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The Association of State Rate Review Authority with Health Insurance Premiums. 国家费率审查机构与健康保险费协会。
Findings brief : health care financing & organization Pub Date : 2015-10-01
Caroline Ticse
{"title":"The Association of State Rate Review Authority with Health Insurance Premiums.","authors":"Caroline Ticse","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Key findings. (1) Adjusted premiums in the individual market in states with prior approval authority combined with loss ratio requirements were lower in 2010-2013 than premiums in states with no rate review authority or file-and-use regulations only. (2) Adjusted premiums declined modestly in prior approval states while premiums increased in states with no rate review authority or with file-and-use regulations only. (3) The findings suggest that states with prior approval authority and loss ratio requirements constrained increases in health insurance premiums.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 7","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34089066","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}
引用次数: 0
Achieving medication adherence through value-based insurance design. 通过基于价值的保险设计实现药物依从性。
Findings brief : health care financing & organization Pub Date : 2015-05-01
Emily Blecker
{"title":"Achieving medication adherence through value-based insurance design.","authors":"Emily Blecker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Key findings. Five main features of value-based insurance design plans were found to be associated with higher rates of medication adherence: (1) Plans that provide more generous coverage (2) Plans that target high-risk patients (3) Plans that offer wellness programs (4) Plans that do not offer disease management programs (5) Plans that make the benefit available only for medication order by mail.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 6","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33338877","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}
引用次数: 0
The impact of the early introduction of palliative care on patient's functioning. 早期引入姑息治疗对患者功能的影响。
Findings brief : health care financing & organization Pub Date : 2015-02-01
Emily Blecker
{"title":"The impact of the early introduction of palliative care on patient's functioning.","authors":"Emily Blecker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) After controlling for other factors that could explain patient functioning, the researchers found that each additional palliative care visit during the first month of follow-up increases patient functioning. (2) Patient functioning, as measured at the initial visit, is a far stronger predictor of subsequent functioning than are additional palliative care visits. (3) While palliative care may increase patient functioning, initial patient functioning likely limits what may be achieved in an absolute sense.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 5","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33123356","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}
引用次数: 0
How prevalent and costly are Choosing Wisely low-value services? Evidence from Medicare beneficiaries. 明智地选择低价值服务有多普遍和多昂贵?来自医疗保险受益人的证据。
Findings brief : health care financing & organization Pub Date : 2014-10-01
Megan Collado
{"title":"How prevalent and costly are Choosing Wisely low-value services? Evidence from Medicare beneficiaries.","authors":"Megan Collado","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Through the Choosing Wisely initiative, medical specialty societies identified non-indicated cardiac testing in low-risk patients and short-interval dual-energy X-ray absorptiometry (DXA) or bone density testing as low-value care. (2) Nationally, 13 percent of low-risk Medicare beneficiaries received non-indicated cardiac tests, and 10 percent of DXAs reimbursed by Medicare were administered at inappropriately short intervals. There is significant geographic variation in the provision of these services. (2) Carefully designed policy and payment changes will likely prove most effective in reducing low-value care.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 4","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32760550","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}
引用次数: 0
The impact of tiered physician networks on patient choices. 分层医生网络对患者选择的影响。
Findings brief : health care financing & organization Pub Date : 2014-09-01
Emily Blecker
{"title":"The impact of tiered physician networks on patient choices.","authors":"Emily Blecker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients exhibited strong loyalty to their physicians. There was no impact of tiering on whether patients decided to switch away from a physician who they'd seen previously. (2) Tiering affected the choices of patients who were selecting new physicians. When patients visited a doctor for the first time, they were less likely to choose doctors in the bottom or non-preferred tier. (3) Patients of the lowest-ranked physicians were more likely to switch health plans following the introduction of tiered networks.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 3","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32685918","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}
引用次数: 0
The challenges in achieving successful P4P programs. 成功实现P4P计划的挑战。
Findings brief : health care financing & organization Pub Date : 2014-03-01
Emily Blecker
{"title":"The challenges in achieving successful P4P programs.","authors":"Emily Blecker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Study results indicate that neither the quality scorecard nor the quality incentive payment program had a significant positive effect on general clinical quality. (2) Three main factors likely combined to weaken program effects: (1) modest size of the incentive; (2) use of rewards only; (3) targeting incentive payments to the group rather than to individuals. (3) The researchers found that, relative to the scorecard and reporting alone, the addition of the Quality Incentive Payment Structure (QIP) was associated with a reduction in quality, a result contrary to the intent of the payment incentive program.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 2","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32194672","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}
引用次数: 0
Reducing inappropriate emergency department and avoidable hospitalization rates: assessing the influence of medical group practice characteristics. 减少不适当急诊科和可避免住院率:评估医疗集团实践特征的影响。
Findings brief : health care financing & organization Pub Date : 2014-02-01
Emily Blecker
{"title":"Reducing inappropriate emergency department and avoidable hospitalization rates: assessing the influence of medical group practice characteristics.","authors":"Emily Blecker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>(1) Practices that are physician-owned and practices that use Electronic Health Records (EHRs) have lower nonemergent emergency department (ED) rates and lower emergent-primary care treatable ED rates. (2) Medical practices with more nurse practitioners or physician assistants per physician have higher emergent-primary care treatable ED and higher ambulatory care sensitive (ACS) rates, but their nonemergent ED rates do not differ statistically from those of other practices. (3) The ability to provide and manage accessible, coordinated care declines as medical practices grow larger and more complex.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"42 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2014-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32194671","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}
引用次数: 0
What happens when Medicare cuts hospital prices? Assessing the impact on inpatient discharges among the elderly. 当医疗保险降低医院价格时会发生什么?评估对老年人住院出院的影响。
Findings brief : health care financing & organization Pub Date : 2013-11-01
Lauren Radomski
{"title":"What happens when Medicare cuts hospital prices? Assessing the impact on inpatient discharges among the elderly.","authors":"Lauren Radomski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Key findings. (1) Between 1995 and 2009, growth in Medicare inpatient prices varied widely across hospital markets. Faster growth typically occurred in less urban areas that had a large market share of for-profit hospitals. (2) By 2008-2009, elderly patients were going to the hospital at the same rate as in the mid-1990s, but their stays were much shorter, and they received much more intensive services. (3) Medicare price cuts, largely attributable to the Balanced Budget Act of 1997, were associated with a decrease in the num­ber of elderly discharges and a decrease in the number of staffed hospital beds, highlighting possible effects of hospital price cuts under health reform.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"16 6","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31932846","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}
引用次数: 0
Patient health causes substantial portion of geographic variation in Medicare costs. 在医疗保险费用的地域差异中，病人的健康状况造成了相当大的一部分。
Findings brief : health care financing & organization Pub Date : 2013-10-01
Megan Collado
{"title":"Patient health causes substantial portion of geographic variation in Medicare costs.","authors":"Megan Collado","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Key findings. (1) Substantial geographic variation exists in Medicare costs, but to determine the source and extent of this variation requires proper accounting for population health differences. (2) While physician practice patterns likely affect Medicare geographic cost variations, population health explains at least 75 to 85 percent of the variations—more than previously estimated. (3) Policy strategies should consider the magnitude of the impact of beneficiary health status on Medicare costs in order to address geographic variation.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"16 5","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31817307","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}
引用次数: 0
Protecting uninsured patients from high hospital charges: lessons from California. 保护没有保险的病人不受高额医院费用的影响:来自加州的经验教训。
Findings brief : health care financing & organization Pub Date : 2013-09-01
Lauren Radomski
{"title":"Protecting uninsured patients from high hospital charges: lessons from California.","authors":"Lauren Radomski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Key findings. (1) In 1997, the amount California hospitals billed uninsured patients was more than twice the amount hospitals received from Medicare for the same services. By 2010, billed charges had grown to be five times what Medicare paid, which trans­lated into a gap of more than $10,000 per day in the hospital. (2) Five years after the passage of the state's Hospital Fair Pricing Act, most California hospitals had financial assistance policies in place to make care more affordable for the state's uninsured population. (3) As of 2011, 81 percent of California hospitals reported charging low-income uninsured patients prices that were at or below Medicare rates. (4) While not required by the law, nearly all California hospitals reported offering free care to uninsured patients with incomes at or below 100 percent of poverty.</p>","PeriodicalId":83710,"journal":{"name":"Findings brief : health care financing & organization","volume":"16 4","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31752092","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}
引用次数: 0
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