Journal of Health Care Finance最新文献

{"title":"Health policies and intervention strategies: a description of current issues and approaches to care of the public health and health care system in the United Arab emirates.","authors":"Aliye T Mosaad,&nbsp;Mustafa Z Younis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The demographic factors of the United Arab Emirates (UAE) have changed drastically within one generation. This is evident in how quickly it has moved from a developing nation, where fishing was once the main source of income, to a country that is quite developed, competing on a global level. From one perspective, socio-economic progress has brought many benefits to the population. These include improved education, better access to health care, and safe drinking water. However, on the other hand, economic development has been the cause for changes in lifestyles, eating habits, and traditional societal and family structures. Over time, these changes have added up, creating an unprecedented impact on the population's health. This impact has crept up onto the society until suddenly a notable epidemic has become recognized in the country. According to the UAE Ministry of Health, 19.5 percent of the UAE population has diabetes, making it the second highest rate in the world. The structure and responsibilities of the current UAE health care systems along with other cultural factors were investigated in order to determine their impact on the growing epidemic.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 3","pages":"86-100"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32668520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public hospitals in peril: factors associated with financial distress.","authors":"Zo Ramamonjiarivelo, R. Weech-Maldonado, Larry R. Hearld, R. Pradhan","doi":"10.5465/AMBPP.2013.12764ABSTRACT","DOIUrl":"https://doi.org/10.5465/AMBPP.2013.12764ABSTRACT","url":null,"abstract":"As \"safety net providers,\" public hospitals have played a major role in health care delivery, especially in serving the indigent and the uninsured. For several decades, public hospitals have been operating in a challenging environment, and some of them have experienced financial difficulties. The purpose of this study was to explore the organizational and environmental factors associated with public hospitals' financial distress. This study used a national sample of public hospitals based on longitudinal panel data from 1997 to 2009, resulting in a sample size of 7,257 hospital-year observations. The Altman Z-score method was applied to assess hospitals' financial condition. The significant findings from a random effects logistic regression model with state and year fixed-effects indicated that higher Medicare HMO penetration was associated with financial distress. Organizational variables such as health network, size, occupancy rate, and outpatient mix decreased the odds of financial distress; and membership in a multihospital system increased the odds of financial distress.","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 3 1","pages":"14-30"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70696593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of star physicians on diffusion of a medical technology: the case of laparoscopic gastric bypass surgery.","authors":"Laura Shinn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Using data on all bariatric surgeries performed in the state of Pennsylvania from 1995 through 2007, this article uses logistic and OLS regressions to measure the effect of star physicians and star hospitals on the diffusion of an innovation in bariatric surgery called laparoscopic gastric bypass surgery (LGBS). This article tests for effects at both the hospital and physician level. Compared to hospitals with no star physicians (11 percent adoption rate), those with star physicians on staff show a much higher adoption rate (89 percent). Compared to hospitals that are not classified as star hospitals (13 percent diffusion rate), hospitals with star status show a much higher diffusion rate (87 percent from first quarter 2000 to fourth quarter 2001); being a star hospital raises the likelihood of that hospital diffusing LCBS from 13 percent to 87 percent. At the physician level, the empirical results indicate that star physicians exert positive asymmetric influence on the adoption and utilization rates of nonstars at the same hospital. Stars are those who: (1) graduated from a Top 30 medical school, (2) completed residency at a Top 30 hospital, or (3) are included in a Castle Connolly Top Doctors publication. The results of this article support earlier work on the role of key individuals in technology diffusion. It extends research on medical technology diffusion by testing a new data set for a chronic disease treatment. JEL classifications: D2, I10, I11, L2, O33. D2 production and organizations; L2 firm objectives, organization and behavior; I10 health general; I11 Analysis of health care markets; O33 technological change: choices and consequences; diffusion processes.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 3","pages":"67-85"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32668519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using a social entrepreneurial approach to enhance the financial and social value of health care organizations.","authors":"Sandra S Liu,&nbsp;Jui-Fen Rachel Lu,&nbsp;Kristina L Guo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this study, a conceptual framework was developed to show that social entrepreneurial practices can be effectively translated to meet the social needs in health care. We used a theory-in-use case study approach that encompasses postulation of a working taxonomy from literature scanning and a deliberation of the taxonomy through triangulation of multilevel data of a case study conducted in a Taiwan-based hospital system. Specifically, we demonstrated that a nonprofit organization can adopt business principles that emphasize both financial and social value. We tested our model and found comprehensive accountability across departments throughout the case hospital system, and this led to sustainable and continual growth of the organization. Through social entrepreneurial practices, we established that both financial value creation and fulfilling the social mission for the case hospital system can be achieved.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 3","pages":"31-46"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32668517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of the CVP structure of nonprofit teaching and for-profit non-teaching hospitals.","authors":"L. Liu, D. Forgione, M. Younis","doi":"10.1016/J.JVAL.2013.03.1026","DOIUrl":"https://doi.org/10.1016/J.JVAL.2013.03.1026","url":null,"abstract":"","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"39 1 1","pages":"12-38"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/J.JVAL.2013.03.1026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55102343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost conundrum: financing the business of health care insurance.","authors":"Annemarie Kelly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Health care spending in both the governmental and private sectors skyrocketed over the last century. This article examines the rapid growth of health care expenditures by analyzing the extent of this financial boom as well some of the reasons why health care financing has become so expensive. It also explores how the market concentration of insurance companies has led to growing insurer profits, fewer insurance providers, and less market competition. Based on economic data primarily from the Government Accountability Office, the Kaiser Family Foundation, and the American Medical Associa tion, it has become clear that this country needs more competitive rates for the business of health insurance. Because of the unique dynamics of health insurance payments and financing, America needs to promote affordability and innovation in the health insurance market and lower the market's high concentration levels. In the face of booming insurance profits, soaring premiums, many believe that in our consolidated health insurance market, the \"business of insurance\" should not be exempt from antitrust laws. All in all, it is in our nation's best interest that Congress restore the application of antitrust laws to health sector insurers by passing the Health Insurance Industry Antitrust Enforcement Act as an amendment to the McCarran-Ferguson Act's \"business of insurance\" provision.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"39 4","pages":"15-27"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31705917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antipsychotic polypharmacy prescribing patterns and costs in the Florida adult and child Medicaid populations.","authors":"Edmund R Becker, Robert J Constantine, Marie A McPherson, Mary Elizabeth Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The rapid growth in the use of antipsychotic medications and their related costs have resulted in states developing programs to measure, monitor, and insure their beneficial relevance to public program populations. One such program developed in the state of Florida has adopted an evidence-based approach to identify prescribers with unusual psychotherapeutic prescription patterns and track their utilization and costs among Florida Medicaid patients. This study reports on the prescriber prescription and cost patterns for adults and children using three measures of unusual antipsychotic prescribing patterns: (1) two antipsychotics for 60 days (2AP60), (2) three antipsychotics for 60 days (3AP60), and (2) two antipsychotics for 90 or more days (2AP90). We find that over the four-year study period there were substantial increases in several aspects of the Florida Medicaid behavioral drug program. Overall, for adults and children, patient participation increased by 29 percent, the number of prescriptions grew by 30 percent, and the number of prescribers that wrote at least one prescription grew 48.5 percent, while Medicaid costs for behavioral drugs increased by 32 percent. But the results are highly skewed. We find that a relatively small number of prescribers account for a disproportionately large share of prescriptions and costs of the unusual antipsychotic prescriptions. In general, the top 350 Medicaid prescribers accounted for more than 70 percent of the unusual antipsychotic prescriptions, and we find that this disparity in unusual prescribing patterns appears to be substantially more pronounced in adults than in children prescribers. For just the top 13 adult and children prescribers, their practice patterns accounted for 11 percent to 21 percent of the unusual prescribing activity and, overall, these 13 top prescribers accounted for 13 percent of the total spent on antipsychotics by the Florida Medicaid program and 9.3 percent of the total expenditure by the state for all drugs. Our findings suggest that a strategy to monitor and ensure patient safety and prescribing patterns that targets a relatively small number of Medicaid providers could have a substantial benefit and prove to be cost effective.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 1","pages":"40-67"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31839941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Protection and Affordable Care Act's provisions regarding medical loss ratios and quality: evidence from Texas.","authors":"Troy Quast","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The Patient Protection and Affordable Care Act (PPACA) includes a provision that penalizes insurance companies if their Medical Loss Ratio (MLR) falls below a specified threshold. The MLR is roughly measured as the ratio of health care expenses to premiums paid by enrollees. I investigate whether there is a relationship between MLRs and the quality of care provided by insurance companies.</p><p><strong>Methods: </strong>I employ a ten-year sample of market-level financial data and quality variables for Texas insurers, as well as relevant control variables, in regression analyses that utilize insurer and market fixed effects.</p><p><strong>Results: </strong>Of the 15 quality measures, only one has a statistically significant relationship with the MLR. For this measure, the relationship is negative.</p><p><strong>Conclusions: </strong>Although the MLR provision may provide incentives for insurance companies to lower premiums, this sample does not suggest that there is likely to be a beneficial effect on quality.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31839937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend analysis of key solvency ratios for health plans in Medicaid managed care.","authors":"Michael J McCue","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The focus of this article is to assess the solvency of health plans that manage Medicaid members across key plan traits, specifically Medicaid dominant or plans with more than 75 percent Medicaid members, and plans owned by publicly traded companies, and sponsored by health care providers. The study accessed National Association of Insurance Commissioners (NAIC) financial data and computed key solvency ratios for 117 Medicaid health plans over a five-year time trend from 2007 to 2011. A mean test compared the mean values for each year and for the entire study period on risk-based capital (RBC), cash-flow margin and debt to total capital ratios across these plan traits. For all years except 2008 Medicaid dominant plans had a lower RBC ratio for all four out of five years. Cash-flow margin ratio for Medicaid dominant plans was only lower in 2011 than non-Medicaid dominant plans. From 2007 to 2010, debt to total capital was higher for plans owned by publicly traded companies than non-publicly traded companies. Given the potential for an expanding Medicaid market, Medicaid health plans have reduced their risk of insolvency by increasing the RBC over time and reducing their debt capital. However between 2010 and 2011 cash-flow margin ratio decreased by almost 180 basis points for Medicaid dominant plans.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"40 1","pages":"68-78"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31839943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-level estimates of the economic costs of alcohol and drug abuse.","authors":"Thomas M Wickizer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Substance abuse (SA) imposes a substantial economic burden on society. This burden arises largely from indirect costs associated with lost productivity (morbidity), premature mortality, and crime. The economic impact of SA has been estimated on a national level, but state-level estimates, needed for resource allocation and policy development, are lacking. I used standard cost-of-illness methods to quantify the economic cost of SA for Washington State for 2005. The cost of SA was estimated at $5.21 billion, $832 per non-institutionalized person in the state. Translated into 2012 dollars, these costs would be $6.12 billion and $977, respectively. Categories accounting for the greatest costs were mortality ($2.03 billion), crime ($1.09 billion), morbidity ($1.03 billion), and health care ($791 million). There were 3,224 deaths (7 percent of all deaths), 89,000 years of productive life lost, and 29,000 hospital discharges in 2005 in Washington State associated with SA. Continued attention should be directed at developing effective approaches to prevent and treat SA. If successful, these efforts should reduce the future economic burden of SA.</p>","PeriodicalId":56181,"journal":{"name":"Journal of Health Care Finance","volume":"39 3","pages":"71-84"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31381456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}