limited. This causes economic and medical hardships and serves as a barrier to retirement to Mexico. Increasing numbers of U.S. retirees will be interested in moving to Mexico in the future because of the climate, the culture, and the lower cost of living. The numbers are increasing as a result of several factors such as aging "baby boomers" and the rapidly growing Mexican-origin population in the U.S.A. who are citizens or permanent residents but would like to return to their communities of origin after working in the U.S.A. There are several policy initiatives that could provide opportunities for improving health insurance coverage for these retirees that could be cost-effective. The full version of this paper is available too at: http://www.insp.mx/salud/index.htmlMuchos jubilados estadunidenses cuentan con una cobertura de seguro médico restringida mientras viven en México. Los beneficios de Medicare y Medicaid no son transferibles a otros países, y el Medigap (el seguro privado que complementa a Medicare es muy limitado. Esto genera privaciones económicas y médicas y es una barrera para el retiro en México. Un número creciente de jubilados estadunidenses estaría interesado en mudarse a México en el futuro, debido al clima, la cultura y el costo más bajo de la vida. Este número creciente es resultado de varios factores: el envejecimiento de los baby boomers y la creciente población de origen mexicano con ciudadanía estadunidense o con residencia permanente, a la que le gustaría regresar a su comunidad de origen después de haber trabajado en Estados Unidos de América. En este trabajo se presentan diversas iniciativas que podrían ofrecer oportunidades para mejorar la cobertura de seguro m

  11. Physicians cite hurdles ranging from lack of coverage to poor communication in providing high-quality care to latinos.

    Science.gov (United States)

    Vargas Bustamante, Arturo; Chen, Jie

    2011-10-01

    We surveyed physicians about their ability to provide high-quality care to patients from diverse ethnic backgrounds. Primarily, we wanted to explore the challenges faced by physicians treating Latino patients compared to physicians whose patients were primarily white and non-Latino. We found that physicians treating Latinos, particularly those who worked in primary care in comparison to specialists, were less likely than physicians treating primarily white patients to believe in their ability to provide high-quality care. They cited problems of inadequate time with patients, patients' ability to pay, patients' nonadherence to recommended treatment, difficulties communicating with patients, relative lack of specialist availability, and lack of timely transmission of reports among physicians. Insurance expansions and complementary reforms mandated by the Affordable Care Act of 2010 and other recent legislation should aid physicians in closing some of these gaps in quality.

  12. Micro-insurance as the Basis for Development of Voluntary Medical Insurance in Ukraine

    Directory of Open Access Journals (Sweden)

    Pahnenko Olena M.

    2014-01-01

    Full Text Available The article analyses the modern state of development of medical insurance in Ukraine and also studies advantages and shortcomings of the use of micro-insurance for popularisation of programmes of voluntary medical insurance and satisfaction of needs in high quality medical services for all layers of the population. It identifies that as of today the Ukrainian healthcare system is at the stage of reformation, mandatory medical insurance is not yet introduced and main consumers of the programmes of voluntary medical insurance are corporate clients. The article considers main constraints of development of medical insurance in Ukraine, including: low level of income of the population; absence of high quality providers of medical services in regions; and insufficient degree of trust of the population to the insurance sphere. The article shows that introduction of micro-insurance would positively influence the development of insurance medicine in the country, would facilitate provision of medical services even for poor citizens and would allow reduction of state budget expenditures on healthcare. The conducted study of restrictions and shortcomings of introduction of micro-insurance allowed identification of the fact that main of them are information asymmetry (unfavourable selection of risks, moral risk and insurance fraud, significant limitation of insurance coverage and difficulties in identifying optimal insurance tariffs.

  13. Insuring low-level radioactive waste sites: Past, present, and future

    Energy Technology Data Exchange (ETDEWEB)

    Viveiros, G.F. III

    1989-11-01

    The primary purpose of the paper is to provide information concerning the availability of nuclear liability insurance coverage under the Facility Form for low-level radioactive waste facilities only. The paper describes the past history of insurers and their merger into the Nuclear Atomic Energy Liability Underwriters (MAELU). The paper discusses the coverage afforded, underwriting suspension, and work the nuclear insurance pools are doing to lift the suspension.

  14. Chinese newspaper coverage of (unproven) stem cell therapies and their providers.

    Science.gov (United States)

    Ogbogu, Ubaka; Du, Li; Rachul, Christen; Bélanger, Lisa; Caulfield, Timothy

    2013-04-01

    China is a primary destination for stem cell tourism, the phenomenon whereby patients travel abroad to receive unproven stem cell-based treatments that have not been approved in their home countries. Yet, much remains unknown about the state of the stem cell treatment industry in China and about how the Chinese view treatments and providers. Given the media's crucial role in science/health communication and in framing public dialogue, this study sought to examine Chinese newspaper portrayal and perceptions of stem cell treatments and their providers. Based on a content analysis of over 300 newspaper articles, the study revealed that while Chinese newspaper reporting is generally neutral in tone, it is also inaccurate, overly positive, heavily influenced by "interested" treatment providers and focused on the therapeutic uses of stem cells to address the health needs of the local population. The study findings suggest a need to counterbalance providers' influence on media reporting through strategies that encourage media uptake of accurate information about stem cell research and treatments.

  15. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Science.gov (United States)

    2010-06-28

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ57 Requirements for Group Health Plans and Health Insurance... temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The text of those temporary regulations also serves as the text...

  16. AEE's Report on the Insurance Issue: Part II.

    Science.gov (United States)

    Marlow, Peggy

    1986-01-01

    Sixty-three outdoor adventure programs were reviewed to research the availability of general liability insurance for outdoor programs. Data were gathered on populations served, activities, insurer, and amount of general liability coverage. Three companies offered policies with high risk activity exclusions. Alternative ways to provide for…

  17. Concomitant administration of pneumococcal-23 and zoster vaccines provides adequate herpes zoster coverage.

    Science.gov (United States)

    Wyman, Marcia J; Stabi, Katie L

    2013-01-01

    To determine whether concomitant administration of zoster vaccine and polysaccharide pneumococcal-23 vaccine (PPV23) provides sufficient protection against herpes zoster infections. Literature was retrieved through the Centers for Disease Control and Prevention (CDC) website, PubMed (inception-February 2013), and Scopus (inception-February 2013) using the key words herpes zoster, pneumococcal, vaccine, concomitant, simultaneous administration, Pneumovax, Zostavax, and barriers. In addition, reference citations from publications were used. All English-language articles identified from the data sources were evaluated. Two studies evaluating concomitant and nonconcomitant administration of zoster vaccine and PPV23 were included. Current product labeling recommends a 4-week interval between zoster vaccine and PPV23 administration; however, the Food and Drug Administration (FDA) and the CDC promote concomitant administration to prevent a missed opportunity to vaccinate. This has caused confusion among health care professionals regarding the appropriate timing of these vaccines. A randomized trial that evaluated the immunogenicity of zoster vaccine and PPV23 given together versus separated by at least 4 weeks demonstrated that the varicella zoster virus (VZV) antibody levels of concomitant versus nonconcomitant vaccination groups did not meet noninferiority requirements. However, a large retrospective cohort trial that compared the incidence of herpes zoster infections following concomitant versus nonconcomitant administration of PPV23 and zoster vaccine did not find a statistically significant between-group difference. Concomitant administration of zoster vaccine and PPV23 is advocated by the CDC and FDA to improve immunization rates among vaccine-eligible individuals. Since there is no direct evidence that simultaneous administration of zoster vaccine and PPV23 puts patients at increased risk of developing herpes zoster, the vaccines should be given during the same

  18. Inequity between male and female coverage in state infertility laws.

    Science.gov (United States)

    Dupree, James M; Dickey, Ryan M; Lipshultz, Larry I

    2016-06-01

    To analyze state insurance laws mandating coverage for male factor infertility and identify possible inequities between male and female coverage in state insurance laws. We identified states with laws or codes related to infertility insurance coverage using the National Conference of States Legislatures' and the National Infertility Association's websites. We performed a primary, systematic analysis of the laws or codes to specifically identify coverage for male factor infertility services. Not applicable. Not applicable. Not applicable. The presence or absence of language in state insurance laws mandating coverage for male factor infertility care. There are 15 states with laws mandating insurance coverage for female factor infertility. Only eight of those states (California, Connecticut, Massachusetts, Montana, New Jersey, New York, Ohio, and West Virginia) have mandates for male factor infertility evaluation or treatment. Insurance coverage for male factor infertility is most specific in Massachusetts, New Jersey, and New York, yet significant differences exist in the male factor policies in all eight states. Three states (Massachusetts, New Jersey, and New York) exempt coverage for vasectomy reversal. Despite national recommendations that male and female partners begin infertility evaluations together, only 8 of 15 states with laws mandating infertility coverage include coverage for the male partner. Excluding men from infertility coverage places an undue burden on female partners and risks missing opportunities to diagnose serious male health conditions, correct reversible causes of infertility, and provide cost-effective treatments that can downgrade the intensity of intervention required to achieve a pregnancy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Perceived Relationships among Components of Insurance Service for Users of Complementary Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Urban Sebjan

    2013-12-01

    Full Text Available This article explores the relationship between the components of the services provided by complementary voluntary health insurance (CVHI, to which users ascribe different levels of importance. Research model that consists of four constructs (importance of quality service, additional coverage, price discounts of CVHI and insurance company reputation and an indicator of the importance of insurance premium of CVHI was tested with structural equation modelling (SEM on the sample of 300 Slovenian users of CVHI. Our findings show that - according to the users - the importance of the component of CVHI service (insurance premium is reflected in the perceived importance of other components of CVHI (additional coverage, quality, price discounts and insurance company reputation.

  20. Climate Effects on Rainfall Index Insurance Purchase Decisions

    OpenAIRE

    James L. Novak; Nadolnyak, Denis A.

    2008-01-01

    Rainfall Index (RI) insurance provides forage and hay producers with group risk protection against drought related losses. However, insurance premiums and risk protection are currently based on pooled weather data series and do not account for the impacts of specific climate phases, specifically the El Niño Southern Oscillation (ENSO), on local rainfall distribution. This analysis examines differences in the expected payoffs on the RI insurance under varying coverage levels based on probabili...

  1. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal.

    Science.gov (United States)

    Ruiz-Casares, Mónica; Cleveland, Janet; Oulhote, Youssef; Dunkley-Hickin, Catherine; Rousseau, Cécile

    2016-01-01

    Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.

  2. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal.

    Directory of Open Access Journals (Sweden)

    Mónica Ruiz-Casares

    Full Text Available Following changes to the Interim Federal Health (IFH program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues.

  3. Explaining the Growth in US Health Care Spending Using State-Level Variation in Income, Insurance, and Provider Market Dynamics.

    Science.gov (United States)

    Herring, Bradley; Trish, Erin

    2015-01-01

    The slowed growth in national health care spending over the past decade has led analysts to question the extent to which this recent slowdown can be explained by predictable factors such as the Great Recession or must be driven by some unpredictable structural change in the health care sector. To help address this question, we first estimate a regression model for state personal health care spending for 1991-2009, with an emphasis on the explanatory power of income, insurance, and provider market characteristics. We then use the results from this simple predictive model to produce state-level projections of health care spending for 2010-2013 to subsequently compare those average projected state values with actual national spending for 2010-2013, finding that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns. We also use the results from this predictive model to both examine the Great Recession's likely reduction in health care spending and project the Affordable Care Act's insurance expansion's likely increase in health care spending. © The Author(s) 2015.

  4. How to best define target populations of medicines in view of their coverage by the national health insurance scheme?

    Science.gov (United States)

    Hamers, Françoise F; Massol, Jacques; Maillère, Patricia

    2010-01-01

    The target population of a medicine may include different populations that may partially overlap including the population that has been evaluated in the clinical trials, the population for which the medicine provides an actual benefit (SMR), that for which the drug provides an improvement of the actual benefit (ASMR), etc. The definition of the target population in both qualitative and quantitative terms has key public health and economic implications. Recommendations are made to shed light on the definitions, to clarify the requests of the public decision makers and to improve the methods and the sources allowing the quantification of target populations. © 2010 Société Française de Pharmacologie et de Thérapeutique.

  5. Variation in hepatitis B immunization coverage rates associated with provider practices after the temporary suspension of the birth dose

    Directory of Open Access Journals (Sweden)

    Mullooly John P

    2006-11-01

    Full Text Available Abstract Background In 1999, the American Academy of Pediatrics and U.S. Public Health Service recommended suspending the birth dose of hepatitis B vaccine due to concerns about potential mercury exposure. A previous report found that overall national hepatitis B vaccination coverage rates decreased in association with the suspension. It is unknown whether this underimmunization occurred uniformly or was associated with how providers changed their practices for the timing of hepatitis B vaccine doses. We evaluate the impact of the birth dose suspension on underimmunization for the hepatitis B vaccine series among 24-month-olds in five large provider groups and describe provider practices potentially associated with underimmunization following the suspension. Methods Retrospective cohort study of children enrolled in five large provider groups in the United States (A-E. Logistic regression was used to evaluate the association between the birth dose suspension and a child's probability of being underimmunized at 24 months for the hepatitis B vaccine series. Results Prior to July 1999, the percent of children who received a hepatitis B vaccination at birth varied widely (3% to 90% across the five provider groups. After the national recommendation to suspend the hepatitis B birth dose, the percent of children who received a hepatitis B vaccination at birth decreased in all provider groups, and this trend persisted after the policy was reversed. The most substantial decreases were observed in the two provider groups that shifted the first hepatitis B dose from birth to 5–6 months of age. Accounting for temporal trend, children in these two provider groups were significantly more likely to be underimmunized for the hepatitis B series at 24 months of age if they were in the birth dose suspension cohort compared with baseline (Group D OR 2.7, 95% CI 1.7 – 4.4; Group E OR 3.1, 95% CI 2.3 – 4.2. This represented 6% more children in Group D and 9

  6. Surviving the Current Hard Insurance Market.

    Science.gov (United States)

    Shoaf, Lawrence G.

    1986-01-01

    School districts can expect to see significant increases in insurance renewal premiums. Advice is offered on safety and loss control procedures, dealing with an insurance broker, and bidding for insurance coverage. (MLF)

  7. 76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Science.gov (United States)

    2011-06-24

    ... the Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human... with respect to group health plans and health insurance coverage offered in connection with a group.... The temporary regulations provide guidance to employers, group health plans, and health insurance...

  8. How Medicaid Enrollees Fare Compared with Privately Insured and Uninsured Adults: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.

    Science.gov (United States)

    Gunja, Munira Z; Collins, Sara R; Blumenthal, David; Doty, Michelle M; Beutel, Sophie

    2017-04-01

    ISSUE: The number of Americans insured by Medicaid has climbed to more than 70 million, with an estimated 12 million gaining coverage under the Affordable Care Act’s Medicaid expansion. Still, some policymakers have questioned whether Medicaid coverage actually improves access to care, quality of care, or financial protection. GOALS: To compare the experiences of working-age adults who were either: covered all year by private employer or individual insurance; covered by Medicaid for the full year; or uninsured for some time during the year. METHOD: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. FINDINGS AND CONCLUSIONS: The level of access to health care that Medicaid coverage provides is comparable to that afforded by private insurance. Adults with Medicaid coverage reported better care experiences than those who had been uninsured during the year. Medicaid enrollees have fewer problems paying medical bills than either the privately insured or the uninsured.

  9. Health Insurance and Children with Disabilities

    Science.gov (United States)

    Szilagyi, Peter G.

    2012-01-01

    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…

  10. The Israeli Long-Term Care Insurance Law: selected issues in providing home care services to the frail elderly.

    Science.gov (United States)

    Schmid, Hillel

    2005-05-01

    The paper describes and analyses selected issues related to the provision of home care services to frail elderly people following the Israeli Long-Term Care Insurance Law (1988). The goals and principles of the Law, which mandates the provision of home care services to frail elderly people, are presented. The paper also evaluates its contribution toward enhancing the well-being of elderly clients. Several major dilemmas that arose following implementation of the Law are analysed and evaluated in comparison with other countries that have enacted and implemented similar laws. These dilemmas are community vs institutional care; services in kind vs monetary allowances; service provision through contracting out with nongovernmental agencies; unstable and unskilled labour force; and service quality. Finally, policy implications are discussed, mainly in the following areas: investment in human resources as a condition for achieving high service quality, and the need for coordination between the agencies that provide long-term care services to elderly people.

  11. Towards universal health coverage in India: a historical examination of the genesis of Rashtriya Swasthya Bima Yojana - The health insurance scheme for low-income groups.

    Science.gov (United States)

    Virk, A K; Atun, R

    2015-06-01

    Many low- and middle-income countries have introduced State-funded health programmes for vulnerable groups as part of global efforts to universalise health coverage. Similarly, India introduced the Rashtriya Swasthya Bima Yojana (RSBY) in 2008, a publicly-funded national health insurance scheme for people below the poverty line. The authors explore the RSBY's genesis and early development in order to understand its conceptualisation and design principles and thereby establish a baseline for assessing RSBY's performance in the future. Qualitative case study of the RSBY in Delhi. This paper presents results from documentary analysis and semi-structured interviews with senior-level policymakers including the former Labour Minister, central government officials and affiliates, and technical specialists from the World Bank and GIZ. With national priorities focused on broader economic development goals, the RSBY was conceptualised as a social investment in worker productivity and future economic growth in India. Hence, efficiency, competition, and individual choice rather than human needs or egalitarian access were overriding concerns for RSBY designers. This measured approach was strongly reflected in RSBY's financing and benefit structure. Hence, the programme's focus on only the 'poorest' (BPL) among the poor. Similarly, only costlier forms of care, secondary treatments in hospitals, which policymakers felt were more likely to have catastrophic financial consequences for users were covered. This paper highlights the risks of a narrow approach driven by developmental considerations alone. Expanding access and improving financial protection in India and elsewhere requires a more balanced approach and evidence-informed health policies that are guided by local morbidity and health spending patterns. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Voluntary Health Insurance expenditure in low- and middle-income countries: Exploring trends during 1995-2012 and policy implications for progress towards universal health coverage.

    Science.gov (United States)

    Pettigrew, Luisa M; Mathauer, Inke

    2016-04-18

    Most low- and middle-income countries (LMIC) rely significantly on private health expenditure in the form of out-of-pocket payments (OOP) and voluntary health insurance (VHI). This paper assesses VHI expenditure trends in LMIC and explores possible explanations. This illuminates challenges deriving from changes in VHI expenditure as countries aim to progress equitably towards universal health coverage (UHC). Health expenditure data was retrieved from the WHO Global Health Expenditure Database to calculate VHI, OOP and general government health (GGHE) expenditure as a share of total health expenditure (THE) for the period of 1995-2012. A literature analysis offered potential reasons for trends in countries and regions. In 2012, VHI as a percentage of THE (abbreviated as VHI%) was below 1 % in 49 out of 138 LMIC. Twenty-seven countries had no or more than five years of data missing. VHI% ranged from 1 to 5 % in 39 LMIC and was above 5 % in 23 LMIC. There is an upwards average trend in VHI% across all regions. However, increases in VHI% cannot be consistently linked with OOP falling or being redirected into private prepayment. There are various countries which exhibit rising VHI alongside a rise in OOP and fall in GGHE, which is a less desirable path in order to equitably progress towards UHC. Reasons for the VHI expenditure trends across LMIC include: external influences; government policies on the role of VHI and its regulation; and willingness and ability of the population to enrol in VHI schemes. Many countries have paid insufficient attention to the potentially risky role of VHI for equitable progress towards UHC. Expanding VHI markets bear the risk of increasing fragmentation and inequities. To avoid this, health financing strategies need to be clear regarding the role given to VHI on the path towards UHC.

  13. Breast cancer screening among women in Namibia: explaining the effect of health insurance coverage and access to information on screening behaviours.

    Science.gov (United States)

    Kangmennaang, Joseph; Mkandawire, Paul; Luginaah, Isaac

    2017-09-01

    Breast cancer contributes substantially to morbidity and mortality in Namibia as is the case in most countries in Sub-Saharan Africa (SSA). However, there is a dearth of nationally representative studies that examine the odds of screening for breast cancer in Namibia and SSA at large. This paper aims to fill this gap by examining the determinants of breast cancer screening guided by the Health Belief Model. We applied hierarchical binary logit regression models to explore the determinants of breast cancer screening using the 2013 Namibia Demography and Health Survey (NDHS). We accounted for the effect of unobserved heterogeneity that may affect breast cancer, testing behaviours among women cluster level. The NDHS is a nationally representative dataset that has recently started to collect information on cancer screening. The results show that women who have health insurance coverage (odds ratio (OR) = 1.62, p ≤ 0.01), maintain contact with health professionals (OR = 1.47, p = 0.01), and who have secondary (OR = 1.38, p = 0.01) and higher (OR = 1.77, p ≤ 0.01) education were more likely to be screened for breast cancer. Factors that influence women's perception of their susceptibility to breast cancer such as birthing experience, age, region and place of residence were associated with screening in this context. Overall, the health belief model predicted women's testing behaviours and also revealed the absence of relevant risk factors in the NDHS data that might influence screening. Overall, our results show that strategies for early diagnosis of breast cancer should be given major priority by cancer control boards as well as ministries of health in SSA. These strategies should centre on early screening and may involve reducing or eliminating barriers to health care, access to relevant health information and encouraging breast self-examination.

  14. Unemployment Insurance Query (UIQ)

    Data.gov (United States)

    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...

  15. Understanding recurrent readmission after major surgery among patients with employer-provided health insurance.

    Science.gov (United States)

    Kim, Yuhree; Ejaz, Aslam; Xu, Li; Gani, Faiz; Canner, Joseph K; Schneider, Eric B; Pawlik, Timothy M

    2016-08-01

    Most studies on readmission only report data on first readmission within 30 days. These data may underestimate the true impact of readmission, as recurrent readmissions are common among patients undergoing major surgery. We therefore sought to define characteristics and readmission patterns of patients recurrently readmitted after major surgery. A total of 81,769 patients discharged after 10 major surgical procedures (coronary artery bypass graft, abdominal aortic aneurysm, carotid endarterectomy, aortic valve replacement, esophagectomy, gastrectomy, pancreatectomy, pulmonary resection, hepatectomy, and colorectal resection) between 2010 and 2012 were identified from a large employer-provided health plan. Maximum number of unplanned readmissions experienced within 365 days of discharge was measured. Median patient age was 55 years, and a slight majority (55.4%) was male. Comorbidities were common as 36.9% had a Charlson comorbidity index (CCI) of ≥2. Median length of stay was 5 (interquartile range, 3 and 8) days. Among 24,344 (29.8%) patients who experienced readmission, 64.0% experienced 1 readmission, whereas 36.0% experienced recurrent readmissions within 365 day of a prior discharge. Compared with patients experiencing 1 readmission, patients with ≥2 readmissions were more likely to be female (47.3% vs 44.2%) and have more comorbidities (Charlson comorbidity index ≥2, 49.5% vs 42.5%; both P < .001). Complications during the index hospitalization were more common among patients experiencing recurrent readmissions (35.5% vs 30.7%, P < .001). Although median length of stay during index hospitalization was longer among patients with recurrent readmissions (6 vs 7 days), median time to first readmission was shorter (97 vs 40 days, both P < .001). Among study cohort, 4.5% experienced 3 or more readmissions; these patients accounted for 14.8% of all admissions and 13.7% of hospital charges for the study cohort during the entire follow-up period. Among

  16. [Analysis of state costs of the social security benefits provided to the insured presenting with lung cancer and pulmonary diseases caused by external factors].

    Science.gov (United States)

    Kuklińska-Janiak, Dorota

    2013-12-01

    Lung cancer and pneumoconioses constitute two serious problems of contemporary medicine and a public health system. To analyze the costs associated with social security benefits provided to the insured presenting with lung cancer and pulmonary diseases (including pneumoconioses) caused by external factors. The analysis was based on the data obtained from the Department of Statistics and Actuarial Forecasts of the Social Insurance Institution (SlI) in Warsaw. Structural diversity of the costs of the separate benefits available within the national health insurance system has been considered. Based on the data available in Poland costs associated with the incidence of lung cancer and pneumoconiosis were assessed taking into account sex and age of the insured as well as the administrative division of Poland. Additionally, mortality rates from the selected pulmonary diseases were analyzed. Costs of the pensions paid to the insured presenting with lung cancer amount to 81.11% of the total social security costs associated with these diseases, while the sick leave money paid to the insured lung cancer patients equal to 15.5% of the total costs. In the insured women, costs of the pensions paid due to occupational pulmonary diseases (predominantly pneumoconioses) constitute 41.1% and in the insured men--11.5% of the total 'occupational' pensions. Although the maximal incidence of lung cancer occurs in both men and women above their retirement ages the costs of the work incapacity pensions paid to lung cancer patients still exceed 81% of the total social security costs associated with these diseases. In the insured women, the cost of pensions paid due to occupational pulmonary diseases, most of which are pneumoconioses, ranks first among the costs of 'occupational' pensions received by these subjects, while in the insured men the respective cost ranks third (after injuries plus intoxications and cardiovascular diseases) among their 'occupational' pensions. Moreover, the

  17. Individual insurance: health insurers try to tap potential market growth.

    Science.gov (United States)

    November, Elizabeth A; Cohen, Genna R; Ginsburg, Paul B; Quinn, Brian C

    2009-11-01

    Individual insurance is the only source of health coverage for people without access to employer-sponsored insurance or public insurance. Individual insurance traditionally has been sought by older, sicker individuals who perceive the need for insurance more than younger, healthier people. The attraction of a sicker population to the individual market creates adverse selection, leading insurers to employ medical underwriting--which most states allow--to either avoid those with the greatest health needs or set premiums more reflective of their expected medical use. Recently, however, several factors have prompted insurers to recognize the growth potential of the individual market: a declining proportion of people with employer-sponsored insurance, a sizeable population of younger, healthier people forgoing insurance, and the likelihood that many people receiving subsidies to buy insurance under proposed health insurance reforms would buy individual coverage. Insurers are pursuing several strategies to expand their presence in the individual insurance market, including entering less-regulated markets, developing lower-cost, less-comprehensive products targeting younger, healthy consumers, and attracting consumers through the Internet and other new distribution channels, according to a new study by the Center for Studying Health System Change (HSC). Insurers' strategies in the individual insurance market are unlikely to meet the needs of less-than-healthy people seeking affordable, comprehensive coverage. Congressional health reform proposals, which envision a larger role for the individual market under a sharply different regulatory framework, would likely supersede insurers' current individual market strategies.

  18. Welfare reform and health insurance of immigrants.

    Science.gov (United States)

    Kaushal, Neeraj; Kaestner, Robert

    2005-06-01

    To investigate the effect of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) on the health insurance coverage of foreign- and U.S.-born families headed by low-educated women. Secondary data from the March series of the Current Population Surveys for 1994-2001. Multivariate regression methods and a pre- and post-test with comparison group research design (difference-in-differences) are used to estimate the effect of welfare reform on the health insurance coverage of low-educated, foreign- and U.S.-born unmarried women and their children. Heterogeneous responses by states to create substitute Temporary Aid to Needy Families or Medicaid programs for newly arrived immigrants are used to investigate whether the estimated effect of PRWORA on newly arrived immigrants is related to the actual provisions of the law, or the result of fears engendered by the law. PRWORA increased the proportion of uninsured among low-educated, foreign-born, unmarried women by 9.9-10.7 percentage points. In contrast, the effect of PRWORA on the health insurance coverage of similar U.S.-born women is negligible. PRWORA also increased the proportion of uninsured among foreign-born children living with low-educated, single mothers by 13.5 percentage points. Again, the policy had little effect on the health insurance coverage of the children of U.S.-born, low-educated single mothers. There is some evidence that the fear and uncertainty engendered by the law had an effect on immigrant health insurance coverage. This research demonstrates that PRWORA adversely affected the health insurance of low-educated, unmarried, immigrant women and their children. In the case of unmarried women, it may be partly because the jobs that they obtained in response to PRWORA were less likely to provide health insurance. The research also suggests that PRWORA may have engendered fear among immigrants and dampened their enrollment in safety net programs.

  19. Green commercial building insurance in Malaysia

    Science.gov (United States)

    Yang, Yu Xin Ou; Chew, Boon Cheong; Loo, Heoy Shin; Tan, Lay Hong

    2017-03-01

    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

  20. Provider payment methods and health worker motivation in community-based health insurance: a mixed-methods study.

    Science.gov (United States)

    Robyn, Paul Jacob; Bärnighausen, Till; Souares, Aurélia; Traoré, Adama; Bicaba, Brice; Sié, Ali; Sauerborn, Rainer

    2014-05-01

    In a community-based health insurance (CBHI) introduced in 2004 in Nouna health district, Burkina Faso, poor perceived quality of care by CBHI enrollees has been a key factor in observed high drop-out rates. The poor quality perceptions have been previously attributed to health worker dissatisfaction with the provider payment method used by the scheme and the resulting financial risk of health centers. This study applied a mixed-methods approach to investigate how health workers working in facilities contracted by the CBHI view the methods of provider payment used by the CBHI. In order to analyze these relationships, we conducted 23 in-depth interviews and a quantitative survey with 98 health workers working in the CBHI intervention zone. The qualitative in-depth interviews identified that insufficient levels of capitation payments, the infrequent schedule of capitation payment, and lack of a payment mechanism for reimbursing service fees were perceived as significant sources of health worker dissatisfaction and loss of work-related motivation. Combining qualitative interview and quantitative survey data in a mixed-methods analysis, this study identified that the declining quality of care due to the CBHI provider payment method was a source of significant professional stress and role strain for health workers. Health workers felt that the following five changes due to the provider payment methods introduced by the CBHI impeded their ability to fulfill professional roles and responsibilities: (i) increased financial volatility of health facilities, (ii) dissatisfaction with eligible costs to be covered by capitation; (iii) increased pharmacy stock-outs; (iv) limited financial and material support from the CBHI; and (v) the lack of mechanisms to increase provider motivation to support the CBHI. To address these challenges and improve CBHI uptake and health outcomes in the targeted populations, the health care financing and delivery model in the study zone should be

  1. AEE's Report on the Insurance Issue

    Science.gov (United States)

    Marlow, Peggy

    1986-01-01

    Provides timely information and strategies for coping with changes in the insurance industry that affect cost and availability of liability coverage for experiential education programs. Suggests ways for outdoor programs to transfer and avoid risk and to control risk if it must be assumed. (JHZ)

  2. Benefit distribution of social health insurance: evidence from china's urban resident basic medical insurance.

    Science.gov (United States)

    Pan, Jay; Tian, Sen; Zhou, Qin; Han, Wei

    2016-09-01

    Equity is one of the essential objectives of the social health insurance. This article evaluates the benefit distribution of the China's Urban Residents' Basic Medical Insurance (URBMI), covering 300 million urban populations. Using the URBMI Household Survey data fielded between 2007 and 2011, we estimate the benefit distribution by the two-part model, and find that the URBMI beneficiaries from lower income groups benefited less than that of higher income groups. In other words, government subsidy that was supposed to promote the universal coverage of health care flew more to the rich. Our study provides new evidence on China's health insurance system reform, and it bears meaningful policy implication for other developing countries facing similar challenges on the way to universal coverage of health insurance. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  3. A model for determining when an analysis contains sufficient detail to provide adequate NEPA coverage for a proposed action

    Energy Technology Data Exchange (ETDEWEB)

    Eccleston, C.H.

    1994-11-01

    Neither the National Environmental Policy Act (NEPA) nor its subsequent regulations provide substantive guidance for determining the Level of detail, discussion, and analysis that is sufficient to adequately cover a proposed action. Yet, decisionmakers are routinely confronted with the problem of making such determinations. Experience has shown that no two decisionmakers are Likely to completely agree on the amount of discussion that is sufficient to adequately cover a proposed action. one decisionmaker may determine that a certain Level of analysis is adequate, while another may conclude the exact opposite. Achieving a consensus within the agency and among the public can be problematic. Lacking definitive guidance, decisionmakers and critics alike may point to a universe of potential factors as the basis for defending their claim that an action is or is not adequately covered. Experience indicates that assertions are often based on ambiguous opinions that can be neither proved nor disproved. Lack of definitive guidance slows the decisionmaking process and can result in project delays. Furthermore, it can also Lead to inconsistencies in decisionmaking, inappropriate Levels of NEPA documentation, and increased risk of a project being challenged for inadequate coverage. A more systematic and less subjective approach for making such determinations is obviously needed. A paradigm for reducing the degree of subjectivity inherent in such decisions is presented in the following paper. The model is specifically designed to expedite the decisionmaking process by providing a systematic approach for making these determination. In many cases, agencies may find that using this model can reduce the analysis and size of NEPA documents.

  4. Following the ACA Repeal-and-Replace Effort, Where Does the U.S. Stand on Insurance Coverage? Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--June 2017.

    Science.gov (United States)

    Collins, Sara R; Gunja, Munira Z; Doty, Michelle M

    2017-09-01

    After Congress's failure to repeal and replace the Affordable Care Act, some policy leaders are calling for bipartisan approaches to address weaknesses in the law’s coverage expansions. To do this, policymakers will need data about trends in insurance coverage, reasons why people remain uninsured, and consumer perceptions of affordability. To examine U.S. trends in insurance coverage and the demographics of the remaining uninsured population, as well as affordability and satisfaction among adults with marketplace and Medicaid coverage. Analysis of the Commonwealth Fund Affordable Care Act Tracking Survey, March–June 2017 The uninsured rate among 19-to-64-year-old adults was 14 percent in 2017, or an estimated 27 million people, statistically unchanged from one year earlier. Uninsured rates ticked up significantly in three subgroups: 35-to-49-year-olds, adults with incomes of 400 percent of poverty or more (about $48,000 for an individual), and adults living in states that had not expanded Medicaid. Half of uninsured adults, or an estimated 13 million, are likely eligible for marketplace subsidies or the Medicaid expansion in their state. Four of 10 uninsured adults are unaware of the marketplaces. Adults in marketplace plans with incomes below 250 percent of poverty are much more likely to view their premiums as easy to afford compared with people with higher incomes. Policies to improve coverage include a federal commitment to supporting the marketplaces and the 2018 open enrollment period, expansion of Medicaid in 19 remaining states, and enhanced subsidies for people with incomes of 250 percent of poverty or more.

  5. Medical care price indexes for patients with employer-provided insurance: nationally representative estimates from MarketScan Data.

    Science.gov (United States)

    Dunn, Abe; Liebman, Eli; Pack, Sarah; Shapiro, Adam Hale

    2013-06-01

    Commonly observed shifts in the utilization of medical care services to treat diseases may pose problems for official price indexes at the Bureau of Labor Statistics (BLS) that do not account for service shifts. We examine how these shifts may lead to different price estimates than those observed in official price statistics at the BLS. We use a convenience sample of enrollees with employer-provided insurance from the MarketScan database for the years 2003 to 2007. Population weights that consider the age, sex, and geographic distribution of enrollees are assigned to construct representative estimates. We compare two types of price indexes: (1) a Service Price Index (SPI) that is similar to the BLS index, which holds services fixed and measures the prices of the underlying treatments; (2) a Medical Care Expenditure Index (MCE) that measures the cost of treating diseases and allows for utilization shifts. Over the entire period of study the CAGR of the SPI grows 0.7 percentage points faster than the preferred MCE index. Our findings suggest that the health component of inflation may be overstated by 0.7 percentage points per year, and real GDP growth may be understated by a similar amount. However, more work may be necessary to precisely replicate the indexes of the BLS to obtain a more accurate measure of these price differences. © Health Research and Educational Trust.

  6. Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

    Science.gov (United States)

    Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

    2013-10-01

    The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

  7. Implications of employer coverage of contraception: Cost-effectiveness analysis of contraception coverage under an employer mandate.

    Science.gov (United States)

    Canestaro, W; Vodicka, E; Downing, D; Trussell, J

    2017-01-01

    Mandatory employer-based insurance coverage of contraception in the US has been a controversial component of the Affordable Care Act (ACA). Prior research has examined the cost-effectiveness of contraception in general; however, no studies have developed a formal decision model in the context of the new ACA provisions. As such, this study aims to estimate the relative cost-effectiveness of insurance coverage of contraception under employer-sponsored insurance coverage taking into consideration newer regulations allowing for religious exemptions. A decision model was developed from the employer perspective to simulate pregnancy costs and outcomes associated with insurance coverage. Method-specific estimates of contraception failure rates, outcomes and costs were derived from the literature. Uptake by marital status and age was drawn from a nationally representative database. Providing no contraception coverage resulted in 33 more unintended pregnancies per 1000 women (95% confidence range: 22.4; 44.0). This subsequently significantly increased the number of unintended births and terminations. Total costs were higher among uninsured women owing to higher costs of pregnancy outcomes. The effect of no insurance was greatest on unmarried women 20-29 years old. Denying female employees' full coverage of contraceptives increases total costs from the employer perspective, as well as the total number of terminations. Insurance coverage was found to be significantly associated with women's choice of contraceptive method in a large nationally representative sample. Using a decision model to extrapolate to pregnancy outcomes, we found a large and statistically significant difference in unintended pregnancy and terminations. Denying women contraception coverage may have significant consequences for pregnancy outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Problems of health insurance coverage and health care in the United States: public and private solution strategies Problemas de cobertura de seguridade em saúde e serviços nos Estados Unidos da América: estratégias para soluções públicas e privadas

    Directory of Open Access Journals (Sweden)

    E. Richard Brown

    1992-09-01

    Full Text Available A nearly universal consensus has developed in the United States that the current health care financing system is a failure. The system has been unable to control the continuing rapid rise in health care costs (by far, the highest in the world, and it has been unable to stem the growing population that has no health insurance coverage (at least 36 million people. There is nearly universal political agreement that government must provide health insurance to a far greater share of the population than ever before. The political debate now focuses on whether this expanded government role should supplement the private insurance system with an enlarged public program covering those left out of private insurance coverage, or replace private insurance with a universal government health insurance program covering the entire population.É praticamente consenso nos EUA que o atual sistema de saúde está falido. O sistema não foi capaz de controlar o rápido aumento nos custos dos cuidados em saúde (de longe, o mais elevado do mundo, e também não foi capaz de estancar o crescimento da população sem qualquer cobertura de seguro saúde (pelo menos 26 milhões de pessoas. Politicamente, há quase total concordância de que o governo deve prover seguro de saúde a uma parcela bem maior da população do que no passado. O debate político agora centra-se na questão se este papel expandido do governo deve suplementar o sistema de seguridade privado através de um programa aumentado, de modo a cobrir os que ficam de fora da cobertura oferecida pelo seguro privado, ou substituir o seguro privado por um programa de seguro-saúde governamental de abrangência universal, dando cobertura a toda a população.

  9. Private health insurance in South Korea: an international comparison.

    Science.gov (United States)

    Shin, Jaeun

    2012-11-01

    The goal of this study is to present the historical and policy background of the expansion of private health insurance in South Korea in the context of the National Health Insurance (NHI) system, and to provide empirical evidence on whether the increased role of private health insurance may counterbalance government financing, social security contributions, out-of-pocket payments, and help stabilize total health care spending. Using OECD Health Data 2011, we used a fixed effects model estimation. In this model, we allow error terms to be serially correlated over time in order to capture the association of private health insurance financing with three other components of health care financing and total health care spending. The descriptive observation of the South Korean health care financing shows that social security contributions are relatively limited in South Korea, implying that high out-of-pocket payments may be alleviated through the enhancement of NHI benefit coverage and an increase in social security contributions. Estimation results confirm that private health insurance financing is unlikely to reduce government spending on health care and social security contributions. We find evidence that out-of-pocket payments may be offset by private health insurance financing, but to a limited degree. Private health insurance financing is found to have a statistically significant positive association with total spending on health care. This indicates that the duplicated coverage effect on service demand may cancel out the potential efficiency gain from market initiatives driven by the active involvement of private health insurance. This study finds little evidence for the benefit of private insurance initiatives in coping with the fiscal challenges of the South Korean NHI program. Further studies on the managerial interplay among public and private insurers and on behavioral responses of providers and patients to a given structure of private-public financing are

  10. Choice of health insurer and healthcare provider : An analysis of regulated competition in the Dutch healthcare system

    NARCIS (Netherlands)

    D.M.I.D. Duijmelinck (Daniëlle)

    2015-01-01

    markdownabstractConsumer choice of health insurer is an essential precondition for achieving efficiency and consumer responsiveness in healthcare. In healthcare, consumer preferences are highly heterogeneous. This implies that if groups of consumers with specific preferences feel not free to switch

  11. 76 FR 43606 - Common Crop Insurance Regulations; Onion Crop Insurance Provisions

    Science.gov (United States)

    2011-07-21

    ... , including any personal information provided, and can be accessed by the public. All comments must include... changes to improve the insurance coverage offered, address program integrity issues, simplify program.... Section 1--FCIC proposes to revise the definitions of ``direct seeded'' and ``transplanted'' by adding the...

  12. The rate of growth in scientific publication and the decline in coverage provided by Science Citation Index.

    Science.gov (United States)

    Larsen, Peder Olesen; von Ins, Markus

    2010-09-01

    The growth rate of scientific publication has been studied from 1907 to 2007 using available data from a number of literature databases, including Science Citation Index (SCI) and Social Sciences Citation Index (SSCI). Traditional scientific publishing, that is publication in peer-reviewed journals, is still increasing although there are big differences between fields. There are no indications that the growth rate has decreased in the last 50 years. At the same time publication using new channels, for example conference proceedings, open archives and home pages, is growing fast. The growth rate for SCI up to 2007 is smaller than for comparable databases. This means that SCI was covering a decreasing part of the traditional scientific literature. There are also clear indications that the coverage by SCI is especially low in some of the scientific areas with the highest growth rate, including computer science and engineering sciences. The role of conference proceedings, open access archives and publications published on the net is increasing, especially in scientific fields with high growth rates, but this has only partially been reflected in the databases. The new publication channels challenge the use of the big databases in measurements of scientific productivity or output and of the growth rate of science. Because of the declining coverage and this challenge it is problematic that SCI has been used and is used as the dominant source for science indicators based on publication and citation numbers. The limited data available for social sciences show that the growth rate in SSCI was remarkably low and indicate that the coverage by SSCI was declining over time. National Science Indicators from Thomson Reuters is based solely on SCI, SSCI and Arts and Humanities Citation Index (AHCI). Therefore the declining coverage of the citation databases problematizes the use of this source.

  13. INTRODUCTION OF INSURANCE REPOSITORY AS AN ALTERNATIVE OF INTERNET INSURANCE IN CLASSICAL MEANING: LEGISLATION ASPECTS

    Directory of Open Access Journals (Sweden)

    M. Malik

    2016-04-01

    Full Text Available This paper examines the legislation and regulation of insurance repositories. The basic conditions and requirements of creating and functioning of the new insurance market institute were studied. The basic requirements for managing personal of insurance repository were noticed. The study reveals the interaction mechanism of insurers and insured at the book-entry insurance policies turnover market via creation of the new institute, which is set to issue and control electronic insurance coverage.

  14. Prevalence of Frailty Indicators and Association with Socioeconomic Status in Middle-Aged and Older Adults in a Swiss Region with Universal Health Insurance Coverage: A Population-Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Idris Guessous

    2014-01-01

    Full Text Available Frailty prevalence in older adults has been reported but is largely unknown in middle-aged adults. We determined the prevalence of frailty indicators among middle-aged and older adults from a general Swiss population characterized by universal health insurance coverage and assessed the determinants of frailty with a special focus on socioeconomic status. Participants aged 50 and more from the population-based 2006–2010 Bus Santé study were included (N = 2,930. Four frailty indicators (weakness, shrinking, exhaustion, and low activity were measured according to standard definitions. Multivariate logistic regressions were used to determine associations. Overall, 63.5%, 28.7%, and 7.8% participants presented no frailty indicators, one frailty indicator, and two or more frailty indicators, respectively. Among middle-aged participants (50–65 years, 75.1%, 22.2%, and 2.7% presented 0, 1, and 2 or more frailty indicators. The number of frailty indicators was positively associated with age, hypertension, and current smoking and negatively associated with male gender, body mass index, waist-to-hip ratio, and serum total cholesterol level. Lower income level but not education was associated with higher number of frailty indicators. Frailty indicators are frequently encountered in both older and middle-aged adults from the Swiss general population. Despite universal health insurance coverage, household income is independently associated with frailty.

  15. The ABCs of HIPCs (health insurance purchasing cooperatives).

    Science.gov (United States)

    Wicks, E K; Curtis, R E; Haugh, K

    1993-01-01

    HIPCs, or health care purchasing cooperatives, are attracting widespread interest as a key element of the managed competition approach to health reform. HIPCs perform several useful roles for individuals and small employers unable to obtain health insurance coverage in the current system by spreading risk more evenly and purchasing coverage in a given region or market area. While HIPCs are generally associated with managed competition, they are also compatible with reform strategies that require employers to pay for coverage or those that provide incentives for expanded coverage.

  16. The role of micro health insurance in providing financial risk protection in developing countries- a systematic review

    OpenAIRE

    Shifa Salman Habib; Shagufta Perveen; Hussain Maqbool Ahmed Khuwaja

    2016-01-01

    Abstract Background Out of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI) has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was co...

  17. Climate Feedback: Bringing the Scientific Community to Provide Direct Feedback on the Credibility of Climate Media Coverage

    Science.gov (United States)

    Vincent, E. M.; Matlock, T.; Westerling, A. L.

    2015-12-01

    While most scientists recognize climate change as a major societal and environmental issue, social and political will to tackle the problem is still lacking. One of the biggest obstacles is inaccurate reporting or even outright misinformation in climate change coverage that result in the confusion of the general public on the issue.In today's era of instant access to information, what we read online usually falls outside our field of expertise and it is a real challenge to evaluate what is credible. The emerging technology of web annotation could be a game changer as it allows knowledgeable individuals to attach notes to any piece of text of a webpage and to share them with readers who will be able to see the annotations in-context -like comments on a pdf.Here we present the Climate Feedback initiative that is bringing together a community of climate scientists who collectively evaluate the scientific accuracy of influential climate change media coverage. Scientists annotate articles sentence by sentence and assess whether they are consistent with scientific knowledge allowing readers to see where and why the coverage is -or is not- based on science. Scientists also summarize the essence of their critical commentary in the form of a simple article-level overall credibility rating that quickly informs readers about the credibility of the entire piece.Web-annotation allows readers to 'hear' directly from the experts and to sense the consensus in a personal way as one can literaly see how many scientists agree with a given statement. It also allows a broad population of scientists to interact with the media, notably early career scientists.In this talk, we will present results on the impacts annotations have on readers -regarding their evaluation of the trustworthiness of the information they read- and on journalists -regarding their reception of scientists comments.Several dozen scientists have contributed to this effort to date and the system offers potential to

  18. Contraception and abortion coverage: What do primary care physicians think?

    Science.gov (United States)

    Chuang, Cynthia H; Martenis, Melissa E; Parisi, Sara M; Delano, Rachel E; Sobota, Mindy; Nothnagle, Melissa; Schwarz, Eleanor Bimla

    2012-08-01

    Insurance coverage for family planning services has been a highly controversial element of the US health care reform debate. Whether primary care providers (PCPs) support public and private health insurance coverage for family planning services is unknown. PCPs in three states were surveyed regarding their opinions on health plan coverage and tax dollar use for contraception and abortion services. Almost all PCPs supported health plan coverage for contraception (96%) and use of tax dollars to cover contraception for low-income women (94%). A smaller majority supported health plan coverage for abortions (61%) and use of tax dollars to cover abortions for low-income women (63%). In adjusted models, support of health plan coverage for abortions was associated with female gender and internal medicine specialty, and support of using tax dollars for abortions for low-income women was associated with older age and internal medicine specialty. The majority of PCPs support health insurance coverage of contraception and abortion, as well as tax dollar subsidization of contraception and abortion services for low-income women. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Pre-Existing Condition Insurance Plan Data

    Data.gov (United States)

    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...

  20. Access to Private Coverage for Children Enrolled in CHIP.

    Science.gov (United States)

    McMorrow, Stacey; Kenney, Genevieve M; Waidmann, Timothy; Anderson, Nathaniel

    2015-01-01

    To provide updated information on the potential substitution of public for private coverage among low-income children by examining the type of coverage held by children before they enrolled in Children's Health Insurance Program (CHIP) and exploring the extent to which children covered by CHIP had access to private coverage while they were enrolled. We conducted a major household telephone survey in 2012 of enrollees and disenrollees in CHIP in 10 states. We used the survey responses and Medicaid/CHIP administrative data to estimate the coverage distribution of all new enrollees in the 12 months before CHIP enrollment and to identify children who may have had access to employer coverage through one of their parents while enrolled in CHIP. About 13% of new enrollees had any private coverage in the 12 months before enrolling in CHIP, and most were found to have lost that coverage as a result of parental job loss. About 40% of CHIP enrollees had a parent with an employer-sponsored insurance (ESI) policy, but only half reported that the policy could cover the child. Approximately 30% of new enrollees had public coverage during the year before but were uninsured just before enrolling. Access to private coverage among CHIP enrollees is relatively limited. Furthermore, even when there is potential access to ESI, affordability is a serious concern for parents, making it possible that many children with access to ESI would remain uninsured in the absence of CHIP. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  1. The rise in health care coverage and affordability since health reform took effect: findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014.

    Science.gov (United States)

    Collins, Sara R; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-01-01

    New results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that the Affordable Care Act's subsidized insurance options and consumer protections reduced the number of uninsured working-age adults from an estimated 37 million people, or 20 percent of the population, in 2010 to 29 million, or 16 percent, by the second half of 2014. Conducted from July to December 2014, for the first time since it began in 2001, the survey finds declines in the number of people who report cost-related access problems and medical-related financial difficulties. The number of adults who did not get needed health care because of cost declined from 80 million people, or 43 percent, in 2012 to 66 million, or 36 percent, in 2014. The number of adults who reported problems paying their medical bills declined from an estimated 75 million people in 2012 to 64 million people in 2014.

  2. Assuring Access to Affordable Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

  3. Willingness to Pay for Complementary Health Care Insurance in Iran.

    Science.gov (United States)

    Nosratnejad, Shirin; Rashidian, Arash; Akbari Sari, Ali; Moradi, Najme

    2017-09-01

    Complementary health insurance is increasingly used to remedy the limitations and shortcomings of the basic health insurance benefit packages. Hence, it is essential to gather reliable information about the amount of Willingness to Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable complementary health insurance. The study sample consisted of 300 household heads all over provinces of Iran in 2013. The method applied was double bounded dichotomous choice and open-ended question approach of contingent valuation. The average WTP for complementary health insurance per person per month by double bounded dichotomous choice and open-ended question method respectively was 199000 and 115300 Rials (8 and 4.6 USD, respectively). Household's heads with higher levels of income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. The WTP value can be used as a premium in a society. As an important finding, the study indicated that the households were willing to pay higher premiums than currently collected for the complementary health insurance coverage in Iran. This offers the policy makers the opportunity to increase the premium and provide good benefits package for insured people of country then better risk pooling.

  4. Professional liability insurance and medical error disclosure.

    Science.gov (United States)

    McLennan, Stuart; Shaw, David; Leu, Agnes; Elger, Bernice

    2015-01-01

    To examine medicolegal stakeholders' views about the impact of professional liability insurance in Switzerland on medical error disclosure. Purposive sample of 23 key medicolegal stakeholders in Switzerland from a range of fields between October 2012 and February 2013. Data were collected via individual, face-to-face interviews using a researcher-developed semi-structured interview guide. Interviews were transcribed and analysed using conventional content analysis. Participants, particularly those with a legal or quality background, reported that concerns relating to professional liability insurance often inhibited communication with patients after a medical error. Healthcare providers were reported to be particularly concerned about losing their liability insurance cover for apologising to harmed patients. It was reported that the attempt to limit the exchange of information and communication could lead to a conflict with patient rights law. Participants reported that hospitals could, and in some case are, moving towards self-insurance approaches, which could increase flexibility regarding error communication The reported current practice of at least some liability insurance companies in Switzerland of inhibiting communication with harmed patients after an error is concerning and requires further investigation. With a new ethic of transparency regarding medical errors now prevailing internationally, this approach is increasingly being perceived to be misguided. A move away from hospitals relying solely on liability insurance may allow greater transparency after errors. Legalisation preventing the loss of liability insurance coverage for apologising to harmed patients should also be considered.

  5. Life Insurance. Universal-Life Insurance

    OpenAIRE

    Smith, Mike; Hayhoe, Celia Ray

    2009-01-01

    Universal-life insurance was created to address many of the problems associated with whole-life insurance. One problem with whole-life insurance is its lack of flexibility. A second problem with whole life is that it is much like a black box. The owner cannot see exactly how it works. Universal life provides solutions to these problems. To fully understand universal life, refer to "Life Insurance: Whole-Life Insurance", Virginia Cooperative Extension publication 354-145, for some backgroun...

  6. [Acceptability of HIV testing provided to infants in pediatric services in Cote d'Ivoire, meanings for pediatric diagnostic coverage].

    Science.gov (United States)

    Oga, Maxime; Brou, Hermann; Dago-Akribi, Hortense; Coffie, Patrick; Amani-Bossé, Clarisse; Ekouévi, Didier; Yapo, Vincent; Menan, Hervé; Ndondoki, Camille; Timité-Konan, M; Leroy, Valériane

    2014-01-01

    , when he is opposed to the infant HIV testing, or also the facilitator with his realization if he is convinced. The father position thus remains essential face to the question of pediatric HIV testing acceptability. The mothers are aware of this and predict the difficulties of achieving their infant to be tested without the preliminary opinion of their partner at the same time father, and head of the family. The issue of pediatric HIV testing, at the end of our analysis, highlights three elements which require a comprehensive management to improve the coverage of pediatric HIV test. These three elements would not exist without being influenced; therefore they are constantly in interaction and prevent or support the realization or not pediatric test. Also, with the aim to improve the pediatric HIV test coverage, it is necessary to take into account the harmonious management of these elements. Firstly, the mother alone (with her knowledge, and perceptions), its marital environment (with the proposal of the HIV test integrating (1) the partner and/or father with his perceptions and knowledge on HIV infection and (2) facility of speaking about the test and its realization at both or one about the parents, the mother) and of the knowledge, attitudes and practices about the infection of health care workers of the sanitary institution. Our recommendations proposed taking into account a redefinition of the HIV/AIDS approach towards the families exposed to HIV and a more accentuated integration of the father facilitating their own HIV test acceptation and that of his child.

  7. Risk allocation in a public-private catastrophe insurance system : an actuarial analysis of deductibles, stop-loss, and premiums

    NARCIS (Netherlands)

    Paudel, Y.; Botzen, W. J. W.; Aerts, J. C. J. H.; Dijkstra, T. K.

    A public-private (PP) partnership could be a viable arrangement for providing insurance coverage for catastrophe events, such as floods and earthquakes. The objective of this paper is to obtain insights into efficient and practical allocations of risk in a PP insurance system. In particular, this

  8. Risk allocation in a public-private catastrophe insurance system : An actuarial analysis of deductibles, stop-loss, and premiums

    NARCIS (Netherlands)

    Paudel, Y.; Botzen, W.J.W.; Dijkstra, Th.; Aerts, J.C.J.H.

    2015-01-01

    A public-private (PP) partnership could be a viable arrangement for providing insurance coverage for catastrophe events, such as floods and earthquakes. The objective of this paper is to obtain insights into efficient and practical allocations of risk in a PP insurance system. In particular, this

  9. Disparity in dental coverage among older adult populations: a comparative analysis across selected European countries and the USA.

    Science.gov (United States)

    Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Lee, Jinkook; Listl, Stefan

    2015-04-01

    Insurance against the cost of preventing and treating oral diseases can reduce inequities in dental-care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the USA and various European countries. The analyses relied on 2006-2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and on 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents 51 years of age and older. A series of logistic regression models was estimated to identify disparities in dental coverage. The highest extent of significant insurance differences between various population subgroups was found for the USA. In comparison with southern and eastern European countries, a lower number of significant differences in coverage was found for Scandinavian countries. Countries categorised as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than did countries categorised as not having comprehensive public coverage. The exceptions were Poland and Switzerland. The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and that the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies in order to provide more equitable dental coverage. © 2014 FDI World Dental Federation.

  10. Hydrological drought index insurance for irrigation districts in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Maestro, T.; Bielza, M.; Garrido, A.

    2016-11-01

    Hydrological droughts are a major risk for irrigated agriculture in many regions of the world. The aim of this article is to propose an insurance tool to help irrigators manage the risk of water scarcity in the framework of the Spanish Crop Insurance System (SCIS). Only the United States Insurance System provides this type of coverage, but has very restrictive conditions. To determine the type of insurance scheme that better fits with the SCIS and to the Spanish irrigated agriculture, an expert panel was held with the participation of all stakeholders involved in crop insurance. Following the expert panel conclusions, an hydrological drought index insurance (HDII) addressed to irrigation districts (ID) is proposed. It would compensate water deficits suffered in the whole ID. We detail the conditions that the ID should fulfill to be eligible for HDII. HDII is applied to the Bardenas Irrigation District V (ID-V) in Spain, and the hedging effectiveness of the instrument is analyzed comparing ID-V’s gross margins with and without the insurance contract. Results suggest that the proposed insurance scheme could provide an effective means of reducing farmers’ vulnerability to water shortages and there is no major impediment for it to be included as a new line in the SCIS. This type of insurance can be generalized to any ID fulfilling the conditions mentioned in this paper. (Author)

  11. Willingness To Pay for Social Health Insurance in Iran

    Science.gov (United States)

    Nosratnejad, Shirin; Rashidian, Arash; Mehrara, Mohsen; Sari, Ali Akbari; Mahdavi, Ghadir; Moeini, Maryam

    2014-01-01

    Objective: The substantial level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the community. Hence, it is essential to gather reliable information about the amount of Willingness To Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable social health insurance. Method: The study sample included 300 household heads in all Iranian provinces. The double bounded dichotomous choice approach was used to elicit the WTP. Result: The average WTP for social health insurance per person per month was 137 000 Rial (5.5 $US). Household heads with higher levels of education, income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. Conclusions: From a policy point of view, the WTP value can be used as a premium in a society. An important finding of this study is that although households’ Willingness To Pay is not more than the total insurance premium, households are willing to pay more than the premium they ought to pay for health insurance coverage. That is, total insurance premium is 150 000 Rials and households ought to pay approximately half of this sum. This can afford policy makers the ideal opportunity to provide good insurance coverage for medical services according to the need of society. PMID:25168979

  12. Taking up or turning down: new estimates of household demand for employer-sponsored health insurance.

    Science.gov (United States)

    Abraham, Jean Marie; Feldman, Roger

    2010-01-01

    This study provides new estimates of demand for employer-sponsored health insurance, using the 1997-2001 linked Household Component-Insurance Component of the Medical Expenditure Panel Survey (MEPS). Our focus is on households' decisions to take up coverage through a worker's employer. We found a significant inverse relationship between the out-of-pocket premium and the probability of taking up coverage, with the price effect considerably larger when we used instrumental variables methods to account for endogenous out-of-pocket premiums. Additionally, workers in families with more children eligible for Medicaid were less likely to take up coverage.

  13. Evolution of health coverage in Mexico: evidence of progress and challenges in the Mexican health system.

    Science.gov (United States)

    Urquieta-Salomón, José E; Villarreal, Héctor J

    2016-02-01

    To consolidate an effective and efficient universal health care coverage requires a deep understanding of the challenges faced by the health care system in providing services demanded by population in need. This study analyses the dynamics of health insurance coverage and effective access coverage to some health interventions in Mexico. It examines the evolution of inequalities and heterogeneous performance of the insurance subsystems incorporated under the Mexican health care system. Two types of coverage indicators were selected: health insurance and effective access to preventive health interventions intended for normative population. Data were drawn from National Health and Nutrition Surveys 2006 and 2012. The economic inequality was estimated using the Standardized Concentration Index by household per capita consumption expenditure as socioeconomic-status indicator. Approximately 75% of the population reported being covered by one of the existing insurance schemes, representing a huge step forward from 2006, when as much as 51.62% of the population had no health insurance. About 87% of this growth was attributable to the expansion of Non Contributory Health Insurance whereas 7% emanated from the Social Security subsystem. The results revealed that inequality in access to health insurance was virtually eradicated; however, traces of unequal access persisted in some subpopulations groups. Coverage indicators of effective access showed a slight improvement in the period analysed, but prenatal care and interventions to prevent chronic disease still presented a serious shortage. Furthermore, there was no evidence that inequities in coverage of these interventions have decreased in recent years. The results provided a mixed picture, generalizable to the system as a whole, expansion of insurance status represents one of the most remarkable advances that have not been accompanied by a significant improvement in effective access. In addition, existing inequalities are

  14. 44 CFR 71.3 - Denial of flood insurance.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Denial of flood insurance. 71... OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program IMPLEMENTATION OF COASTAL BARRIER LEGISLATION § 71.3 Denial of flood insurance. (a) No new flood insurance coverage...

  15. Expanding Medicare and employer plans to achieve universal health insurance.

    Science.gov (United States)

    Davis, K

    1991-05-15

    This article presents a proposal for expanding Medicare and employer-based health insurance plans to achieve universal health insurance. Under this proposed health care financing system, employees would provide basic health insurance coverage to workers and dependents, or pay a payroll tax contribution toward the cost of their coverage under Medicare. States would have the option of buying all Medicaid beneficiaries and other poor individuals into Medicare by paying the Medicare premiums and cost sharing. Other uninsured individuals would be automatically covered by Medicare. Employer plans would incorporate Medicare's provider payment methods. This proposal would result in incremental federal governmental outlays on the order of $25 billion annually. These new federal budgetary costs would be met through a combination of premiums, employer payroll tax, income tax, and general tax revenues. The principal advantage of this plan is that it draws on the strengths of the current system while simplifying the benefit and provider payment structure and instituting innovations to promote efficiency.

  16. Participation in the National Health Insurance Scheme Among ...

    African Journals Online (AJOL)

    Background: The National Health Insurance Scheme was established under Act 35 of 1999 by the Federal Government of Nigeria and is aimed at providing easy access to health care for all Nigerians at an affordable cost through various prepayment systems. It is totally committed to achieving universal coverage and ...

  17. Health Insurance without Single Crossing

    DEFF Research Database (Denmark)

    Boone, Jan; Schottmüller, Christoph

    2017-01-01

    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...

  18. Efficiency of the Austrian disease management program for diabetes mellitus type 2: a historic cohort study based on health insurance provider's routine data.

    Science.gov (United States)

    Ostermann, Herwig; Hoess, Victoria; Mueller, Michael

    2012-06-29

    The Austrian diabetes disease management program (DMP) was introduced in 2007 in order to improve health care delivery for diabetics via the promotion of treatment according to guidelines. Considering the current low participation rates in the DMP and the question of further promotion of the program, it is of particular interest for health insurance providers in Austria to assess whether enrollment in the DMP leads to differences in the pattern of the provision of in- and outpatient services, as well as to the subsequent costs in order to determine overall program efficiency. Historic cohort study comparing average annual levels of in- and outpatient health services utilization and its associated costs for patients enrolled and not enrolled in the DMP before (2006) and 2 years after (2009) the implementation of the program in Austria. Data on the use of services and data on costs were extracted from the records of the Austrian Social Insurance Institution for Business. 12,199 persons were identified as diabetes patients treated with anti-diabetic medication or anti-diabetics with insulin throughout the study period. 314 diabetics were enrolled in the DMP. Patients enrolled in the diabetes DMP received a more evolved pattern of outpatient care, featuring higher numbers of services provided by general practitioners and specialists (79 vs. 62), more diagnostic services (22 vs. 15) as well as more services provided by outpatient care centers (9 vs. 6) in line with increased levels of participation in medical assessments as recommended by the treatment guideline in 2009. Hospitalization was lower for DMP patients spending 3.75 days in hospital, as compared to 6.03 days for diabetes patients in regular treatment. Overall, increases in costs of care and medication throughout the study period were lower for enrolled patients (€ 718 vs. € 1.684), resulting in overall costs of € 5,393 p.c. for DMP patients and € 6,416 p.c. for the control group in 2009. Seen from a

  19. The Role of Public Health Insurance in Reducing Child Poverty.

    Science.gov (United States)

    Wherry, Laura R; Kenney, Genevieve M; Sommers, Benjamin D

    2016-04-01

    Over the past 30 years, there have been major expansions in public health insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affordable Care Act. Most of the research to date on health insurance coverage among low-income populations has focused on its effect on health care utilization and health outcomes, with much less attention to the financial protection it offers families. We review a growing body of evidence that public health insurance provides important financial benefits to low-income families. Expansions in public health insurance for low-income children and adults are associated with reduced out of pocket medical spending, increased financial stability, and improved material well-being for families. We also review the potential poverty-reducing effects of public health insurance coverage. When out of pocket medical expenses are taken into account in defining the poverty rate, Medicaid plays a significant role in decreasing poverty for many children and families. In addition, public health insurance programs connect families to other social supports such as food assistance programs that also help reduce poverty. We conclude by reviewing emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. Exposure to Medicaid and CHIP during childhood has been linked to decreased mortality and fewer chronic health conditions, better educational attainment, and less reliance on government support later in life. In sum, the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  20. Selection Behavior in the Market for Private Complementary Long-term Care Insurance in Germany

    DEFF Research Database (Denmark)

    Bauer, Jan; Schiller, Jörg; Schreckenberger, Christopher

    is dominating in this market, with respect to both the decision to buy a CompLTCI policy and the decision about the extent of CompLTCI coverage. We identify occupational status, residential location and the holding of further supplementary health insurance policies as unused observables contributing...... to selection effects in this market. Our results suggest that non-linearitiesin the relationship of potential sources of selection to insurance coverage and risk should be considered. A panel data analysis shows that an increase in health insurance payouts is positively correlated with the uptake of Comp......In this paper, we analyze selection effects in the German market for private complementary longterm care insurance contracts (CompLTCI) within a static and dynamic framework. Using data on more than 98,000 individuals from a German insurance company, we provide evidence that advantageous selection...

  1. Workers’ Compensation Insurance and Occupational Injuries

    Directory of Open Access Journals (Sweden)

    Ilsoon Shin

    2011-06-01

    Conclusion: Private insurance system, fixed flat rate employers’ funding mechanism, and higher coverage of compensation scheme are significantly and positively correlated with lower level of occupational accidents compared with the public insurance system, risk-based funding system, and lower coverage of compensation scheme.

  2. Do Infant Birth Outcomes Vary Among Mothers With and Without Health Insurance Coverage in Sub-Saharan Africa? Findings from the National Health Insurance and Cash and Carry Eras in Ghana, West Africa

    Directory of Open Access Journals (Sweden)

    Abdallah Ibrahim, DrPH

    2014-06-01

    Full Text Available Background: Beginning in the late 1960’s, and accelerating after 1985, a system known as “Cash and Carry” required the people of Ghana to pay for health services out-of-pocket before receiving them. In 2003, Ghana enacted a National Health Insurance Scheme (NHIS (fully implemented by 2005 that allowed pregnant women to access antenatal care and hospital delivery services for low annual premiums tied to income. The objective of this study was to compare trends in low birth weight (LBW among infants born under the NHIS with infants born during the Cash and Carry system when patients paid out-of-pocket for maternal and child health services. Methods: Sampled birth records abstracted from birth folders at the Tamale Teaching Hospital (TTH were examined. Chi-squared tests were performed to determine differences in the prevalence of LBW. A p-value of ≤ 0.05 was considered statistically significant. Analyses were conducted for selected variables in each year from 2000 to 2003 (Cash and Carry and 2008 to 2011(NHIS. Results: Higher birth weights were not observed for deliveries under NHIS compared to those under Cash and Carry. More than one-third of infants in both eras were born to first-time mothers, and they had a significantly higher prevalence of LBW compared to infants born to multiparous mothers. Conclusion and Global Health Implications: Understanding the factors that affect the prevalence of LBW is crucial to public health policy makers in Ghana. LBW is a powerful predictor of infant survival, and therefore, an important factor in determining the country’s progress toward meeting the United Nations Millennium Development Goal of reducing under-five child mortality rates (MDG4 by the end of 2015.

  3. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?

    Science.gov (United States)

    Chomi, Eunice Nahyuha; Mujinja, Phares G M; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-03-19

    Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple health insurance funds affects health care seeking behaviour and utilisation among members of the Community Health Fund, the National Health Insurance Fund and non-members in two districts in Tanzania. Using household survey data collected in 2011 with a sample of 3290 individuals, the study uses a multinomial logit model to examine the influence of predisposing, enabling and need characteristics on the probability of seeking care and choice of provider. Generally, health insurance is found to increase the probability of seeking care and reduce delays. However, the probability, timing of seeking care and choice of provider varies across the CHF and NHIF members. Reducing fragmentation is necessary to provide opportunities for redistribution and to promote equity in utilisation of health services. Improvement in the delivery of services is crucial for achievement of improved access and financial protection and for increased enrolment into the CHF, which is essential for broadening redistribution and cross-subsidisation to promote equity.

  4. Experiences and Attitudes of Primary Care Providers Under the First Year of ACA Coverage Expansion: Findings from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers.

    Science.gov (United States)

    2015-06-01

    A new survey from The Kaiser Family Foundation and The Commonwealth Fund asked primary care providers--physicians, nurse practitioners, and physician assistants--about their views of and experiences with the Affordable Care Act (ACA) and other changes in health care delivery and payment, as well as their thoughts on the future of primary care. In this first brief based on the survey, many providers reported seeing an increased number of patients since the coverage expansions went into effect, but not an accompanying compromise in quality of care. A large majority of primary care providers are satisfied with their medical practice, but a substantial percentage of physicians expressed pessimism about the future of primary care. Similar to the population overall, providers' views of the ACA are divided along party lines. A second brief will report on providers' reactions to other changes occurring in primary care delivery and payment.

  5. Life insurance

    OpenAIRE

    Černá, Lenka

    2009-01-01

    Bachelor's thesis deals with the life insurance market in the Czech Republic. I compared the different insurance products life insurance among themselves. And these products is the formula published in the scientific literature.

  6. 26 CFR 1.7702-2 - Attained age of the insured under a life insurance contract.

    Science.gov (United States)

    2010-04-01

    ... age of the insured under a life insurance contract. (a) In general. This section provides guidance on determining the attained age of an insured under a contract that is a life insurance contract under the... second of the two insureds dies. (ii) Section 1.7702-2(c)(1) provides that if a life insurance contract...

  7. [Variability in antibiotic consumption within a regional health service, according to health area and model of healthcare coverage: national health system vs. civil servants' mutual insurance society].

    Science.gov (United States)

    Sánchez-Martínez, Diego Pablo; Guillén-Pérez, José Jesús; Sánchez-Martínez, Fernando Ignacio; Torres-Cantero, Alberto Manuel

    2015-08-01

    The aim of this study is to describe antibiotic consumption in the Region of Murcia in 2011, within the Spanish and European context, as well as to analyze the differences within the Region, both between health areas, and between users of the regional health service and those protected by the civil servants' mutual insurance society (MUFACE). Retrospective observational study of prescriptions dispensed by the pharmacies in the Region of Murcia during 2011. Consumption rates were expressed as defined daily doses (DDD) per 1,000 inhabitants/day and standardized consumption ratios (SCR). Overall antibiotics consumption rate in the Region of Murcia in 2011 was 30.05 DDD/1000/ day (DID), which is much above the average rate for Spain (20.9 DID) and for the European Union (21.57 DID). Health areas within the Region with the highest and lowest consumption rate are, respectively, Vega Alta (SCR: 124.44; CI95% 124.26 to 124.61) and Cartagena (SCR:84.16; CI95% 84.10 to 84.22). Civil servants covered by the mutual society have higher consumption rates than users of the regional health service (SCR: 105.01; CI95% 104.86 to 105.17). There is a high level of antibiotic prescription in the Region of Murcia Region in relative terms. A great variability in antibiotics consumption was observed between the different health areas, which might be related to the higher rate of the frequency of visits. The highest amount of variability in antibiotics prescription was found in cephalosporins and macrolides.

  8. Working with an Insurance Market in Turmoil.

    Science.gov (United States)

    Boggs, Ronald R.

    1985-01-01

    Outlines specific ways for schools to react to insurance premium increases and new coverage restrictions. Suggests such options as buying less insurance, considering larger retentions,and starting pooling programs, and discusses other non-traditional approaches to conventional insurance programs. (MD)

  9. 48 CFR 47.102 - Transportation insurance.

    Science.gov (United States)

    2010-10-01

    ... 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... carriers and (2) does not buy insurance coverage for its property in the possession of commercial carriers...

  10. An Employer Guide on Insurance-Liability Issues and Child Labor Laws. New Jersey School to Careers: Work-Based Learning Activities.

    Science.gov (United States)

    New Jersey State Dept. of Labor, Trenton.

    This guide provides employers with information on insurance coverage, child labor laws, and recommended steps for reducing potential liabilities that may occur by having students at the employer's site. The guide first covers employer liability issues and school Certificates of Insurance. The next part is organized to address employer concerns…

  11. Impacts of a new insurance benefit with capitated provider payment on healthcare utilization, expenditure and quality of medication prescribing in China.

    Science.gov (United States)

    Sun, Jing; Zhang, Xiaotian; Zhang, Zou; Wagner, Anita K; Ross-Degnan, Dennis; Hogerzeil, Hans V

    2016-02-01

    To assess a new Chinese insurance benefit with capitated provider payment for common diseases in outpatients. Longitudinal health insurance claims data, health administrative data and primary care facility data were used to assess trajectories in outpatient visits, inpatient admissions, expenditure per common disease outpatient (CD/OP) visit and prescribing indicators over time. We conducted segmented regression analyses of interrupted time series data to measure changes in level and trend overtime, and cross-sectional comparisons against external standards. The number of total outpatient visits at 46 primary care facilities (on the CD/OP benefit as of July 2012) increased by 46 895 visits/month (P = 0.004, 95% CI: 15 795-77 994); the average number of CD/OP visits reached 1.84/year/enrollee in 2012; monthly inpatient admissions dropped from 6.4 (2009) to 4.3 (2012) per 1000 enrollees; the median total expenditure per CD/OP visit dropped by CNY 15.40 (P = 0.16, 95% CI: -36.95~6.15); injectable use dropped by 7.38% (P = 0.03, 95% CI: -14.08%~-0.68%); antibiotic use was not improved. Zhuhai's new CD/OP benefit with capitated provider payment has expanded access to primary care, which may have led to a reduction in expensive specialist inpatient services for CD/OP benefit enrollees. Cost awareness was likely raised, and rapidly growing expenditures were contained. Although having been partially improved, inappropriate prescribing of antibiotics and injectables was still prevalent. More explicit incentives and specific quality of care targets must be incorporated into the capitated provider payment to promote scientifically sound and cost-effective care and treatment. © 2015 John Wiley & Sons Ltd.

  12. Consumers’ Collision Insurance Decisions

    DEFF Research Database (Denmark)

    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 (2007......), which refines EU theory to incorporate income and predicts that property insurance is a normal good; (b) a mental accounting model based on the idea that consumers budget their income across consumption categories (Thaler, 1985); and (c) the baseline, classic EU theory, which predicts that insurance...... is an inferior good (Mossin, 1968). The behaviour reported by subjects in our study suggests that insurance is a normal good, while their verbal reports reveal desires to balance two conflicting goals in deductible decisions, keeping premiums “affordable” and keeping deductibles “affordable,” which suggests...

  13. Supplemental health insurance: did Croatia miss an opportunity?

    Science.gov (United States)

    Langenbrunner, John C

    2002-08-01

    Croatia continues to face a health-funding crisis. A recent supplemental health insurance law increases revenues through first increasing co-payments, then raising the payroll tax to cover those co-payments. This public finance "slight-of-hand" will not solve the system's structural issues and may worsen system performance both in terms of efficiency and equity. Should Croatia have considered private supplemental insurance as an alternative? There is a new single private supplemental health insurance market now evolving over the EU countries and into Eastern Europe. Croatians could take advantage of lowered costs due to larger risk pooling and the lower administrative overhead of mature insurance organizations. Private supplemental insurance, when designed well, can address several objectives, including a) increased revenues into the health sector; b) removal of the public burden of coverage of selected services for certain population groups; and c) encourage new management and organizational innovations into the sector. Private and multiple company insurance markets are thought to be superior in terms of consumer responsiveness; choice of benefits; adoption of new, more expensive technology; and use of private sector providers. Private sector insurers may also encourage "spillover" effects encouraging reforms with public sector insurance performance. There is already an emerging private insurance market in Croatia, but can it be expanded and properly regulated? The private insurance companies might capture as much as 30-70% of the market for certain services, such as high cost procedures, preferred providers, and hotel amenities. But the Government will need to strengthen the regulatory framework for private insurance and assure that there is adequate regulatory capacity.

  14. Statutory health insurance competition in Europe: a four-country comparison.

    Science.gov (United States)

    Thomson, Sarah; Busse, Reinhard; Crivelli, Luca; van de Ven, Wynand; Van de Voorde, Carine

    2013-03-01

    This paper explores the goals and implementation of reforms introducing choice of and competition among insurers providing statutory health coverage in Belgium, Germany, the Netherlands and Switzerland. In theory, health insurance competition can enhance efficiency in health care administration and delivery only if people have free choice of insurer (consumer mobility), if insurers do not have incentives to select risks, and if insurers are able to influence health service quality and costs. In practice, reforms in the four countries have not always prioritised efficiency and implementation has varied. Differences in policy goals explain some but not all of the differences in implementation. Despite significant investment in risk adjustment, incentives for risk selection remain and consumer mobility is not evenly distributed across the population. Better risk adjustment might make it easier for older and less healthy people to change insurer. Policy makers could also do more to prevent insurers from linking the sale of statutory and voluntary health insurance, particularly where take-up of voluntary coverage is widespread. Collective negotiation between insurers and providers in Belgium, Germany and Switzerland curbs insurers' ability to influence health care quality and costs. Nevertheless, while insurers in the Netherlands have good access to efficiency-enhancing tools, data and capacity constraints and resistance from stakeholders limit the extent to which tools are used. The experience of these countries offers an important lesson to other countries: it is not straightforward to put in place the conditions under which health insurance competition can enhance efficiency. Policy makers should not, therefore, underestimate the challenges involved. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. HEALTH INSURANCE

    CERN Multimedia

    2000-01-01

    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...

  16. Provider's and user's perspective about immunization coverage among migratory and non-migratory population in slums and construction sites of Chandigarh.

    Science.gov (United States)

    Sharma, Vikas; Singh, Amarjeet; Sharma, Vijaylakshmi

    2015-04-01

    Strengthening routine immunization is a corner stone for countries to achieve the United Nations Millennium Development Goal 4 (MDG 4) which aims to reduce under-five mortality by two-thirds and MDG 5 improving maternal health compared to 1990 estimates by 2015. The poor urban newborns are more vulnerable to many health and nutrition problems compared to the non-poor urban counterparts. Therefore there is a need to strengthen health system to cater the needs of urban poor. Standardized WHO30*7 cluster sampling for slums and convenience sampling for construction sites. In depth interviews were conducted for user's as well as provider's perspective about immunization coverage. Two hundred ten children and 210 mothers were enrolled in slums and 100 were sampled from construction sites. The slum workers are considered as non-migratory groups whereas construction site workers are considered as migratory population. Among children, 23 % were fully immunized, 73 % were partially immunized and 3 % were unimmunized in non-migratory population whereas 3 % were fully immunized, 91 % were partially immunized and 6 % were unimmunized in migratory population. Among mothers, 43 and 39 % were fully immunized, 13 and 15 % partially immunized and 43 and 46 % were unimmunized in non-migratory and migratory population, respectively. The various reasons attributed for low coverage are (a) dissatisfaction of the users with the service delivery and procedural delays (bureaucracy), (b) lack of faith in health workers, (c) insistence upon ID/vaccination card/aadhar card by the health worker before vaccinating child and (d) ignorance of the need of immunization by the people and migration of the population.

  17. Health insurance, alcohol and tobacco use among pregnant and non-pregnant women of reproductive age.

    Science.gov (United States)

    Brown, Qiana L; Hasin, Deborah S; Keyes, Katherine M; Fink, David S; Ravenell, Orson; Martins, Silvia S

    2016-09-01

    Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant women and women planning to become pregnant. We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12-44 years old, by pregnancy status. The women (n=97,788) were participants in the National Survey of Drug Use and Health (NSDUH) in 2010-2013. Logistic regression models assessed the association between health insurance (insured versus uninsured), past month tobacco and alcohol use, and whether this was modified by pregnancy status. Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value≤0.01) and alcohol use (p-value≤0.01). Among pregnant women, being insured was associated with lower odds of alcohol use (adjusted odds ratio [AOR]=0.47; 95% confidence interval [CI]=0.27-0.82), but not associated with tobacco use (AOR=1.14; 95% CI=0.73-1.76). Among non-pregnant women, being insured was associated with lower odds of tobacco use (AOR=0.67; 95% CI=0.63-0.72), but higher odds of alcohol use (AOR=1.23; 95% CI=1.15-1.32). Access to health care, via health insurance coverage is a promising method to help reduce alcohol use during pregnancy. However, despite health insurance coverage, tobacco use persists during pregnancy, suggesting missed opportunities for prevention during prenatal visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. 5 CFR 870.502 - Basic insurance: Waiver/cancellation of insurance.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Basic insurance: Waiver/cancellation of insurance. 870.502 Section 870.502 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Coverage § 870.502 Basic...

  19. 5 CFR 870.505 - Optional insurance: Waiver/cancellation of insurance.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Optional insurance: Waiver/cancellation of insurance. 870.505 Section 870.505 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM Coverage...

  20. Monthly Pre-Existing Condition Insurance Plan Enrollment

    Data.gov (United States)

    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...

  1. Improving The Affordable Care Act: An Assessment Of Policy Options For Providing Subsidies.

    Science.gov (United States)

    Saltzman, Evan A; Eibner, Christine; Enthoven, Alain C

    2015-12-01

    A key challenge of health reform efforts is to make health insurance affordable for individuals and families who lack coverage without harming those with coverage or increasing federal spending. The Affordable Care Act (ACA) addresses this challenge in part by providing tax subsidies to qualified individuals for purchasing individual insurance and retaining tax exemptions for employer and employee contributions to the cost of premiums of employer-sponsored insurance. These tax exemptions cost approximately $250 billion annually in lost tax revenue and have been criticized for favoring higher earners and conferring preferential treatment of employer-sponsored over individual insurance. We analyzed three options for leveling the financial playing field between the two insurance markets by reallocating the value of tax benefits of employer coverage. We found that one option that uses the subsidy formula employed in the insurance Marketplaces under the ACA for both the individual and employer-sponsored insurance markets, and additionally requires the subsidy to be at least $1,250 without an upper income limit on subsidy eligibility imposed, could expand insurance coverage and reduce individual market premiums relative to the ACA with no additional federal spending. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Group Health Insurance Plans for Public-School Personnel, 1964-65.

    Science.gov (United States)

    National Education Association, Washington, DC.

    This report explains the major considerations in developing group health insurance coverage for public school personnel. A general overview is given of (1) group health insurance coverage, (2) patterns of group health insurance, (3) group health insurance organizations, (4) eligibility and enrollment practices, and (5) continuous health insurance…

  3. SCHIP Directors' Perception of Schools Assisting Students in Obtaining Public Health Insurance

    Science.gov (United States)

    Price, James H.; Rickard, Megan

    2009-01-01

    Background: Health insurance coverage increases access to health care. There has been an erosion of employer-based health insurance and a concomitant rise in children covered by public health insurance programs, yet more than 8 million children are still without health insurance coverage. Methods: This study was a national survey to assess the…

  4. Insurance against climate change and flood risk: Insurability and decision processes of insurers

    Science.gov (United States)

    Hung, Hung-Chih; Hung, Jia-Yi

    2016-04-01

    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

  5. On a Stochastic Model in Insurance

    Indian Academy of Sciences (India)

    proportion of the financial risk is shifted to the insur- ance company. The implicit trust between the insured and the insurance company is at the core of the inter- action. A reasonable mathematical theory of insurance can possibly provide a scientific basis for this trust. Certain types of insurance policies have been prevalent.

  6. "Sticker Shock" in Individual Insurance under Health Reform

    OpenAIRE

    Mark Pauly; Scott Harrington; Adam Leive

    2014-01-01

    This paper provides estimates of the changes in premiums, average or expected out of pocket payments, and the sum of premiums and out of pocket payments (total expected price) for a sample of consumers who bought individual insurance in 2010 to 2012, comparing total expected prices before the Affordable Care Act with estimates of total expected prices if they were to purchase silver or bronze coverage after reform, before the effects of any premium subsidies. We provide comparisons for purcha...

  7. Public Insurance and Equality

    DEFF Research Database (Denmark)

    Landes, Xavier; Néron, Pierre-Yves

    2015-01-01

    health and unemployment insurance and pensions) is explained and justified by the greater efficiency of the state, in comparison with markets, in addressing market failures such as moral hazard or adverse selection. Our argument is that while insurance, intrinsically and idealistically, may diverge from......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...... 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...

  8. Income, insurance, and technology: why does health spending outpace economic growth?

    Science.gov (United States)

    Smith, Sheila; Newhouse, Joseph P; Freeland, Mark S

    2009-01-01

    A broad consensus holds that increased medical capability-technology-is the primary driver of health spending growth. However, technology does not expand independently of historical context; it is fueled by rising incomes and more generous insurance coverage. We estimate that medical technology explains 27-48 percent of health spending growth since 1960-a smaller percentage than earlier estimates. Income (gross domestic product, or GDP) growth plays a critical role, primarily through the actions of governments and employers on behalf of pools of consumers. The contribution of insurance is likely to differ, with less of a push from increasing generosity of coverage and more of a push from changes in provider payment.

  9. Health Insurance

    Science.gov (United States)

    Health insurance helps protect you from high medical care costs. It is a contract between you and ... Many people in the United States get a health insurance policy through their employers. In most cases, ...

  10. 5 CFR 875.412 - When will my coverage terminate?

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false When will my coverage terminate? 875.412... REGULATIONS (CONTINUED) FEDERAL LONG TERM CARE INSURANCE PROGRAM Coverage § 875.412 When will my coverage terminate? Your coverage will terminate on the earliest of the following dates: (a) The date you specify to...

  11. Deposit Insurance and Bank Liquidity: Does Ownership Structure Matter?

    Directory of Open Access Journals (Sweden)

    Irwan Trinugroho

    2016-07-01

    Full Text Available We examine how the level deposit insurance coverage affects bank liquidity. We also test the role of ownership in the relationship between deposit insurance coverage and bank liquidity. This study uses quarterly data of Indonesian banks from Q1:2002 - Q2:2008. We argue that the presence of explicit deposit insurance changes a bank‘s behavior in liquidity management in the form of decreasing asset liquidity. We find some evidence on the negative impact of deposit insurance coverage on bank liquidity. However, little is found on the role of ownership structure. The credibility of deposit insurance system and implicit guarantee are the main policy implications.

  12. Self-insurance and the potential effects of health reform on the small-group market.

    Science.gov (United States)

    Linehan, Kathryn

    2010-12-21

    The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers--most often those in very large firms--are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA provisions become effective, some have argued that smaller firms that offer insurance may opt to self-insure their health benefits because of new small-group market rules. Such a shift could affect risk pooling in the small-group market. This paper examines the definition and prevalence of self-insured health plans, the application of PPACA provisions to these plans, and the possible effects on the broader health insurance market, should many more employers decide to self-insure.

  13. Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE, Elevation Points data located within the Flood data geodatabase, Published in Not Provided, City of Roswell Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE dataset current as of unknown. Elevation Points data located within the Flood data geodatabase.

  14. INSURANCE REQUIREMENTS ANDPRACTICES OF ETHIOPIA'S ...

    African Journals Online (AJOL)

    as a social device providing financial compensation for the effects of ... personal injuries and property darn!lge in the world ... business witlloct suficient cover of insurance. The aim of this ... The development of insurance has also its own part.

  15. Regulating the for-profit private healthcare providers towards universal health coverage: A qualitative study of legal and organizational framework in Mongolia.

    Science.gov (United States)

    Tsevelvaanchig, Uranchimeg; Narula, Indermohan S; Gouda, Hebe; Hill, Peter S

    2017-05-29

    Regulating the behavior of private providers in the context of mixed health systems has become increasingly important and challenging in many developing countries moving towards universal health coverage including Mongolia. This study examines the current regulatory architecture for private healthcare in Mongolia exploring its role for improving accessibility, affordability, and quality of private care and identifies gaps in policy design and implementation. Qualitative research methods were used including documentary review, analysis, and in-depth interviews with 45 representatives of key actors involved in and affected by regulations in Mongolia's mixed health system, along with long-term participant observation. There has been extensive legal documentation developed regulating private healthcare, with specific organizations assigned to conduct health regulations and inspections. However, the regulatory architecture for healthcare in Mongolia is not optimally designed to improve affordability and quality of private care. This is not limited only to private care: important regulatory functions targeted to quality of care do not exist at the national level. The imprecise content and details of regulations in laws inviting increased political interference, governance issues, unclear roles, and responsibilities of different government regulatory bodies have contributed to failures in implementation of existing regulations. Copyright © 2017 John Wiley & Sons, Ltd.

  16. An Enumerative Combinatorics Model for Fragmentation Patterns in RNA Sequencing Provides Insights into Nonuniformity of the Expected Fragment Starting-Point and Coverage Profile.

    Science.gov (United States)

    Prakash, Celine; Haeseler, Arndt Von

    2017-03-01

    RNA sequencing (RNA-seq) has emerged as the method of choice for measuring the expression of RNAs in a given cell population. In most RNA-seq technologies, sequencing the full length of RNA molecules requires fragmentation into smaller pieces. Unfortunately, the issue of nonuniform sequencing coverage across a genomic feature has been a concern in RNA-seq and is attributed to biases for certain fragments in RNA-seq library preparation and sequencing. To investigate the expected coverage obtained from fragmentation, we develop a simple fragmentation model that is independent of bias from the experimental method and is not specific to the transcript sequence. Essentially, we enumerate all configurations for maximal placement of a given fragment length, F, on transcript length, T, to represent every possible fragmentation pattern, from which we compute the expected coverage profile across a transcript. We extend this model to incorporate general empirical attributes such as read length, fragment length distribution, and number of molecules of the transcript. We further introduce the fragment starting-point, fragment coverage, and read coverage profiles. We find that the expected profiles are not uniform and that factors such as fragment length to transcript length ratio, read length to fragment length ratio, fragment length distribution, and number of molecules influence the variability of coverage across a transcript. Finally, we explore a potential application of the model where, with simulations, we show that it is possible to correctly estimate the transcript copy number for any transcript in the RNA-seq experiment.

  17. Probabilistic Insurance

    NARCIS (Netherlands)

    P.P. Wakker (Peter); R.H. Thaler (Richard); A. Tversky (Amos)

    1997-01-01

    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

  18. Probabilistic Insurance

    NARCIS (Netherlands)

    Wakker, P.P.; Thaler, R.H.; Tversky, A.

    1997-01-01

    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

  19. Healthcare use and voluntary health insurance after retirement in Thailand.

    Science.gov (United States)

    Kananurak, Papar

    2014-06-01

    The dramatic changes occurring in the age structure of the Thai population make providing healthcare services for the elderly a major challenge for decision makers. Because the number of the elderly will be increasing, together with the number of retired workers, under the Social Health Insurance (SHI) scheme, there will be the unmet needs for healthcare use after retirement. The SHI scheme does not cover workers after retirement unless they could use free healthcare for the elderly. In addition, the government budget is tight regarding the support of universal healthcare and long-term care services for all of the elderly. Therefore, the government could support retired workers who have the ability to pay by facilitating voluntary health insurance. The main objectives of the present study are to analyze the characteristics of workers that need health insurance after retirement and to identify the factors explaining healthcare use to offer healthcare services to meet the workers' needs and expectations. Four hundred insured workers under the Social Health Insurance (SHI) Scheme in Thailand were interviewed using a structured questionnaire. The Anderson-Newman model of healthcare use is the conceptual framework used in this study to understand the factors that explain healthcare use patterns of workers. Multiple regressions are employed extensively to evaluate the variables that predict healthcare use. According to the survey, a person that purchases voluntary health insurance is likely to be female, have a higher personal income, and healthy. The characteristics related to healthcare use were poor health status, a high personal income, and peeople afflicted by chronic illness. There is a gap between healthcare service use and the demand for voluntary health insurance. People that have a high income are more likely to purchase voluntary health insurance, while people in worse health and afflicted by chronic illness may have greater difficulty purchasing voluntary

  20. Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study.

    Science.gov (United States)

    Maina, Jackson Michuki; Kithuka, Peter; Tororei, Samuel

    2016-01-01

    In Kenya, maternal and child health accounts for a large proportion of the expenditures made towards healthcare. It is estimated that one in every five Kenyans has some form of health insurance. Availability of health insurance may protect families from catastrophic spending on health. The study intended to determine the factors affecting the uptake of health insurance among pregnant women in a rural Kenyan district. This was cross-sectional study that sampled 139 pregnant women attending the antenatal clinic at a level 5 hospital in a Kenyan district. The information was collected through a pretested interview schedule. The median age of the study participants was 28 years. Out of the 139 respondents, 86(62%) planned to pay for their deliveries through insurance. There was a significant relationship between insurance uptake and marital status Adjusted odds ratio (AOR) 6.4(1.4-28.8). Those with tertiary education were more likely to take up insurance AOR 5.1 (1.3-19.2). Knowing the benefits of insurance and the limits the insurance would settle in claims was associated with an increase in the uptake of insurance AOR 7.6(2.3-25.1), AOR 6.4(1.5-28.3) respectively. Monthly income and number of children did not affect insurance uptake. Being married, tertiary education and having some knowledge on how insurance premiums are paid are associated with uptake of medical insurance. Information generated from this study if utilized will bring a better understanding as to why insurance coverage may be low and may provide a basis for policy changes among the insurance companies to increase the uptake.

  1. [Technical improvement of cohort constitution in administrative health databases: Providing a tool for integration and standardization of data applicable in the French National Health Insurance Database (SNIIRAM)].

    Science.gov (United States)

    Ferdynus, C; Huiart, L

    2016-09-01

    Administrative health databases such as the French National Heath Insurance Database - SNIIRAM - are a major tool to answer numerous public health research questions. However the use of such data requires complex and time-consuming data management. Our objective was to develop and make available a tool to optimize cohort constitution within administrative health databases. We developed a process to extract, transform and load (ETL) data from various heterogeneous sources in a standardized data warehouse. This data warehouse is architected as a star schema corresponding to an i2b2 star schema model. We then evaluated the performance of this ETL using data from a pharmacoepidemiology research project conducted in the SNIIRAM database. The ETL we developed comprises a set of functionalities for creating SAS scripts. Data can be integrated into a standardized data warehouse. As part of the performance assessment of this ETL, we achieved integration of a dataset from the SNIIRAM comprising more than 900 million lines in less than three hours using a desktop computer. This enables patient selection from the standardized data warehouse within seconds of the request. The ETL described in this paper provides a tool which is effective and compatible with all administrative health databases, without requiring complex database servers. This tool should simplify cohort constitution in health databases; the standardization of warehouse data facilitates collaborative work between research teams. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Dental Use and Expenditures for Older Uninsured Americans: The Simulated Impact of Expanded Coverage

    Science.gov (United States)

    Manski, Richard J; Moeller, John F; Chen, Haiyan; Schimmel, Jody; Pepper, John V; St Clair, Patricia A

    2015-01-01

    Objective To determine if providing dental insurance to older Americans would close the current gaps in dental use and expenditure between insured and uninsured older Americans. Data Sources/Study Setting We used data from the 2008 Health and Retirement Survey (HRS) supplemented by data from the 2006 Medical Expenditure Panel Survey (MEPS). Study Design We compared the simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured. Data Collection/Extraction Methods The HRS is a nationally representative survey administered by the Institute for Social Research (ISR). The MEPS is a nationally representative household survey sponsored by the Agency for Healthcare Research and Quality (AHRQ). Principal Findings We found that expanding dental coverage to older uninsured Americans would close previous gaps in dental use and expense between uninsured and insured noninstitutionalized Americans 55 years and older. Conclusions Providing dental coverage to previously uninsured older adults would produce estimated monthly costs net of markups for administrative costs that comport closely to current market rates. Estimates also suggest that the total cost of providing dental coverage targeted specifically to nonusers of dental care may be less than similar costs for prior users. PMID:25040355

  3. Disparities in health insurance among children with same-sex parents.

    Science.gov (United States)

    Gonzales, Gilbert; Blewett, Lynn A

    2013-10-01

    The objectives of this study were to examine disparities in health insurance coverage for children with same-sex parents and to investigate how statewide policies such as same-sex marriage and second-parent adoptions affect children's private insurance coverage. We used data from the 2008-2010 American Community Survey to identify children (aged 0-17 years) with same-sex parents (n = 5081), married opposite-sex parents (n = 1369789), and unmarried opposite-sex parents (n = 101678). We conducted multinomial logistic regression models to estimate the relationship between family type and type of health insurance coverage for all children and then stratified by each child's state policy environment. Although 77.5% of children with married opposite-sex parents had private health insurance, only 63.3% of children with dual fathers and 67.5% with dual mothers were covered by private health plans. Children with same-sex parents had fewer odds of private insurance after controlling for demographic characteristics but not to the extent of children with unmarried opposite-sex parents. Differences in private insurance diminished for children with dual mothers after stratifying children in states with legal same-sex marriage or civil unions. Living in a state that allowed second-parent adoptions also predicted narrower disparities in private insurance coverage for children with dual fathers or dual mothers. Disparities in private health insurance for children with same-sex parents diminish when they live in states that secure their legal relationship to both parents. This study provides supporting evidence in favor of recent policy statements by the American Academy of Pediatricians endorsing same-sex marriage and second-parent adoptions.

  4. Universal health coverage in Turkey: enhancement of equity.

    Science.gov (United States)

    Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

    2013-07-06

    Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with

  5. Creation and implementation of a certification system for insurability and fire risk classification for forest plantations

    Science.gov (United States)

    Veronica Loewe M.; Victor Vargas; Juan Miguel Ruiz; Andrea Alvarez C.; Felipe Lobo Q.

    2015-01-01

    Currently, the Chilean insurance market sells forest fire insurance policies and agricultural weather risk policies. However, access to forest fire insurance is difficult for small and medium enterprises (SMEs), with a significant proportion (close to 50%) of forest plantations being without coverage. Indeed, the insurance market that sells forest fire insurance...

  6. Did the US Infertility Health Insurance Mandates Affect the Timing of First Birth?

    NARCIS (Netherlands)

    Ohinata, A.

    2011-01-01

    From 1977-2001, 15 US states mandated health insurance providers to offer coverage for infertility treatment. Although the majority of the past literature has studied impacts on older women who are likely to seek treatment, this paper proposes that the mandates may have had a wider impact on the US

  7. Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act.

    Science.gov (United States)

    Frean, Molly; Gruber, Jonathan; Sommers, Benjamin D

    2017-05-01

    Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange. The individual mandate's exemptions and penalties had little impact on coverage rates. The law increased Medicaid among individuals gaining eligibility under the ACA and among previously-eligible populations ("woodwork effect") even in non-expansion states, with no resulting reductions in private insurance. Overall, exchange premium subsidies produced 40% of the coverage gains explained by our ACA policy measures, and Medicaid the other 60%, of which 1/2 occurred among previously-eligible individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Is It Really Worse to Have Public Health Insurance than to Have No Insurance at All? Health Insurance and Adult Health in the United States

    Science.gov (United States)

    Quesnel-Vallee, Amelie

    2004-01-01

    Using prospective cohort data from the 1979 National Longitudinal Survey of Youth, this study examines the extent to which health insurance coverage and the source of that coverage affect adult health. While previous research has shown that privately insured nonelderly individuals enjoy better health outcomes than their uninsured counterparts, the…

  9. Clinical trial insurance in Serbia

    Directory of Open Access Journals (Sweden)

    Žagar Zlatko A.

    2015-01-01

    Full Text Available Prior the commencement of the clinical trial in Serbia the Sponsor is obliged to provide the insurance policy covering the patient's bodily injury and damaged health caused by the clinical trial. According to provisions of Serbian Insurance law insurance polices have to be issued by the insurance companies established in Serbia. Every insurance policy not issued by the insurance company established in Serbia shall be deemed as null and void. The only expectance, is when the foreign clinical trial liability policy is stipulated that the insurance contract acknowledges the jurisdiction of Serbian domestic courts and other Serbian authorities to decide on damage claims (that never happened in Serbian practice. The Sponsor will fulfill this obligation stipulated in Serbian law when provides the Clinical Trial Liability policy issued by the Serbian insurance company. Nowadays, few of Serbian insurance companies are issuing such polices. Under the clinical trial liability insurance cover the insured's are: Sponsor, Medical Centers in Serbia performing or controlling the clinical trial, Principal Investigators and their assistant staff performing or controlling the clinical trial. The beneficiaries of the insurance cover are patients and/or members of their families - inheritresses. The insurance company will indemnify the beneficiary mentioned in the policy when the insured event occurred i.e. when occurred bodily injury, psychic disease and alienation, psychic damages, illnesses and deaths caused by the clinical trial. The amount of indemnity by the insurance company to the beneficiaries is limited by the amount of sum insured per occurrence and/or by the total amount of the sum insured for the total period of the insurance cover. According to case-law in Serbia the total sum insured between EUR 500.000 and EUR 1.000.000 is considered as sufficient so far to indemnify the patients in case of the insured event. If an insurance event occurs the

  10. Long-Term Care Insurance: Coverage Varies Widely in a Developing Market. Report to the Chairman, Subcommittee on Health and Long-Term Care, Select Committeee on Aging, House of Representatives.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Div. of Human Resources.

    In response to a request by Congressman Claude Pepper, the General Accounting Office (GAO) conducted a study to examine the private long-term care insurance market. The GAO analyzed the premiums, benefits, and limitations of 33 policies offered by 25 insurers in 1986. The GAO assessed the potential for abuse in this market by surveying state…

  11. 24 CFR 200.17 - Mortgage coverage.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage coverage. 200.17 Section... Generally Applicable to Multifamily and Health Care Facility Mortgage Insurance Programs; and Continuing Eligibility Requirements for Existing Projects Eligible Mortgage § 200.17 Mortgage coverage. The mortgage...

  12. Modelling in life insurance a management perspective

    CERN Document Server

    Norberg, Ragnar; Planchet, Frédéric

    2016-01-01

    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...

  13. Designing Insurance to Promote Use of Childhood Obesity Prevention Services

    Directory of Open Access Journals (Sweden)

    Kimberly J. Rask

    2013-01-01

    Full Text Available Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

  14. How does retiree health insurance influence public sector employee saving?

    Science.gov (United States)

    Clark, Robert L; Mitchell, Olivia S

    2014-12-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. How Does Retiree Health Insurance Influence Public Sector Employee Saving?

    Science.gov (United States)

    Clark, Robert L.

    2017-01-01

    Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: -Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers;-Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.-After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. PMID:25479891

  16. Acceptability of, and willingness to pay for, community health insurance in rural India.

    Science.gov (United States)

    Jain, Ankit; Swetha, Selva; Johar, Zeena; Raghavan, Ramesh

    2014-09-01

    To understand the acceptability of, and willingness to pay for, community health insurance coverage among residents of rural India. We conducted a mixed methods study of 33 respondents located in 8 villages in southern India. Interview domains focused on health-seeking behaviors of the family for primary healthcare, household expenditures on primary healthcare, interest in pre-paid health insurance, and willingness to pay for such a product. Most respondents reported that they would seek care only when symptoms were manifest; only 6 respondents recognized the importance of preventative services. None reported impoverishment due to health expenditures. Few viewed health insurance as necessary either because they did not wish to be early adopters, because they had alternate sources of financial support, or because of concerns with the design of insurance coverage or the provider. Those who were interested reported being willing to pay Rs. 1500 ($27) as the modal annual insurance premium. Penetration of community health insurance programs in rural India will require education of the consumer base, careful attention to premium rate setting, and deeper understanding of social networks that may act as financial substitutes for health insurance. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  17. Surveillance of Vaccination Coverage among Adult Populations - United States, 2015.

    Science.gov (United States)

    Williams, Walter W; Lu, Peng-Jun; O'Halloran, Alissa; Kim, David K; Grohskopf, Lisa A; Pilishvili, Tamara; Skoff, Tami H; Nelson, Noele P; Harpaz, Rafael; Markowitz, Lauri E; Rodriguez-Lainz, Alfonso; Fiebelkorn, Amy Parker

    2017-05-05

    conditions]). Coverage for all vaccines for adults remained low but modest gains occurred in vaccination coverage for influenza (adults aged ≥19 years), pneumococcal (adults aged 19-64 years with increased risk), Tdap (adults aged ≥19 years and adults aged 19-64 years), herpes zoster (adults aged ≥60 years and ≥65 years), and hepatitis B (HCP aged ≥19 years); coverage for other vaccines and groups with vaccination indications did not improve. The 30% Healthy People 2020 target for herpes zoster vaccination was met. Racial/ethnic disparities persisted for routinely recommended adult vaccines. Missed opportunities to vaccinate remained. Although having health insurance coverage and a usual place for health care were associated with higher vaccination coverage, these factors alone were not associated with optimal adult vaccination coverage. HPV vaccination coverage for males and females has increased since CDC recommended vaccination to prevent cancers caused by HPV, but many adolescents and young adults remained unvaccinated. Assessing factors associated with low coverage rates and disparities in vaccination is important for implementing strategies to improve vaccination coverage. Evidence-based practices that have been demonstrated to improve vaccination coverage should be used. These practices include assessment of patients' vaccination indications by health care providers and routine recommendation and offer of needed vaccines to adults, implementation of reminder-recall systems, use of standing-order programs for vaccination, and assessment of practice-level vaccination rates with feedback to staff members. For vaccination coverage to be improved among those who reported lower coverage rates of recommended adult vaccines, efforts also are needed to identify adults who do not have a regular provider or insurance and who report fewer health care visits.

  18. Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses.

    Science.gov (United States)

    Eibner, Christine; Girosi, Federico; Price, Carter C; Cordova, Amado; Hussey, Peter S; Beckman, Alice; McGlynn, Elizabeth A

    2011-01-01

    The RAND Corporation's Comprehensive Assessment of Reform Efforts microsimulation model was used to analyze the effects of the Patient Protection and Affordable Care Act (PPACA) on employers and enrollees in employer-sponsored health insurance, with a focus on small businesses and businesses offering coverage through health insurance exchanges. Outcomes assessed include the proportion of nonelderly Americans with insurance coverage, the number of employers offering health insurance, premium prices, total employer spending, and total government spending relative to what would have been observed without the policy change. The microsimulation predicts that PPACA will increase insurance offer rates among small businesses from 53 to 77 percent for firms with ten or fewer workers, from 71 to 90 percent for firms with 11 to 25 workers, and from 90 percent to nearly 100 percent for firms with 26 to 100 workers. Simultaneously, the uninsurance rate in the United States would fall from 19 to 6 percent of the nonelderly population. The increase in employer offer rates is driven by workers' demand for insurance, which increases due to an individual mandate requiring all people to obtain insurance policies. Employer penalties incentivizing businesses to offer coverage do not have a meaningful impact on outcomes. The model further predicts that approximately 60 percent of businesses will offer coverage through the health insurance exchanges after the reform. Under baseline assumptions, a total of 68 million people will enroll in the exchanges, of whom 35 million will receive exchange-based coverage from an employer.

  19. Subsidies to employee health insurance premiums and the health insurance market.

    Science.gov (United States)

    Gruber, Jonathan; Washington, Ebonya

    2005-03-01

    One approach to covering the uninsured that is frequently advocated by policy-makers is subsidizing the employee portion of employer-provided health insurance premiums. But, since the vast majority of those offered employer-provided health insurance already take it up, such an approach is only appealing if there is a very high takeup elasticity among those who are offered and uninsured. Moreover, if plan choice decisions are price elastic, then such subsidies can at the same time increase health care costs by inducing selection of more expensive plans. We study an excellent example of such subsidies: the introduction of pre-tax premiums for postal employees in 1994, and then for the remaining federal employees in 2000. We do so using a census of personnel records for all federal employees from 1991 through 2002. We find that there is a very small elasticity of insurance takeup with respect to its after-tax price, and a modest elasticity of plan choice. Our results suggest that the federal government did little to improve insurance coverage, but much to increase health care expenditures, through this policy change.

  20. Immunization Coverage

    Science.gov (United States)

    ... country, and global coverage was estimated at 25%. Rubella is a viral disease which is usually mild in children, but infection during early pregnancy may cause fetal death or congenital rubella syndrome, ...

  1. Functional coverages

    OpenAIRE

    Donchyts, G.; Baart, F.; Jagers, H.R.A.; Van Dam, A

    2011-01-01

    A new Application Programming Interface (API) is presented which simplifies working with geospatial coverages as well as many other data structures of a multi-dimensional nature. The main idea extends the Common Data Model (CDM) developed at the University Corporation for Atmospheric Research (UCAR). The proposed function object model uses the mathematical definition of a vector-valued function. A geospatial coverage will be expressed as a vector-valued function whose dependent variables (the...

  2. National health insurance scheme and provision of oral care in ...

    African Journals Online (AJOL)

    The likelihood of receiving dental care or visiting a dentist is greatly determined by an individual's dental insurance status. Persons with dental insurance coverage are more likely to have received dental treatment than those who are not insured. One of the ways of making dental care affordable and accessible is the ...

  3. Why Employed Latinos Lack Health Insurance: A Study in California

    Science.gov (United States)

    Greenwald, Howard P.; O'Keefe, Suzanne; DiCamillo, Mark

    2005-01-01

    This article assesses the relative importance of several factors believed to reduce the likelihood of health insurance coverage among working Latinos in California, including cost, immigration history, availability of insurance, beliefs about insurance, and beliefs about health and health care. According to a survey of 1,000 randomly selected…

  4. 7 CFR 457.158 - Apple crop insurance provisions.

    Science.gov (United States)

    2010-01-01

    .... Optional Coverage for Fresh Fruit Quality Adjustment (a) In the event of a conflict between the Apple Crop... 7 Agriculture 6 2010-01-01 2010-01-01 false Apple crop insurance provisions. 457.158 Section 457... CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.158 Apple crop insurance...

  5. Life Insurance: A Suggested Adult Business Education Course.

    Science.gov (United States)

    New York State Education Dept., Albany. Bureau of Continuing Education Curriculum Development.

    This course is aimed at the buyer or potential buyer of life insurance for the purpose of helping him to a better understanding of life insurance and of aiding him in making decisions about his own life insurance coverage. It is structured to be taught one evening a week for six to eight weeks. Each session would last about two hours. The course…

  6. 78 FR 7264 - Health Insurance Premium Tax Credit

    Science.gov (United States)

    2013-02-01

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BL49 Health Insurance Premium Tax Credit AGENCY: Internal... regulations relating to the health insurance premium tax credit enacted by the Patient Protection and... coverage and who wish to enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges...

  7. Life Insurance. The Impact of Ownership

    OpenAIRE

    Flashman, Robert H.; Hayhoe, Celia Ray

    2009-01-01

    The major reason most people buy life insurance is to provide financial support for beneficiaries in case the insured person dies prematurely. However, there are additional reasons for purchasing insurance. At the end of this fact sheet you will find a short glossary designed to help you understand terms related to life insurance and ownership.

  8. 46 CFR 308.403 - Insured amounts.

    Science.gov (United States)

    2010-10-01

    ... total amount of war risk insurance obtainable from companies authorized to do an insurance business in a... not included in the contract price: Provided, That no war risk insurance is obtainable from companies... MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk...

  9. Managed competition and consumer price sensitivity in social health insurance.

    Science.gov (United States)

    Schut, Frederik T; Hassink, Wolter H J

    2002-11-01

    This paper examines whether the introduction of managed competition in Dutch social health insurance has resulted in effective price competition among insurance funds. We find evidence of limited price competition, which may be caused by low consumer price sensitivity. Using aggregate panel data from all insurance funds over the period 1996-1998, estimated premium elasticities of market share are -0.3 for compulsory coverage and -0.8 for supplementary coverage. These elasticities are much smaller than in managed competition settings in US group insurance. This may be explained by differences in switching experience and higher search costs associated with individual insurance.

  10. Consumer-centered vs. job-centered health insurance.

    Science.gov (United States)

    Enthoven, A C

    1979-01-01

    Most employees and their dependents in the United States have health insurance provided by the employer or labor-management health and welfare fund. In this system, employees and their families lose their health insurance when the breadwinner loses his or her job while, at the same time, a Medicaid beneficiary can lose Medicaid eligibility by getting a job, even a poorly paid one. Most health insurance pays the doctor on the basis of fee-for-service and the hospital on the basis of cost-reimbursement, rewarding both with more revenue for providing more and more costly services. The insured employee has little or no incentive to seek out a less costly provider. There are no rewards for economy in this system. It should be little wonder, then, that health care costs are out of control. There are alternative financing and delivery systems with built-in incentives to use resources economically, but, the author of this article asserts, their ability to compete and attract patients with their superior economic efficiency is blocked by many laws and government programs. The author believes that the most effective and acceptable way to get costs under control, and at the same time achieve universal coverage, would be through a system of fair economic competition. He discusses his Consumer Choice Health Plan proposal and describes how one of the main barriers to competition is today's system of job-linked health insurance.

  11. DIVORCE AND WOMEN'S RISK OF HEALTH INSURANCE LOSS*

    Science.gov (United States)

    Lavelle, Bridget; Smock, Pamela J.

    2012-01-01

    This article bridges the literatures on the economic consequences of divorce for women with that on marital transitions and health by focusing on women's health insurance. Using a monthly calendar of marital status and health insurance coverage from 1,442 women in the Survey of Income and Program Participation, we examine how women's health insurance changes after divorce. Our estimates suggest that roughly 115,000 American women lose private health insurance annually in the months following divorce and that roughly 65,000 of these women become uninsured. The loss of insurance coverage we observe is not just a short-term disruption. Women's rates of insurance coverage remain depressed for more than two years after divorce. Insurance loss may compound the economic losses women experience after divorce, and contribute to as well as compound previously documented health declines following divorce. PMID:23147653

  12. Idosos com e sem plano de saúde e características socioepidemiológicas associadas Ancianos con y sin póliza de salud y características socioepidemiológicas asociadas Health insurance coverage of the elderly and socioepidemiological characteristics associated

    Directory of Open Access Journals (Sweden)

    Elizabeth S. C. Hernandes

    2012-12-01

    Full Text Available OBJETIVO: Analisar fatores epidemiológicos e sociodemográficos associados à saúde de idosos com ou sem plano de saúde. MÉTODOS: Foram realizadas entrevistas com 2.143 pessoas de 60 anos e mais, no município de São Paulo, em 2000 e 2006. A variável dependente, dicotômica, foi ter ou não plano de saúde. As variáveis independentes abrangeram características sociodemográficas e de condição de saúde. Foram descritas as proporções encontradas para as variáveis analisadas e desenvolvido modelo de regressão logística que considerou significantes as variáveis com p OBJETIVO: Analizar factores epidemiológicos y sociodemográficos asociados a la salud de ancianos con o sin seguro de salud. MÉTODOS: Se realizaron entrevistas con 2.143 personas de 60 años y más, en el municipio de Sao Paulo, en 2000 y 2006. La variable dependiente, dicotómica, fue tener o no póliza de salud. Las variables independientes abarcaron características sociodemográficas y de condición de salud. Se describieron las proporciones encontradas para las variables analizadas y se desarrolló modelo de regresión logística que consideró significantes las variables con p OBJECTIVE: To examine sociodemographic and epidemiological factors associated with private health insurance coverage in the elderly. METHODS: A total of 2,143 individuals aged 60 years or more were interviewed in the city of São Paulo in 2000 and 2006. Having private health insurance was the dichotomous dependent variable. Independent variables included sociodemographic characteristics and self-reported health status. The proportions of the variables studied were described and a logistic regression model considering those variables significant at p < 0.05 was constructed. RESULTS: The elderly with private insurance coverage had significantly higher income and education. The elderly with no private insurance were screened less for cancer and more for respiratory diseases; they waited

  13. Development of State Health Insurance System in Georgia.

    Science.gov (United States)

    Kalandadze, T; Bregvadze, I; Takaishvili, R; Archvadze, A; Moroshkina, N

    1999-06-01

    Since 1994, health resources in Georgia have became insufficient. The spending for the health care services per person in 1985 were US$95. 5, US$12.2 in 1989, and US$0.9 in 1994. Currently there are 58.5 physicians per 10,000 inhabitants. The birth rate decreased from 16. 7 in 1989 to 11 in 1997. The mortality rate of pregnant women due to extragenital pathologies, iron deficiency anemias (40% of the total pregnant women), iodine deficiency and complicated abortions are also on the increase. The State Parliament of Georgia decided to reorganize the health care system and, in August 1995, State Health Care Programs and the new system of reimbursement of providers were launched. The monthly contribution rate of medical insurance, which was 4% of the payroll (3% paid by the employer and 1% by the employee), is transferred from the Central Budget directly to the State Medical Insurance Company, which implements nine State Curative Programs. State medical insurance system co-exists with municipal and private health care. Municipal health coverage is closest to the universal coverage (over 80% of the population), and municipal health care services are the closest to a basic package of services satisfying most health care needs of the population. The exceptions are pregnant women and mothers and children under 1 year of age, who are covered by the Federal Programs under State Medical Insurance.

  14. The effects of insurance carrier market power on dentists and patients.

    Science.gov (United States)

    Brown, L Jackson; Guay, Albert H; House, Donald R

    2009-01-01

    Market power among dental insurance carriers is a carrier's ability to reimburse dentists at rates below what would exist in more competitive areas. Competition among carriers for dentists' participation in their networks protects dentists from highly discounted fees. The authors examined the extent to which dental insurance carriers facing less competition increase fee discounts. The authors selected a sample of dentists from listings of general practitioners. They identified 219 metropolitan areas and contacted 11,542 dentists in those areas by mail, telephone or both. A total of 8,017 dentists completed surveys (a response rate of 69.46 percent). The authors' key focus was the possible relationship between carrier market power and the size of the fee discount. The authors compared discounts across metropolitan areas with their differing levels of insurance coverage and carrier market shares. Carrier market power was directly related to the sizes of fee discounts. The larger discounts were found where there was significant dental insurance coverage and few carriers providing this coverage. Dentists' net incomes were significantly less in areas with larger fee discounts. Dental insurance carrier market power leads to increased fee discounts. These higher discounts reduce dentists' earnings. Although the larger discounts may result in lower overall patient costs, this patient benefit is temporary. Ultimately, the number of practicing dentists in these communities will decrease as dentists seek improved practicing conditions elsewhere. This reduction will lead to overall fee increases until the earning potential of dentists is restored.

  15. The health reform monitoring survey: addressing data gaps to provide timely insights into the affordable care act.

    Science.gov (United States)

    Long, Sharon K; Kenney, Genevieve M; Zuckerman, Stephen; Goin, Dana E; Wissoker, Douglas; Blavin, Fredric; Blumberg, Linda J; Clemans-Cope, Lisa; Holahan, John; Hempstead, Katherine

    2014-01-01

    The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the Affordable Care Act (ACA) during the period before federal government survey data for 2013 and 2014 will be available. Based on a nationally representative, probability-based Internet panel, the HRMS provides quarterly data for approximately 7,400 nonelderly adults and 2,400 children on insurance coverage, access to health care, and health care affordability, along with special topics of relevance to current policy and program issues in each quarter. For example, HRMS data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts. This raises concerns about some people's ability to evaluate trade-offs when choosing health insurance plans. Assisting people as they attempt to enroll in health coverage will require targeted education efforts and staff to support those with low health insurance literacy.

  16. Universal health care coverage--pitfalls and promise of an employment-based approach.

    Science.gov (United States)

    Budetti, P

    1992-02-01

    America's patchwork quilt of health care coverage is coming apart at the seams. The system, such as it is, is built upon an inherently problematic base: employment. By definition, an employment-based approach, by itself, will not assure universal coverage of the entire population. If an employment-based approach is to be the centerpiece of a system that provides universal coverage, special attention must be paid to all the categories of individuals who are not employees--children, unemployed spouses or singles, the unemployable ill and disabled, persons between jobs, students, retirees, the elderly. Moreover, in a purely voluntary employment-based arrangement, some employers will not provide insurance at all, and others will provide inadequate coverage, necessitating other special provisions for coverage. As a consequence, about one out of six people now has no health coverage whatsoever, and even more have inadequate coverage. All the while, the rapidly-increasing transaction costs of sustaining this grossly inadequate pluralistic system eat up sufficient funds to provide basic benefits to the entire population. The time for systematic reforms has come and gone; what is now needed is action to prevent disaster, followed by a complete rebuilding of this country's health coverage system. Although perhaps more likely to be tried than more radical, completely nationalized, ones, stepwise reforms may not go far enough to cure the significant ills of the current employment-based system. Passage of inadequate reforms, then, could well set the stage for nationalized health care in the not too distant future.

  17. Coverage Metrics for Model Checking

    Science.gov (United States)

    Penix, John; Visser, Willem; Norvig, Peter (Technical Monitor)

    2001-01-01

    When using model checking to verify programs in practice, it is not usually possible to achieve complete coverage of the system. In this position paper we describe ongoing research within the Automated Software Engineering group at NASA Ames on the use of test coverage metrics to measure partial coverage and provide heuristic guidance for program model checking. We are specifically interested in applying and developing coverage metrics for concurrent programs that might be used to support certification of next generation avionics software.

  18. The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?

    Science.gov (United States)

    Woolhandler, Steffie; Himmelstein, David U

    2017-09-19

    About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Patient Protection and Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine's conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.

  19. Integration of current identity-based district-varied health insurance schemes in China: implications and challenges.

    Science.gov (United States)

    Wang, Hai-Qiang; Liu, Zhi-Heng; Zhang, Yong-Zhao; Luo, Zhuo-Jing

    2012-03-01

    With China's great efforts to improve public health insurance, clear progress has been achieved toward the ambitious full health insurance coverage strategy for all. The current health insurance schemes in China fall into three categories: urban employee basic health insurance scheme, urban resident scheme, and new rural cooperative medical system. Despite their phasic success, these substantially identity-based, district-varied health insurance schemes have separate operation mechanisms, various administrative institutions, and consequently poor connections. On the other hand, the establishment and implementation of various health insurance schemes provide the preconditioning of more sophisticated social health insurance schemes, the increase in the income of urban and rural people, and the great importance attached by the government. Moreover, the reform of the "Hukou" (household register) system provides economical, official, and institutional bases. Therefore, the establishment of an urban-rural integrated, citizen-based, and nationwide-universal health insurance scheme by the government is critically important to attain equality and national connection. Accordingly, the differences between urban and rural areas should be minimized. In addition, the current schemes, administrative institutions, and networks should be integrated and interconnected. Moreover, more expenditure on health insurance might be essential for the integration despite the settings of global financial crisis. Regardless of the possible challenges in implementation, the proposed new scheme is promising and may be applied in the near future for the benefit of the Chinese people and global health.

  20. Voluntary Public Unemployment Insurance

    DEFF Research Database (Denmark)

    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....... The voluntary system emerged as one of many European “Ghent systems,” essentially government subsidized trade union plans, but has since lost many key features of such plans. We assess system performance using a 10% sample of the Danish population drawn from administrative data. Coverage rates for the voluntary...

  1. Analysis of national pay-as-you-drive insurance systems and other variable driving charges

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, T.

    1995-07-01

    Under Pay as You Drive insurance (PAYD), drivers would pay part of their automobile insurance premium as a per-gallon surcharge every time they filled their gas tank. By transfering a portion of the cost of owning a vehicle from a fixed cost to a variable cost, PAYD would discourage driving. PAYD has been proposed recently in California as a means of reforming how auto insurance is provided. PAYD proponents claim that, by forcing drivers to purchase at least part of their insurance every time they refuel their car, PAYD would reduce or eliminate the need for uninsured motorist coverage. Some versions of PAYD proposed in California have been combined with a no-fault insurance system, with the intention of further reducing premiums for the average driver. Other states have proposed PAYD systems that would base insurance premiums on annual miles driven. In this report we discuss some of the qualitative issues surrounding adoption of PAYD and other policies that would convert other fixed costs of driving (vehicle registration, safety/emission control system inspection, and driver license renewal) to variable costs. We examine the effects of these policies on two sets of objectives: objectives related to auto insurance reform, and those related to reducing fuel consumption, CO{sub 2} emissions, and vehicle miles traveled. We pay particular attention to the first objective, insurance reform, since this has generated the most interest in PAYD to date, at least at the state level.

  2. Development of a Streamlined Work Flow for Handling Patients' Genetic Testing Insurance Authorizations.

    Science.gov (United States)

    Uhlmann, Wendy R; Schwalm, Katie; Raymond, Victoria M

    2017-08-01

    Obtaining genetic testing insurance authorizations for patients is a complex, time-involved process often requiring genetic counselor (GC) and physician involvement. In an effort to mitigate this complexity and meet the increasing number of genetic testing insurance authorization requests, GCs formed a novel partnership with an industrial engineer (IE) and a patient services associate (PSA) to develop a streamlined work flow. Eight genetics clinics and five specialty clinics at the University of Michigan were surveyed to obtain benchmarking data. Tasks needed for genetic testing insurance authorization were outlined and time-saving work flow changes were introduced including 1) creation of an Excel password-protected shared database between GCs and PSAs, used for initiating insurance authorization requests, tracking and follow-up 2) instituting the PSAs sending GCs a pre-clinic email noting each patients' genetic testing insurance coverage 3) inclusion of test medical necessity documentation in the clinic visit summary note instead of writing a separate insurance letter and 4) PSAs development of a manual with insurance providers and genetic testing laboratories information. These work flow changes made it more efficient to request and track genetic testing insurance authorizations for patients, enhanced GCs and PSAs communication, and reduced tasks done by clinicians.

  3. Addressing health care market reform through an insurance exchange: essential policy components, the public plan option, and other issues to consider.

    Science.gov (United States)

    Fronstin, Paul; Ross, Murray N

    2009-06-01

    care and are wary of cost shifting from the public plan to private insurers. FUTURE OF EMPLOYMENT-BASED COVERAGE: The availability of a health insurance exchange may have implications for the future of the employment-based health benefits system and raises major questions for workers. Will employers provide a fixed contribution for the purchase of insurance through an exchange? Would that be large enough to purchase coverage? Would it be flat or vary by such factors as worker health status, age, and/or marital status or the presence of children? Would it be taxed? For both employers and workers, the implications are enormous.

  4. A comparative study of European insurance schemes for extreme weather risks and incentives for risk reduction

    Science.gov (United States)

    de Ruiter, Marleen; Hudson, Paul; de Ruig, Lars; Kuik, Onno; Botzen, Wouter

    2017-04-01

    This paper provides an analysis of the insurance schemes that cover extreme weather events in twelve different EU countries and the risk reduction incentives offered by these schemes. Economic impacts of extreme weather events in many regions in Europe and elsewhere are on the rise due to climate change and increasing exposure as driven by urban development. In an attempt to manage impacts from extreme weather events, natural disaster insurance schemes can provide incentives for taking measures that limit weather-related risks. Insurance companies can influence public risk management policies and risk-reducing behaviour of policyholders by "rewarding behaviour that reduces risks and potential damages" (Botzen and Van den Bergh, 2008, p. 417). Examples of insurance market systems that directly or indirectly aim to incentivize risk reduction with varying degrees of success are: the U.S. National Flood Insurance Programme; the French Catastrophes Naturelles system; and the U.K. Flood Re program which requires certain levels of protection standards for properties to be insurable. In our analysis, we distinguish between four different disaster types (i.e. coastal and fluvial floods, droughts and storms) and three different sectors (i.e. residential, commercial and agriculture). The selected case studies also provide a wide coverage of different insurance market structures, including public, private and public-private insurance provision, and different methods of coping with extreme loss events, such as re-insurance, governmental aid and catastrophe bonds. The analysis of existing mechanisms for risk reduction incentives provides recommendations about incentivizing adaptive behaviour, in order to assist policy makers and other stakeholders in designing more effective insurance schemes for extreme weather risks.

  5. Dental healthcare reforms in Germany and Japan: A comparison of statutory health insurance policy

    Directory of Open Access Journals (Sweden)

    Mayumi Nomura

    2008-10-01

    Full Text Available This article aims to compare statutory health insurance policy during the dental healthcare reforms in Germany and Japan. Germany and Japan have categorized their statutory health insurance systems. People in both countries have been provided with a wide coverage of dental treatment and prosthetics. To compare the trends of the indicators of oral healthcare systems over time, it has been suggested that the strategic allocation of dental expenditure is more important than the amount of expense. German dental healthcare policy has shifted under political and socio-economic pressures towards a cost-effective model. In contrast, Japanese healthcare reforms have focused on keeping the basic statutory health insurance scheme, whereby individuals share more of the cost of statutory health insurance. As a result, Germany has succeeded in dramatically decreasing the prevalence of dental caries among children. On comparing the dental conditions of both countries, the rate of decline in replacement of missing teeth among adults and the elderly in Germany and Japan has been interpreted as indicating the price-conscious demands of prosthetics. The difference in the decline of DMFT in 12-year-olds in Germany and Japan could be described as being due to the dental health insurance policy being shifted from treatment-oriented to preventive-oriented in Germany. These findings suggest that social health insurance provides people with equal opportunity for dental services, and healthcare reforms have improved people's oral health. A mixed coverage of social health insurance coverage for dental care should be reconsidered in Japan.

  6. Reform of the Individual Insurance Market in New Jersey: Lessons for the Affordable Care Act.

    Science.gov (United States)

    Cantor, Joel C; Monheit, Alan C

    2016-08-01

    The individual health insurance market has played a small but important role in providing coverage to those without access to group insurance or public programs. With implementation of the Affordable Care Act (ACA), the individual market has attained a more prominent role. However, achieving accessible and affordable coverage in this market is a long-standing challenge, in large part due to the threat of adverse risk selection. New Jersey pursued comprehensive reforms beginning in the 1990s to achieve a stable, accessible, and affordable individual market. We review how adverse risk selection can pose a challenge to achieving such objectives in the individual health insurance market. We follow this discussion by describing the experience of New Jersey through three rounds of legislative reform and through the first year of the implementation of the ACA coverage provisions. While the New Jersey reforms did not require individuals to purchase coverage, its experiences with direct and indirect market subsidies and regulations guiding plan design, issuance, and rating have important implications for how the ACA may achieve its coverage goals in the absence of the controversial individual purchase mandate. Copyright © 2016 by Duke University Press.

  7. Functional coverages

    NARCIS (Netherlands)

    Donchyts, G.; Baart, F.; Jagers, H.R.A.; Van Dam, A.

    2011-01-01

    A new Application Programming Interface (API) is presented which simplifies working with geospatial coverages as well as many other data structures of a multi-dimensional nature. The main idea extends the Common Data Model (CDM) developed at the University Corporation for Atmospheric Research

  8. What Role Can School Health Providers Play in Health Care Reform?

    Science.gov (United States)

    Fleming, Robin

    2009-01-01

    President Barack Obama is wasting no time in unfolding his plan to provide health coverage for all Americans. He started in February by signing legislation to reinstate the State Children's Health Insurance Program, which expands eligibility criteria to provide 4 million more children access to health care. This first step is one of many needed to…

  9. 76 FR 9233 - Children's Health Insurance Program (CHIP); Allotment Methodology and States' Fiscal Years 2009...

    Science.gov (United States)

    2011-02-17

    ... the Children's Health Insurance Program (CHIP), as amended by the Children's Health Insurance Program.... SUPPLEMENTARY INFORMATION: I. Background A. The Children's Health Insurance Program Title XXI of the Social... Commonwealths and Territories to initiate and expand health insurance coverage to uninsured, low-income children...

  10. Insurability of export credit risks

    OpenAIRE

    Alsem, K.J.

    2003-01-01

    This report presents an analysis of the market for export credit insurance. Governments of all developed countries oer exporting companies export credit (re)insurance, either directly or indirectly. This raises the questions 1. What are the key determinants of export credit risk insurability by the private market? 2. Which export credit risks can be covered by the private market? We provide an answer to these questions by means of a literature review and an extensive field study, with special...

  11. Is employer-based health insurance a barrier to entrepreneurship?

    Science.gov (United States)

    Fairlie, Robert W; Kapur, Kanika; Gates, Susan

    2011-01-01

    The focus on employer-provided health insurance in the United States may restrict business creation. We address the limited research on the topic of "entrepreneurship lock" by using recent panel data from matched Current Population Surveys. We use difference-in-difference models to estimate the interaction between having a spouse with employer-based health insurance and potential demand for health care. We find evidence of a larger negative effect of health insurance demand on business creation for those without spousal coverage than for those with spousal coverage. We also take a new approach in the literature to examine the question of whether employer-based health insurance discourages business creation by exploiting the discontinuity created at age 65 through the qualification for Medicare. Using a novel procedure of identifying age in months from matched monthly CPS data, we compare the probability of business ownership among male workers in the months just before turning age 65 and in the months just after turning age 65. We find that business ownership rates increase from just under age 65 to just over age 65, whereas we find no change in business ownership rates from just before to just after for other ages 55-75. We also do not find evidence from the previous literature and additional estimates that other confounding factors such as retirement, partial retirement, social security and pension eligibility are responsible for the increase in business ownership in the month individuals turn 65. Our estimates provide some evidence that "entrepreneurship lock" exists, which raises concerns that the bundling of health insurance and employment may create an inefficient level of business creation. Copyright © 2010 Elsevier B.V. All rights reserved.

  12. Premium growth and its effect on employer-sponsored insurance.

    Science.gov (United States)

    Vistnes, Jessica; Selden, Thomas

    2011-03-01

    We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers' health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.

  13. Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

    Science.gov (United States)

    Sohn, Heeju

    2015-08-01

    Most American adults under 65 obtain health insurance through their employers or their spouses' employers. The absence of a universal healthcare system in the United States puts Americans at considerable risk for losing their coverage when transitioning out of jobs or marriages. Scholars have found evidence of reduced job mobility among individuals who are dependent on their employers for healthcare coverage. This paper finds similar relationships between insurance and divorce. I apply the hazard model to married individuals in the longitudinal Survey of Income Program Participation (N=17,388) and find lower divorce rates among people who are insured through their partners' plans without alternative sources of their own. Furthermore, I find gender differences in the relationship between healthcare coverage and divorce rates: insurance dependent women have lower rates of divorce than men in similar situations. These findings draw attention to the importance of considering family processes when debating and evaluating health policies.

  14. Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

    Science.gov (United States)

    Sohn, Heeju

    2016-01-01

    Most American adults under 65 obtain health insurance through their employers or their spouses’ employers. The absence of a universal healthcare system in the United States puts Americans at considerable risk for losing their coverage when transitioning out of jobs or marriages. Scholars have found evidence of reduced job mobility among individuals who are dependent on their employers for healthcare coverage. This paper finds similar relationships between insurance and divorce. I apply the hazard model to married individuals in the longitudinal Survey of Income Program Participation (N=17,388) and find lower divorce rates among people who are insured through their partners’ plans without alternative sources of their own. Furthermore, I find gender differences in the relationship between healthcare coverage and divorce rates: insurance dependent women have lower rates of divorce than men in similar situations. These findings draw attention to the importance of considering family processes when debating and evaluating health policies. PMID:26949269

  15. Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity - a systematic review.

    Science.gov (United States)

    Ananthapavan, J; Peeterson, A; Sacks, G

    2017-12-20

    Curbing the obesity epidemic is likely to require a suite of interventions targeting the obesogenic environment as well as individual behaviour. Evidence suggests that the effectiveness of behaviour modification programmes can be enhanced by financial incentives that immediately reward weight loss behaviour. This systematic review investigated the effectiveness of incentives with a focus on assessing the relative effectiveness of incentives that target different behaviours as well as factors of importance when implementing these programmes in real-world settings (health insurer settings). A narrative review of the academic and grey literature including a variety of study designs was undertaken. Twenty studies met inclusion criteria and were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results suggest that incentivizing weight loss is effective in the short term while the incentives are in place. There are various incentive designs, and although the relative effectiveness of each of these on weight loss is not clear, it appears that positive incentives increase the uptake into programmes and may reduce dropouts. As with other weight loss initiatives, there is a need to explore ways to maintain weight loss in the longer term - incentives for weight maintenance could play a role. © 2017 World Obesity Federation.

  16. Latin American immigrants have limited access to health insurance in Japan: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Suguimoto S Pilar

    2012-03-01

    Full Text Available Abstract Background Japan provides universal health insurance to all legal residents. Prior research has suggested that immigrants to Japan disproportionately lack health insurance coverage, but no prior study has used rigorous methodology to examine this issue among Latin American immigrants in Japan. The aim of our study, therefore, was to assess the pattern of health insurance coverage and predictors of uninsurance among documented Latin American immigrants in Japan. Methods We used a cross sectional, mixed method approach using a probability proportional to estimated size sampling procedure. Of 1052 eligible Latin American residents mapped through extensive fieldwork in selected clusters, 400 immigrant residents living in Nagahama City, Japan were randomly selected for our study. Data were collected through face-to-face interviews using a structured questionnaire developed from qualitative interviews. Results Our response rate was 70.5% (n = 282. Respondents were mainly from Brazil (69.9%, under 40 years of age (64.5% and had lived in Japan for 9.45 years (SE 0.44; median, 8.00. We found a high prevalence of uninsurance (19.8% among our sample compared with the estimated national average of 1.3% in the general population. Among the insured full time workers (n = 209, 55.5% were not covered by the Employee's Health Insurance. Many immigrants cited financial trade-offs as the main reasons for uninsurance. Lacking of knowledge that health insurance is mandatory in Japan, not having a chronic disease, and having one or no children were strong predictors of uninsurance. Conclusions Lack of health insurance for immigrants in Japan is a serious concern for this population as well as for the Japanese health care system. Appropriate measures should be taken to facilitate access to health insurance for this vulnerable population.

  17. [Labor market structure and access to private health insurance in Brazil].

    Science.gov (United States)

    Machado, Ana Flavia; Andrade, Mônica Viegas; Maia, Ana Carolina

    2012-04-01

    This paper aims to describe health insurance coverage among different types of workers in Brazil. Health insurance coverage and labor market insertion are used to define homogeneous groups of workers. The Grade of Membership method is used to build a typology of workers. The database was the Brazilian National Household Survey (PNAD) for 1998 and 2003, including a health survey. Five worker profiles were defined. The key variables were: health insurance coverage, schooling, and work status. The main findings show a positive association between health insurance coverage, income from work, and trade union membership.

  18. Determination of Vine Growers’ Tendency, Problems and Solution Offers for Agricultural Insurance Applications in Viticulture Business in Trakya Region

    Directory of Open Access Journals (Sweden)

    Mehmet Ali KİRACI

    2015-08-01

    Full Text Available This study was carried out in order to provide informative data for improvement of agricultural insurance sector by determination of awareness of vine-growers in Tekirdağ, Edirne, Kırklareli and Çanakkale provinces about agricultural insurance, their tendencies about the insurance, the reasons for taking out or not taking out an insurance policy and the problems faced and solution offers.. Questionnaire studies were made with a total of 289 growers within the research area, of which 60 had an active insurance policy, and the data obtained were analyzed and evaluated. Hail and frost are the most important agricultural uncertainties in the research area. According to the data and observations, government contribution of 50% appeared to be important for increasing prevalency of agricultural insurance policies. Although attendance to introductory contact meetings was low (18%, majority of the growers (75,4% reported that they were aware of scope and conditions of partially government subsidized agricultural insurance. Eighty-eight percent of surveyed growers defined agricultural insurance correctly. The most important reason that account for the insufficient adoption of agricultural insurance by growers is the small size and low-income of the vineyards. The other causes are insufficient insurance coverage, the lack of entrances of land shareholders into the farmer registration system and the lack of confidence for payment of a full cover indemnity. The problems of insured growers are inaccurate damage assessment process, high exemption amount in indemnity payments and neglectance of declerations of growers during insurance process about determination of product yield and price

  19. Pharmaceutical policies used by private health insurance companies in Saudi Arabia.

    Science.gov (United States)

    Bawazir, Saleh A; Alkudsi, Mohammed A; Al Humaidan, Abdullah S; Al Jaser, Maher A; Sasich, Larry D

    2013-07-01

    Currently, the Council of Cooperative Health Insurance (CCHI) is the body responsible for regulating health insurance in the KSA. While the cooperative health insurance schedule (i.e., model policy for health insurance) is available on the CCHI web site, policies related to pharmaceuticals are ambiguous. The primary objective of this study was to assess the impact of health insurance policies provided by health insurance companies in KSA on access to medication and its use. This study was descriptive in design and used a survey, which was conducted through face-to-face interviews with the medical managers of health insurance companies. The survey took place between March and June, 2011. All 25 insurance companies accredited by CCHI were eligible to be included in the study. Out of these 25 companies, three were excluded from this survey as no response was received. All the 16 companies responded "Yes" that they had a prior authorization policy; however, their reasons varied. Eight (50%) of the companies were concerned about the duration of treatment. While 10 (62.5%) did not offer additional coverage over the CCHI model policy, the other 6 (37.5%) reported that they could reconcile certain conditions. The survey also demonstrated that 10 insurance companies allowed refilling of medication but with certain limitations. Six out of the 10 permitted refilling within a maximum time of three months, whereas the other four companies did not have any time-based limits for refilling. The other six companies did not allow refilling without prescription. Although this paper was primarily descriptive, the findings revealed a substantial scope for improvement in terms of pharmaceutical policy standards and regulation in the health insurance companies in KSA. Additionally, the study highlighted such areas to augment the overall quality use of medication, over-prescribing and irrational use of medication. Further research, thus, is definitely needed.

  20. Long-term care insurance and market for aged care in Japan: focusing on the status of care service providers by locality and organisational nature based on survey results.

    Science.gov (United States)

    Kubo, Makoto

    2014-09-01

    The purpose of this paper is to examine the status of care service providers by locality and organisational nature. Questionnaires were sent to 9505 home-based care service providers registered in the databases of 17 prefectures. The prefectures were selected according to population size. Numerous for-profit providers have newly entered the aged care service market and are operating selectively in Tokyo, a typical example of a metropolitan area. Furthermore, both for-profit and non-profit providers have suffered from a shortage of care workers and difficult management conditions, which tend to be more pronounced in Tokyo. The market under long-term care insurance was successful in terms of the volume of services, but most providers were sceptical as to whether competition in the market could facilitate quality care services. © 2013 The Author. Australasian Journal on Ageing © 2013 ACOTA.

  1. HEALTH INSURANCE: CONTRIBUTIONS AND REIMBURSEMENT MAXIMAL

    CERN Multimedia

    HR Division

    2000-01-01

    Affected by both the salary adjustment index on 1.1.2000 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maximal, has changed significantly. An adjustment of the amounts of the reimbursement maximal and the fixed contributions is therefore necessary, as from 1 January 2000.Reimbursement maximalThe revised reimbursement maximal will appear on the leaflet summarising the benefits for the year 2000, which will soon be available from the divisional secretariats and from the AUSTRIA office at CERN.Fixed contributionsThe fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions):voluntarily insured member of the personnel, with complete coverage:815,- (was 803,- in 1999)voluntarily insured member of the personnel, with reduced coverage:407,- (was 402,- in 1999)voluntarily insured no longer dependent child:326,- (was 321...

  2. Dealing with drought in irrigated agriculture through insurance schemes: an application to an irrigation district in Southern Spain

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz, M.; Bielza, J.; Garrido, A.; Iglesias, A.

    2015-07-01

    Hydrological drought is expected to have an increasing impact on both crop and fruit yields in arid and semi-arid regions. Some existing crop insurance schemes provide coverage against water deficits in rain-fed agriculture. The Prevented Planting Program in the USA covers against drought for irrigated agriculture. However, drought insurance for irrigated agriculture is still a challenge for companies and institutions because of the complexity of the design and implementation of this type of insurance. Few studies have attempted to evaluate the risk of loss due to irrigation water scarcity using both stand-alone production functions and crop simulation models. This paper’s contributions are that it evaluates the suitability of AquaCrop for calculating drought insurance premiums for irrigated agriculture and that it discusses contract conditions and insurance design for hydrological drought risk coverage as part of a traditional insurance product, with on-field loss assessment in combination with a trigger index. This method was applied to an irrigation district in southern Spain. Our insurance premium calculation showed that it is feasible to apply this method provided that its data requirements are met, such as a large enough set of reliable small-scale yield and irrigation time series data, especially soil data, to calibrate AquaCrop. The choice of a trigger index should not be underestimated because it proved to have a decisive influence on insurance premiums and indemnities. Our discussion of the contract conditions shows that hydrological drought insurance must comply with a series of constraints in order to avoid moral hazard and basis risk. (Author)

  3. 75 FR 27121 - Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Dependent...

    Science.gov (United States)

    2010-05-13

    ... Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the... and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 Under the Patient... implementing the requirements for group health plans and health insurance issuers in the group and individual...

  4. Crop-insurance

    NARCIS (Netherlands)

    Wijk, van der S.

    1945-01-01

    Crop insurance was fairly new in the Netherlands but there was no legal objection or limitation to particular crops. If a crop were insured, it was important that the whole area of the crop were insured. Speculative insurance seemed preferable to mutual insurance.

    Crop insurance covered all risks

  5. Crop insurance: Risks and models of insurance

    Directory of Open Access Journals (Sweden)

    Čolović Vladimir

    2014-01-01

    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.

  6. Group Life Insurance

    CERN Document Server

    2013-01-01

    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 &...

  7. SERVICE QUALITY MEASUREMENT AND DEMAND FOR INSURANCE: AN EMPIRICAL STUDY FROM NIGERIAN INSURANCE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Abass, OlufemiAdebowale

    2016-11-01

    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.

  8. Preference heterogeneity and selection in private health insurance: the case of Australia.

    Science.gov (United States)

    Buchmueller, Thomas C; Fiebig, Denzil G; Jones, Glenn; Savage, Elizabeth

    2013-09-01

    A basic prediction of theoretical models of insurance is that if consumers have private information about their risk of suffering a loss there will be a positive correlation between risk and the level of insurance coverage. We test this prediction in the context of the market for private health insurance in Australia. Despite a universal public system that provides comprehensive coverage for inpatient and outpatient care, roughly half of the adult population also carries private health insurance, the main benefit of which is more timely access to elective hospital treatment. Like several studies on different types of insurance in other countries, we find no support for the positive correlation hypothesis. Because strict underwriting regulations create strong information asymmetries, this result suggests the importance of multi-dimensional private information. Additional analyses suggest that the advantageous selection observed in this market is driven by the effect of risk aversion, the ability to make complex financial decisions and income. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Income, social stratification, class, and private health insurance: a study of the Baltimore metropolitan area.

    Science.gov (United States)

    Muntaner, C; Parsons, P E

    1996-01-01

    Most studies of inequalities and access to health care have used income as the sole indicator of social stratification. Despite the significance of social theory in health insurance research, there are no empirical studies comparing the ability of different models of social stratification to predict health insurance coverage. The aim of this study is to provide a comparative analysis using a variety of theory-driven indicators of social stratification and assess the relative strength of the association between these indicators and private health insurance. Data were collected in a 1993 telephone interview of a random digit dialing sample of the white population in the Baltimore Metropolitan Statistical Area. Indicators of social stratification included employment status, full-time work, education, occupation, industry, household income, firm size, and three types of assets: ownership, organizational, and skill/credential. The association between social stratification and private health insurance was strongest for those having higher household incomes, having attained at least a bachelor's degree, and working in a firm with more than 50 employees, followed by being an owner or manager, and by being employed. The addition of education and firm size improved the prediction of the household income model. The authors conclude that studies of inequalities in health insurance coverage can benefit from the inclusion of theory-driven indicators of social stratification such as human capital, labor market segmentation, and control over productive assets.

  10. Ghana's National Health insurance scheme and maternal and child health: a mixed methods study.

    Science.gov (United States)

    Singh, Kavita; Osei-Akoto, Isaac; Otchere, Frank; Sodzi-Tettey, Sodzi; Barrington, Clare; Huang, Carolyn; Fordham, Corinne; Speizer, Ilene

    2015-03-17

    Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program's strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant services. This paper uses qualitative and quantitative data from a baseline assessment for the Maternal and Newborn errals Evaluation from the Northern and Central Regions to describe women's experiences with the NHIS and to study associations between insurance and skilled facility delivery, antenatal care and early care-seeking for sick children. The assessment included a quantitative household survey (n = 1267 women), a quantitative community leader survey (n = 62), qualitative birth narratives with mothers (n = 20) and fathers (n = 18), key informant interviews with health care workers (n = 5) and focus groups (n = 3) with community leaders and stakeholders. The key independent variables for the quantitative analyses were health insurance coverage during the past three years (categorized as all three years, 1-2 years or no coverage) and health insurance during the exact time of pregnancy. Quantitative findings indicate that insurance coverage during the past three years and insurance during pregnancy were associated with greater use of facility delivery but not ANC. Respondents with insurance were also significantly more likely to indicate that an illness need not be severe for them to take a sick child for care. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts. Findings from the qualitative interviews uncovered specific challenges women faced regarding registration for the NHIS and other

  11. Who is willing to pay for long-term care insurance in Catalonia?

    Science.gov (United States)

    Costa-Font, Joan; Rovira-Forns, Joan

    2008-04-01

    Both public and private insurance for long-term care (LTC) in European countries employed is underdeveloped. However, limited evidence is gathered on the behavioural demand responses to the introduction of insurance schemes expanding insurance coverage. This paper aims at empirically examining the determinants of the ex ante demand for LTC coverage drawing upon an insurance-based WTP referendum approach format. Data is collected from a representative population sample of Catalonia (Spain), before a countrywide funding system was developed. Our findings suggest that (based on our questionnaire format) only one-fifth of the population is willing to pay for LTC coverage though it is a highly elastic product. Ex ante demand for LTC coverage is driven by individual's perceptions of old age disability risk (private information asymmetry) and housing tenure (giving rise to self-insurance), the latter reduces the probability of insurance coverage demand.

  12. Servicemembers' Group Life Insurance--Veterans' Group Life Insurance regulation update--ABO, VGLI application, SGLI 2-year disability extension. Final rule.

    Science.gov (United States)

    2014-07-31

    This document amends the Department of Veterans Affairs (VA) insurance regulations concerning Servicemembers' Group Life Insurance (SGLI) to reflect the statutory provisions of the Veterans' Benefits Act of 2010, which became law on October 13, 2010, and resulted in the need for amendments to change the SGLI Disability Extension period from 1 year to 2 years in duration; provide SGLI Traumatic Injury Protection (TSGLI) retroactive coverage effective from October 7, 2001, for all qualifying injuries regardless of the geographic location and military operation in which the injuries were incurred; and remove the SGLI and Veterans' Group Life Insurance (VGLI) Accelerated Benefits Option (ABO) discount rate. This rule also clarifies that ``initial premium'' refers to ``initial Veterans' Group Life Insurance premium,'' updates the current address of the Office of Servicemembers' Group Life Insurance (OSGLI), managed by Prudential Insurance Company of America, to reflect where the ABO application is mailed for processing, and corrects the OSGLI phone number. Finally, this rule removes the ABO application form from the regulation, and it corrects and clarifies language concerning the VGLI application period that was inadvertently incorrectly modified in a prior amendment of the regulations.

  13. [Mental disorders of working age : Evaluation of the administrative incidence and prevalence as well as regional differences in Lower Saxony on the basis of secondary data from a statutory health insurance provider].

    Science.gov (United States)

    Gerdau-Heitmann, Cornelia; Mümken, Sarah; Eberhard, Sveja; Koppelin, Frauke

    2017-12-01

    Mental disorder is the subject of ever-increasing attention in the field of public health. However, the actual number of such cases is difficult to determine owing to the lack of comprehensive longitudinal studies. The administrative incidence and prevalence of mental disorders were estimated on the basis of data from 2010 to 2013 provided by the health insurance company AOK, Lower Saxony, and were assessed according to age and gender. Additionally, possible correlations between local conditions and the occurrence of diagnosed mental disorders were examined for both urban and rural districts. Analyses were conducted using the secondary datasets of 1.5 million persons born between 1940 and 1994 who had been continuously insured throughout the period specified. Only documented diagnoses from outpatient care were taken into account. One third of the insured persons showed at least one documented diagnosis of a mental disorder within a 12-month period. In approximately 11 out of 100 cases, there was a newly documented diagnosis in 2012. With the exception of cases relating to psychotropic substance use, women were significantly more frequently affected than men. Age-specific differences were also determined. At a regional level, in relation to administrative prevalence, mental disorders showed positive correlations in the density of doctors and psychotherapists. Moreover, regions with a high rate of unemployment generally show a higher prevalence of mental disorders. Despite certain limitations, the use of administrative incidence and prevalence data is a viable approach to assessing gender- and age-specific, and regional differences. Our regional analyses suggest a correlation between the local job situation and the level of regional administrative prevalence.

  14. Understanding CBHI hospitalisation patterns: a comparison of insured and uninsured women in Gujarat, India

    Science.gov (United States)

    2014-01-01

    Background Community-based health insurance has been associated with increased hospitalisation in low-income settings, but with limited analysis of the illnesses for which claims are submitted. A review of claims submitted to VimoSEWA, an inpatient insurance scheme in Gujarat, India, found that fever, diarrhoea and hysterectomy, the latter at a mean age of 37 years, were the leading reasons for claims by adult women. We compared the morbidity, outpatient treatment-seeking and hospitalisation patterns of VimoSEWA-insured women with uninsured women. Methods We utilised data from a cross-sectional survey of 1,934 insured and uninsured women in Gujarat, India. Multivariable logistic regression identified predictors of insurance coverage and the association of insurance with hospitalisation. Self-reported data on morbidity, outpatient care and hospitalisation were compared between insured and uninsured women. Results Age, marital status and occupation of adult women were associated with insurance status. Reported recent morbidity, type of illness and outpatient treatment were similar among insured and uninsured women. Multivariable analysis revealed strong evidence of a higher odds of hospitalisation amongst the insured (OR = 2.7; 95% ci. 1.6, 4.7). The leading reason for hospitalisation for uninsured and insured women was hysterectomy, at a similar mean age of 36, followed by common ailments such as fever and diarrhoea. Insured women appeared to have a higher probability of being hospitalised than uninsured women for all causes, rather than specifically for fever, diarrhoea or hysterectomy. Length of stay was similar while choice of hospital differed between insured and uninsured women. Conclusions Despite similar reported morbidity patterns and initial treatment-seeking behaviour, VimoSEWA members were more likely to be hospitalised. The data did not provide strong evidence that inpatient hospitalisation replaced outpatient treatment for common illnesses or that

  15. Public perceptions on national health insurance : moving towards ...

    African Journals Online (AJOL)

    Public perceptions on national health insurance : moving towards universal health coverage in South Africa. Olive Shisana, Thomas Rehle, Julia Louw, Nompumelelo Zungu-Dirwayi, Pelisa Dana, Laetitia Rispel ...

  16. Public perceptions on national health insurance: Moving towards ...

    African Journals Online (AJOL)

    Public perceptions on national health insurance: Moving towards universal health coverage in South Africa. Olive Shisana, Thomas Rehle, Julia Louw, Nompumelelo Zungu-Dirwayi, Pelisa Dana, Laetitia Rispel ...

  17. Health services utilization and costs of the insured and uninsured ...

    African Journals Online (AJOL)

    2013-07-05

    Jul 5, 2013 ... of health insurance coverage would especially improve the health of those in the .... rent, cooking fuel, educational expenses, transport, health, household .... done in an urban setting where the findings from the study could be ...

  18. 33 CFR 136.111 - Insurance.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Insurance. 136.111 Section 136...; DESIGNATION OF SOURCE; AND ADVERTISEMENT General Procedure § 136.111 Insurance. (a) A claimant shall provide the following information concerning any insurance which may cover the removal costs or damages for...

  19. 75 FR 9246 - Cooperative Share Loan Insurance

    Science.gov (United States)

    2010-03-01

    ... URBAN DEVELOPMENT Cooperative Share Loan Insurance AGENCY: Office of the Chief Information Officer, HUD... cooperative housing loan insurance will be published to update existing policies, and better enable mortgagees to submit cooperative share loans for FHA insurance. This new publication will provide instructions...

  20. Congressional Statistics: Disability Insurance for December 2014

    Data.gov (United States)

    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...