Health Economics Policy and Law最新文献_第7页

Managed competition in Aotearoa New Zealand: past experiences and future prospects. 新西兰奥特亚罗瓦的管理竞争：过去的经验和未来的前景。

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-02-14 DOI: 10.1017/S1744133123000403

Jacqueline Cumming

{"title":"Managed competition in Aotearoa New Zealand: past experiences and future prospects.","authors":"Jacqueline Cumming","doi":"10.1017/S1744133123000403","DOIUrl":"https://doi.org/10.1017/S1744133123000403","url":null,"abstract":"This paper considers whether and how managed competition arrangements could be introduced into the Aotearoa health and disability system. The paper describes the key features of the system, including new organisational arrangements established from 1 July 2022. It discusses major reforms and managed competition plans that were developed in the 1990s, with the managed competition plans abandoned fairly early on, as a result of major issues with the reforms that had been implemented and with problems in designing a fair payment system for competing health plans. The paper goes on to argue that the development of capitated, risk-bearing and competing Primary Health Organisations set up in the 2000s should be considered in terms of managed competition, and the paper points to the issues that have arisen in Aotearoa due to a lack of regulations that would have better supported the better achievement of effectiveness, efficiency, and equity goals over the past 20 years. Finally, the paper also looks ahead to whether and how managed competition might again be considered in Aotearoa and the extent to which the system currently includes key pre-conditions to support such arrangements.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Healthcare reform in the Netherlands: after 15 years of regulated competition. 荷兰的医疗改革：经过 15 年的规范竞争。

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-02-01 DOI: 10.1017/S1744133123000385

Hans Maarse, Patrick Jeurissen

{"title":"Healthcare reform in the Netherlands: after 15 years of regulated competition.","authors":"Hans Maarse, Patrick Jeurissen","doi":"10.1017/S1744133123000385","DOIUrl":"https://doi.org/10.1017/S1744133123000385","url":null,"abstract":"This article discusses the results and prospects of the market reform in Dutch health care which came into force in 2006. Attention is paid to the results of the health insurance reform, the experience with the shift from passive to active purchasing and the impact of the reform on healthcare provision and cost control respectively. Other topics discussed are the consequences of the reform for administrative costs, institutional trust in health insurance, and the power balance in health care after reform. The central message is that the high expectations of the market reform have not come true. Dutch health care features a high degree of hybridity and there are indications that the system is becoming ever more hybrid: the system operates much less market-like than the market frame suggests. Currently, the policy narrative on the reform is changing. Policymakers and policy documents underscore the need for cooperation in provider networks and more state direction. The Dutch experience with health care reform illustrates the pendulum theory. After a period of a belief in competition and less state direction the pendulum in policymaking swings back to a belief in cooperation and a pro-active role of the state.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preconditions for efficiency and affordability in mixed health systems: are they fulfilled in the Australian public-private mix? 混合医疗系统的效率和可负担性的先决条件：澳大利亚的公私混合医疗系统是否满足了这些先决条件？

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-01-24 DOI: 10.1017/S1744133123000336

Chiara Berardi, Pablo Arija Prieto, Josefa Henríquez, Francesco Paolucci

{"title":"Preconditions for efficiency and affordability in mixed health systems: are they fulfilled in the Australian public-private mix?","authors":"Chiara Berardi, Pablo Arija Prieto, Josefa Henríquez, Francesco Paolucci","doi":"10.1017/S1744133123000336","DOIUrl":"https://doi.org/10.1017/S1744133123000336","url":null,"abstract":"The Australian health system is characterised by high quality care by international standards, produced by a mix of public and private provision and funding of healthcare services. Despite good overall results, three issues are of concern. The first issue relates to the public procurement of healthcare, whose flaws have impacted individuals' access to care, and the high out-of-pocket spending. The second issue concerns the sustainability of the private health insurance market, given the government's goal of relieving cost and capacity from the public scheme, incentivising participation. Third, there are existing inefficiencies and inequities related to the duplication resulting from the interaction between public and private schemes. To ensure a sustainable, efficient and equitable health system, structural reforms are necessary to achieve long-term performance improvements. Using a framework for mixed public-private health systems, we assess the extent to which the Australian healthcare system achieves preconditions for efficiency and affordability in competitive healthcare markets.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Managed competition in Colombia: convergence of public and private insurance and delivery. 哥伦比亚的有管理竞争：公共和私营保险与交付的融合。

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-01-22 DOI: 10.1017/S1744133123000348

Ramon Castano, Sergio I Prada, Norman Maldonado, Victoria Soto

引用次数: 0

Managed competition in the United States: How well is it promoting equity and efficiency? 美国的管理竞争：促进公平和效率的效果如何？

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-01-08 DOI: 10.1017/S174413312300035X

Randall P Ellis, Alex Hoagland, Angelique Acquatella

{"title":"Managed competition in the United States: How well is it promoting equity and efficiency?","authors":"Randall P Ellis, Alex Hoagland, Angelique Acquatella","doi":"10.1017/S174413312300035X","DOIUrl":"https://doi.org/10.1017/S174413312300035X","url":null,"abstract":"Managed competition frameworks aim to control healthcare costs and promote access to high-quality health insurance and services through a combination of public policies and market forces. In the United States, managed competition delivery systems are varied and diffused across a patchwork of divided markets and populations. This, coupled with extremely high national health spending per capita, makes a more unified managed competition strategy an appealing alternative to a currently struggling healthcare system. We examine the relative effectiveness of three existing programmes in the U.S. that each rely upon some principles of managed competition: health insurance exchanges instituted by the Affordable Care Act, Medicaid managed care organisations, and Medicare Advantage plans. Although each programme leverages some competitive features, each faces significant hurdles as a candidate for expansion. We highlight these challenges with a survey of academic health economists, and find that provider and insurer consolidation, highly segmented markets, and failing to incentivise competitive efficiencies all dampen the success of existing programmes. Although managed competition for all is a potentially desirable framework for future health reform in the U.S., successful expansion relies on addressing fundamental issues revealed by imperfect existing programmes.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Roadmaps to managed competition: to what extent does South Africa meet the preconditions for equity and efficiency? 有管理的竞争路线图：南非在多大程度上满足了公平和效率的先决条件？

IF 1.7 3区医学

Health Economics Policy and Law Pub Date : 2024-01-04 DOI: 10.1017/S1744133123000324

Alex van den Heever

{"title":"Roadmaps to managed competition: to what extent does South Africa meet the preconditions for equity and efficiency?","authors":"Alex van den Heever","doi":"10.1017/S1744133123000324","DOIUrl":"https://doi.org/10.1017/S1744133123000324","url":null,"abstract":"South Africa offers universal health coverage through large public and private systems. The private system is characterised by a regulated market for health insurance, referred to domestically as medical schemes. From 2000, the private system was undergoing a reform process consistent with theoretical approaches for regulated competition for health insurance. However, from 2008, the reform process was interrupted, leaving in place a partial framework which included open enrolment, community rating and regulated minimum benefits but excluded, inter alia, risk equalisation. The incomplete reform, however, provides an opportunity to examine the system outcomes that result from a partial approach. This paper therefore reviews the system outcomes of the partial reform using a descriptive data analysis. The findings then inform an evaluation of the extent to which the preconditions for regulated competition have been met as indicated by the theory of regulated competition in healthcare. The paper therefore highlights the areas where regulatory interventions need to be prioritised in South Africa to achieve the objectives of regulatory competition that are able to achieve access, fairness and efficiency. The analysis points to significant failures at the level of health insurance competition in South Africa with resulting outcomes consistent with the theory of regulated competition.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-18"},"PeriodicalIF":1.7,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strengthening primary health care in China: governance and policy challenges. 加强中国的初级卫生保健：治理和政策挑战。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-01-01 Epub Date: 2023-10-17 DOI: 10.1017/S1744133123000257

Jiwei Qian, M Ramesh

引用次数: 0

Health insurance and fertility among low-income, childless, single women: evidence from the ACA Medicaid expansions. 低收入、无子女、单身女性的医疗保险和生育率:来自ACA医疗补助扩张的证据。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-01-01 Epub Date: 2023-11-22 DOI: 10.1017/S1744133123000282

J Sebastian Leguizamon

引用次数: 0

Financial risk protection in private health insurance: empirical evidence on catastrophic and impoverishing spending from Germany's dual insurance system. 私人医疗保险中的财务风险保护：德国双重保险制度中灾难性和贫困性支出的经验证据。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1017/S1744133123000105

Philipp Hengel, Miriam Blümel, Martin Siegel, Katharina Achstetter, Julia Köppen, Reinhard Busse

{"title":"Financial risk protection in private health insurance: empirical evidence on catastrophic and impoverishing spending from Germany's dual insurance system.","authors":"Philipp Hengel, Miriam Blümel, Martin Siegel, Katharina Achstetter, Julia Köppen, Reinhard Busse","doi":"10.1017/S1744133123000105","DOIUrl":"10.1017/S1744133123000105","url":null,"abstract":"Financial risk protection from high costs for care is a main goal of health systems. Health system characteristics typically associated with universal health coverage and financial risk protection, such as financial redistribution between insureds, are inherent to, e.g. social health insurance (SHI) but missing in private health insurance (PHI). This study provides evidence on financial protection in PHI for the case of Germany's dual insurance system of PHI and SHI, where PHI covers 11% of the population. Linked survey and claims data of PHI insureds (n = 3105) and population-wide household budget data (n = 42,226) are used to compute the prevalence of catastrophic health expenditures (CHE), i.e. the share of households whose out-of-pocket payments either exceed 40% of their capacity-to-pay or push them (further) into poverty. Despite comparatively high out-of-pocket payments, CHE is low in German PHI. It only affects the poor. Key to low financial burden seems to be the restriction of PHI to a small, overall wealthy group. Protection for the worse-off is provided through special mandatorily offered tariffs. In sum, Germany's dual health insurance system provides close-to-universal coverage. Future studies should further investigate the effect of premiums on financial burden, especially when linked to utilisation.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"3-20"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving access to healthcare in Ireland: an implementation failure. 改善爱尔兰的医疗服务：实施失败。

IF 3 3区医学

Health Economics Policy and Law Pub Date : 2024-01-01 Epub Date: 2023-08-22 DOI: 10.1017/S1744133123000130

Sheelah Connolly

引用次数: 0