15,740 results
Search Results
152. Influence of service quality on consumer loyalty: a mediation analysis of health insurance
- Author
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Abdel Fattah, Fadi Abdel Muniem, Dahleez, Khalid Abed, Darwazeh, Riyad Neman, and Al Alawi, Abrar Mohammed Mubarak
- Published
- 2021
- Full Text
- View/download PDF
153. Forecasting health financing sustainability under the unified pool reform: evidence from China's Urban Employee Basic Medical Insurance.
- Author
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Wu, Jing, Yang, Hualei, and Pan, Xiaoqing
- Subjects
HEALTH insurance ,HEALTH care reform ,INSURANCE funding ,GROWTH funds ,SUSTAINABLE development ,MORAL hazard - Abstract
Objective: The integration of the health insurance fund pool may threaten the sustainability of the fund by increasing its expenditures through the exacerbation of the moral hazard of participations. The purpose of this paper is to assess and predict the impact of the single pool reform of China's Urban Employee Basic Medical Insurance (UEBMI) on the expenditure and sustainability of the health insurance fund. Methods: In this paper, we consider the pilot implementation of the single pool reform in some provinces of China as a quasi-natural experiment, and develop a staggered DID model to assess the impact of the single pool reform on medical reimbursement expenditure. Based on the results, an actuarial model is developed to predict the impact on the accumulated balance of China's health insurance fund if the single pool reform is continued. Results: We found that the medical reimbursement expenditure would increase by 66.4% per insured person after the unified provincial-level pool reform. There is individual heterogeneity in the effects of the unified single pool reform on medical reimbursement expenditure, and the reimbursement expenditure of retired elderly has the largest increase. If the unified single pool reform is gradually promoted, the current and accumulated balance of the UEBMI pooling fund would have gaps in 2031 and 2042, respectively. Conclusion: We verified that a larger fund pool will bring unreasonable growth of fund expenditures, which will threaten the sustainable development of health insurance. To minimize the impact of the unified single pool reform on the sustainability of the health insurance fund, we suggest strengthening the monitoring of moral hazard behavior, promoting the delayed retirement system, and encouraging childbearing. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
154. FICCI Working Paper on Health Insurance Fraud: ACKNOWLEDGEMENT
- Subjects
Insurance fraud ,Health insurance ,Business, international - Abstract
FICCI is deeply indebted to the Health Insurance Advisory Group for focussing on Health Insurance Fraud as one of the areas of intervention. FICCI is especially thankful to the Working [...]
- Published
- 2012
155. FICCI Working Paper on Health Insurance Fraud: Introduction
- Subjects
Insurance fraud ,Health insurance ,Business, international - Abstract
There is a growing concern among the insurance industry about the increasing incidence of abuse and fraud in health insurance. FICCI sub group on health insurance fraud was set up [...]
- Published
- 2012
156. Reducing medical claims cost to Ghana's National Health Insurance scheme: a cross-sectional comparative assessment of the paper- and electronic-based claims reviews.
- Author
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Nsiah-Boateng, Eric, Asenso-Boadi, Francis, Dsane-Selby, Lydia, Andoh-Adjei, Francis-Xavier, Otoo, Nathaniel, Akweongo, Patricia, and Aikins, Moses
- Subjects
HEALTH insurance claims ,INSURANCE claims adjustment ,HEALTH insurance companies ,CROSS-sectional method ,INSURANCE ,NATIONAL health services ,COMPARATIVE studies ,COST control ,FRAUD ,HEALTH facilities ,INDUSTRIES ,HEALTH insurance ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,EVALUATION research ,ECONOMICS - Abstract
Background: A robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana.Methods: The study was a cross-sectional comparative assessment of paper- and electronic-based claims reviews of the NHIS. Medical claims of subscribers for the year, 2014 were requested from the claims directorate and analysed. Proportions of claims adjusted by the paper- and electronic-based claims reviews were determined for each type of healthcare facility. Bivariate analyses were also conducted to test for differences in claims adjustments between healthcare facility types, and between the two claims reviews.Results: The electronic-based review made overall adjustment of 17.0% from GHS10.09 million (USD2.64 m) claims cost whilst the paper-based review adjusted 4.9% from a total of GHS57.50 million (USD15.09 m) claims cost received, and the difference was significant (p < 0.001). However, there were no significant differences in claims cost adjustment rate between healthcare facility types by the electronic-based (p = 0.0656) and by the paper-based reviews (p = 0.6484).Conclusions: The electronic-based review adjusted significantly higher claims cost than the paper-based claims review. Scaling up the electronic-based review to cover claims from all accredited care providers could reduce spurious claims cost to the scheme and ensure long term financial sustainability. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
157. BridgeHealth White Paper Suggests Bundle-Priced Benefits to Guard Against Fiduciary Fraud Lawsuits
- Subjects
CIGNA Corp. ,Fiduciary duties ,Employers ,Litigation ,Fraud ,Health insurance ,Health maintenance organizations ,Lawsuit/litigation ,Business ,Business, international - Abstract
DENVER -- BridgeHealth, a leading provider of high-quality, lower-cost, bundled surgical case rate benefit plans, says an innovative benefits solution can help employers avoid a 'tsunami of millions of dollars [...]
- Published
- 2017
158. Does the economics of moral hazard need to be revisited? A comment on the paper by John Nyman.
- Author
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Blomqvist, Åke
- Subjects
- *
MEDICAL economics , *INSURANCE , *HEALTH facilities utilization , *HEALTH policy , *MANAGED care programs , *MEDICAL care costs - Abstract
In a recent paper, professor John Nyman revisits an issue that has been central to much of the literature in health economics in recent years, namely the trade-off between the gains from insurance, on the one hand, and the efficiency losses from the moral hazard effect that arises as a result of the implicit subsidy to health services utilization under conventional insurance plans, on the other. The result, according to Nyman, has been a tendency in the health policy debate to put too much emphasis on insurance plan features such as consumer cost and provisions to control utilization in managed-care plans. One of the principal points in Nyman's paper is that the conventional approach underestimates the gains from insurance because it fails to take into account what can be termed the "affordability" effect: that certain interventions are so costly that, in the absence of insurance, the individual would have to go without them, even if they potentially would have very large health benefits.
- Published
- 2001
- Full Text
- View/download PDF
159. Encouraging Strong Family Relationships. State Policies That Work. Brief Number 6
- Author
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Center for the Study of Social Policy
- Abstract
The relational well-being of families is an important factor affecting a family's economic success, physical and mental heath, the readiness and success of children in school, and the engagement of youth in positive and productive roles. In short, the strength of family bonds is crucial to a family's capacity to provide, nurture, and care for its members. "Strong Family Relationships" is defined as the relational well-being of families. While the successful promotion of "strong family relationships" is clearly tied to ensuring family economic success and family health, this brief focuses primarily on strengthening the formation of families, the interaction of parents and children, the connection of families to social networks, and the adequacy and quality of necessary family resources. Addressing these many facets of family life is important given the dramatic changes and pressures associated with contemporary American family life. For example, fewer couples are marrying or are choosing to marry at later ages, more are cohabiting, increasing numbers of children will spend some part of their childhood in a single parent home, and rising health care, housing, and child care costs are making it difficult for families to balance the competing demands of work and family. This brief is a companion to a complete policy and research paper that provides an overview of current trends affecting American families and offers a beginning framework for state policies that strengthen family relationships. (Contains 72 endnotes.) [For the full report, "Encouraging Strong Family Relationships. Policy Matters: Setting and Measuring Benchmarks for State Policies. A Discussion Paper for the "Policy Matters" Project," see ED536821.]
- Published
- 2012
160. Employees State Insurance Corporation Medical College and Hospital Reports Findings in Pediatrics (The Indian Academy of Pediatrics and Directorate General of Health Services, Government of India White Paper on Transition of Care for Youth with...).
- Subjects
GOVERNMENT publications ,HEALTH insurance ,STATE government personnel ,INSURANCE company personnel ,MEDICAL care ,EMPLOYMENT - Abstract
A report from the Employees State Insurance Corporation Medical College and Hospital in New Delhi, India, highlights the need for a well-organized transition of care (ToC) for youth with special health care needs (YSHCN) who are transitioning from pediatric to adult health care systems. The report emphasizes that without proper ToC, these patients may experience unsatisfactory health outcomes. The research also provides standard operating procedures for developing ToC at a hospital level. This emerging concept of ToC is well-established in developed countries but is still in its early stages in India. [Extracted from the article]
- Published
- 2024
161. Settling a U.S. Senatorial Debate: Understanding Declines in State Higher Education Funding
- Author
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Klein, Michael W.
- Abstract
This paper examines the debate in the U.S. Senate over the reasons why state governments have decreased funding for higher education. One side believes that federal mandates on states to pay for Medicaid have forced them to reduce spending on higher education. The other side believes that states unwisely reduced taxes, which decreased their revenues and caused cuts to higher education funding. This study finds that important factors regarding revenues and spending are missing from the Senate's debate. Revenues decline for a number of reasons, including the effects of unemployment. Court decisions have required many states to increase spending on K-12 education. As a policy priority, higher education is disadvantaged, in part because lawmakers understand, and perhaps accept, that institutions may increase tuition to replace cuts in appropriations. This acceptance is part of a "grand paradox" between what lawmakers say and what they do regarding higher education. Ultimately, leadership determines states' spending. If governors and legislators have the political will, they can make funding for higher education a priority. [This paper was presented at the Symposium on the Financing of Education presented by the "Journal of Education Finance" at the Oxford Union, Oxford, England on Dec 9, 2014.]
- Published
- 2015
162. 2009 Disability Status Report: United States
- Author
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Cornell University, Employment and Disability Institute, Erickson, W. Lee C., and von Schrader, S.
- Abstract
The Annual Disability Status Reports provide policy makers, disability advocates, reporters, and the public with a summary of the most recent demographic and economic statistics on the non-institutionalized population with disabilities. They contain information on the population size and disability prevalence for various demographic subpopulations, as well as statistics related to employment, earnings, household income, veterans' service-connected disability and health insurance. Comparisons are made to people without disabilities and across disability types. The Status Reports primarily look at the working-age population because the employment gap between people with and without disabilities is a major focus of government programs and advocacy efforts. Employment is also a key factor in the social integration and economic self-sufficiency of working-age people with disabilities. The estimates in the 2009 Disability Status Reports are based on American Community Survey (ACS) data--a US Census Bureau survey that has replaced the Decennial Census long form. The estimates in these reports are based on responses from a sample of the population and may differ from actual population values because of sampling variability and other factors. Differences observed between the estimates for two or more groups may not be statistically significant. Finally, the 2009 Disability Status Report estimates should not be compared to estimates from any reports based on ACS data collected prior to 2008. In 2008, the US Census Bureau made a number of significant changes to the ACS. These changes included an entirely new set of disability questions as described in this paper. A glossary is included. [This paper was produced with the editing and production assistance of Sara VanLooy, Jeff Trondsen, and Joe Williams. For the 2008 edition of this report, see ED539268.]
- Published
- 2011
163. Toward Reducing Poverty across Generations: Early Findings from New York City's Conditional Cash Transfer Program
- Author
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Society for Research on Educational Effectiveness (SREE), Miller, Cynthia, and Riccio, James
- Abstract
Aimed at low-income families in six of New York City's highest-poverty communities, Family Rewards ties cash rewards to a pre-specified set of activities and outcomes thought to be critical to families' short- and long-term success in the areas of children's education, family preventive health care, and parents' employment. The purpose of this project is to experimentally evaluate the effects of this three-year innovative holistic conditional cash transfer (CCT) initiative. This paper presents initial findings from an ongoing and comprehensive evaluation of Family Rewards. It examines the program's implementation in the field and families' responses to it during the first two of its three years of operations, and early findings on the program's impacts on children's educational processes and outcomes. More specifically, this paper addresses the following questions: (1) What are the effects of ONYC-Family Rewards on family income, poverty, and financial hardship?; (2) What are the effects of ONYC-Family Rewards on use of health care and health insurance?; (3) What are the effects of ONYC-Family Rewards on parents' employment and educational attainment?; and (4) What are the effects of ONYC-Family Rewards on children's educational outcomes? Overall, this study shows that, despite an extraordinarily rapid start-up, the program was operating largely as intended by its second year. Although many families struggled with the complexity of the program, most were substantially engaged with it and received a large amount of money for meeting the conditions it established. Specifically, nearly all families (98 percent) earned at least some rewards in both program years, with payments averaging more than $6,000 during the first two program years combined. The program reduced current poverty and hardship; increased savings; increased families' continuous use of health insurance coverage and increased their receipt of medical care; and increased employment in jobs that are not covered by the unemployment insurance (UI) system but reduced employment in UI-covered jobs. The program has had mixed success in improving children's academic performance specifically. Contrary to expectations, Family Rewards did not affect school attendance or annual standardized test scores in Math and English Language Arts (ELA) for either group of youngest children, but did lead to notable gains for a group of more academically prepared high school students. The program also had important effects on several key proposed mediators of the intervention. However, these effects vary by parents with different age groups of children. Appended are: (1) References; and (2) Tables and Figures. (Contains 2 tables.)
- Published
- 2011
164. 2010 Profile of a Research Administrator
- Author
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Shambrook, Jennifer and Roberts, Thomas J.
- Abstract
This paper expands upon the seminal work of Roberts and House, which described the first empirical study of the demographic profile of a research administrator. The original work was based upon data from the 2005 Research Administrator Survey (RAS), a regional study of research administrators in the southeastern United States. In this paper, nationwide demographic data from the 2010 Research Administrators stress Perception Survey (RASPerS) are compared to the 2005 RAS data. These comparisons revealed that the general profile of a research administrator continues to be overwhelmingly female (80.1%), holding a higher education degree (88.7%), and aged 40-49 years (31.9%). The 2010 data showed an extremely significant difference in the modal salary level, which increased from $50,000 to $74,999 (40.0%). In 2005, the increase was from $40,000 to $50,000 (23%). Level of education was slightly higher in 2010 than in 2005, with more research administrators holding both bachelor's and master's degrees. Additional demographic and social data are described from the 2010 RASPerS. These include both work and non-work factors. These data are offered to provide information that may be useful for others with an interest in expanding the body of knowledge about the profession of research administration. (Contains 4 tables.)
- Published
- 2011
165. New White Paper Calls for Health Insurer Transparency and More Competition in North Carolina.
- Subjects
INSURANCE companies ,HEALTH insurance ,HEALTH equity - Abstract
As a former healthcare executive, I've consistently called for reforms to one of the main problems I see in healthcare: health insurers", Wendell Potter writes in the white paper. Keywords: Democracy; Health Insurance; Health and Medicine; North Carolina Center for Health and Democracy EN Democracy Health Insurance Health and Medicine North Carolina Center for Health and Democracy 40 40 1 05/08/23 20230508 NES 230508 2023 MAY 14 (NewsRx) -- By a News Reporter-Staff News Editor at Health Insurance Week -- The North Carolina Center for Health & Democracy released a new white paper, " How Do We Fix Healthcare in North Carolina", authored by health insurance payment reform advocate, bestselling author and former health insurance executive, Wendell Potter. [Extracted from the article]
- Published
- 2023
166. Costs of hospitalization for chronic kidney disease in Guangzhou, China
- Author
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Zhang, Hui, Zhang, Chao, Zhu, Sufen, Zhu, Feng, and Wen, Yan
- Published
- 2019
- Full Text
- View/download PDF
167. California Report Card '09: Setting the Agenda for Children
- Author
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Children Now, Oakland, CA.
- Abstract
Despite economic and social challenges facing California, Children Now advocates that the foundation of state vitality and well-being is a healthy, educated and skilled population, and urges efficient investments in children. State leadership is called upon to: (1) Ensure every child has affordable health insurance coverage; (2) Invest earlier in a child's life, to capitalize on the opportunity to improve cognitive, social and emotional development; (3) Increase access to preventive supports and services through integrated services; (4) Improve the K-12 system with evidence-based reforms; and (5) Deliver safe and enriching after school programs to all children who lack access to them, tailoring them to the distinctive programmatic needs of local communities. The "2009 California Report Card" provides an agenda for strengthening California through its children by detailing: (1) key public policy developments in 2008 that impact children's well-being; (2) policy objectives for improving the well-being of children; (3) recent data representing the current status of California's children; and (4) specific, immediate actions to target during the 2009-10 legislative session. (Contains 208 endnotes.)
- Published
- 2009
168. Proposed Business and Franchising Models for Primary Care in Kenya
- Author
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Davis, Elise Catherine, Evans, Ashley, Uptmore, Caroline, Lang, Sarah, McElroy, Jessica K., Ellenburg, David, Nguyen, Tony, and Kash, Bita A.
- Abstract
Purpose: The purpose of this paper is to present proposed solutions and interventions to some of the major barriers to providing adequate access to healthcare in Kenya. Specific business models are proposed to improve access to quality healthcare in low- and middle-income countries. Finally, strategies are developed for the retail clinic concept (RCC). Design/methodology/approach: Google Scholar, PubMed and EBSCOhost were among the databases used to collect articles relevant to the purpose in Kenya. Various governmental and news articles were collected from Google searches. Relevant business models from other sectors were considered for potential application to healthcare and the retail clinic concept. Findings: After a review of current methodologies and approaches to business and franchising models in various settings, the most relevant models are proposed as solutions to improving quality healthcare in Kenya through the RCC. For example, authors reviewed physician recruitment strategies, insurance plans and community engagement. The paper is informed by existing literature and reports as well as key informants. Research limitations/implications: This paper lacks primary data collection within Kenya and is limited to a brief scoping review of literature. The findings provide effective strategies for various business and franchising models in healthcare. Originality/value: The assembling of relevant information specific to Kenya and potential business models provides effective means of improving health delivery through business and franchising, focusing on innovative approaches and models that have proven effective in other settings.
- Published
- 2018
- Full Text
- View/download PDF
169. Statement of Principles on Academic Retirement and Insurance Plans.
- Abstract
A policy statement on retirement and insurance plans formulated by the American Association of University Professors and the Association of American Colleges is presented. Retirement plans are seen to attract individuals, permit them to devote their energies to the profession, and to provide for an orderly retirement. (MLW)
- Published
- 1980
170. Peaks, Cliffs and Valleys: The Peculiar Incentives in Teacher Retirement Systems and their Consequences for School Staffing
- Author
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Urban Inst., Washington, DC., Costrell, Robert M., and Podgursky, Michael
- Abstract
This paper examines the pattern of incentives for work versus retirement in five state teacher pension systems. We do this by examining the annual accrual of pension wealth from an additional year of work over a teacher's career. Accrual of wealth is highly nonlinear and heavily loaded at arbitrary years that would normally be considered midcareer. One typical pattern exhibits low accrual in early years, accelerating in mid-late fifties, followed by dramatic decline, or even negative returns in years that are relatively young for retirement. We consider five states for specific analysis: We identify key factors in the defined benefit formulas that drive such patterns, and likely consequences for employee behavior. We examine the efficiency and equity consequences of these systems and lessons that might be drawn for pension reform. (Contains 10 figures and 1 table.) [This paper was supported with funds from the National Center for Employment Incentives at Vanderbilt University and the Center for the Analysis of Longitudinal Data.] in Education Research at the Urban Institute.]
- Published
- 2007
171. Poor on Paper: An Over view of the Ethics and Morality of Medicaid Planning.
- Author
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Karp, Joseph S. and Gershbein, Sara I.
- Subjects
- *
MEDICAID , *HEALTH policy , *HEALTH insurance , *CIVIL rights - Abstract
The article presents an overview of the ethics and morality of Medicaid planning in the U.S. Medicaid planning refers to the legal fiction of rearranging assets to make someone poor on paper so that he or she may qualify for Medicaid. Medicaid was initially developed by the U.S. Congress in 1965 during the presidency of former U.S. President Lyndon Baines Johnson and during an era of civil rights reforms. The reasons why Medicaid planning is undertaken often affect whether it is perceived as moral. For instance, as will be seen below, whether Medicaid planning is utilized to preserve an inheritance, to enhance an institutionalized person's quality of care, or to protect a community spouse from impoverishment can all affect judgments of morality.
- Published
- 2005
172. The Relationship of HIPAA to Special Education
- Author
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Utah State Univ., Logan. Mountain Plains Regional Resource Center. and Benitz, Catherine
- Abstract
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) includes important, but limited, protections for millions of working Americans and their families around the ability to obtain and keep health coverage. Among its specific protections, HIPAA: (1) Limits the use of preexisting condition exclusions; (2) Prohibits group health plans from discriminating by denying coverage or charging extra for coverage based on past or present poor health; (3) Guarantees certain small employers and certain individuals who lose job-related coverage the right to purchase health insurance; and (4) Guarantees, in most cases, that employers or individuals who purchase health insurance can renew the coverage regardless of any health conditions of individuals covered under the insurance policy. The privacy provisions of HIPAA apply to health information created or maintained by health care providers who engage in certain electronic transactions, health plans, and health care clearinghouses. The privacy rule standards address the use and disclosure of individual health information, or "protected health information," by organizations (covered entities) subject to the privacy rule, as well as standards for individual's privacy rights to understand and control how their health information is used. A major goal of the privacy rule is to ensure that an individual's health information is properly protected while allowing the flow of health information needed to provide and promote high-quality health care and to protect the public's health and well being. The purpose of this paper is to provide clarification to educators regarding the privacy of records and information related to the requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The paper was originally distributed in 2003 and has been updated with resources and web page links. Additional resources and websites are provided for the reader to obtain current information regarding the required privacy regulations.
- Published
- 2006
173. Supply Of Office Paper Branch Territorial Compulsory Medical Insurance Fund Of The Khanty-mansiysk Autonomous Okrug - Yugra In Surgut
- Subjects
Health insurance ,Business, international - Abstract
Request for quotations: Supply of office paper Branch Territorial Compulsory Medical Insurance Fund of the Khanty-Mansiysk Autonomous Okrug - Yugra in Surgut The initial (maximum) contract price: 5442.53 Russian Rouble [...]
- Published
- 2016
174. Provision with maintaining a ris, pacs and paper printing system for the radiology department of the medical center raumur primary health insurance fund of paris (cpam of paris)
- Subjects
Medical centers ,Radiology ,Health insurance ,Business, international - Abstract
Contract notice: Provision with maintaining a ris, pacs and paper printing system for the radiology department of the medical center raumur primary health insurance fund of paris (cpam of paris). [...]
- Published
- 2016
175. Evolution of the mental health care system in Poland[This paper].
- Author
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Puzynski, S. and Moskalewicz, J.
- Subjects
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HEALTH services accessibility , *CITIZEN participation in community health services , *HEALTH insurance , *HEALTH policy - Abstract
Objective: The aim of this paper is to trace evolution of mental health system in Poland. Method: Available Polish literature and fundamental policy documents including mental health legislation are reviewed and major milestones in this evolution identified and then discussed against the background of political and social developments. Results: The mental health system evolved since the beginning of the 1970s from large hospitals towards community-based care. It was found that the changes were rather slow due to financial shortages and lack of clear demand from users. Recent transitions offer opportunities to increase impact of users and their families. On the other hand, however, introduction of health insurance system reduces prospects for well co-ordinated mental health policy and may lead to inequalities in access to services. Conclusion: It can be concluded that evolution of mental health services has been influenced by prevailing ideologies as much as by technical and professional considerations. [ABSTRACT FROM AUTHOR]
- Published
- 2001
- Full Text
- View/download PDF
176. Maintaining the Gains: The Importance of Preserving Coverage in MEDICAID and SCHIP.
- Author
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Southern Inst. on Children and Families, Columbia, SC., O'Brien, Ellen, and Mann, Cindy
- Abstract
As states face increasing fiscal pressures, many are considering proposals to cut eligibility levels, eliminate outreach, and retract simplified enrollment procedures for children and families eligible for Medicaid and the State Children's Health Insurance Program (SCHIP). This paper presents evidence on the importance of maintaining gains made in the number of children and families enrolled in these programs and of building further on improvements in Medicaid and SCHIP coverage. Following an executive summary are introductory remarks detailing the phased-in eligibility expansions for Medicaid and the enactment of SCHIP, the increased program participation, and the potential risk to coverage gains due to proposed state actions. The paper is then organized in two major parts. Part 1 examines research evidence on how public health insurance coverage enhances access to care, health, family finances, and quality of life. Part 2 examines evidence on Medicaid and SCHIP's importance to communities, focusing on economic, health, and social consequences of public health insurance coverage beyond the target population. Among the key findings presented are that previously uninsured children enrolled in Medicaid have fewer unmet needs and fewer delays in getting needed care. Medicaid reduces emergency room use and the rate of preventable hospitalizations. Medicaid expansions are related to reduced infant mortality. Low-income families of children enrolled in Medicaid spend considerably less out-of-pocket than families of uninsured Medicaid-eligible children. Medicaid brings federal matching funds into states, thereby promoting community economic development through job creation and income growth. Public coverage reduces uncompensated care burdens on providers and localities, thereby strengthening local providers capacity to serve all people; and provides access to care for low-income children and parents at risk of communicable disease, thereby reducing burdens on public health departments to provide medical services to the uninsured. The paper concludes by pointing out that research findings provide an objective foundation for state policymakers to evaluate the potential consequences of their choices. (Contains 70 references.) (KB)
- Published
- 2003
177. Health Care Coverage among Child Support-Eligible Children.
- Author
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Urban Inst., Washington, DC. and Aron, Laudan Y.
- Abstract
Using data from the National Survey of America's Families (a nationally representative survey of the economic, social, and health characteristics of children, adults, and their families), this paper discusses health care coverage among child support eligible children. It begins with a detailed profile of child support eligible children living with their mothers, including their demographic and socioeconomic characteristics and their child support and health insurance characteristics. In addition to current health insurance status, it examines what types of health insurance coverage children have had over the prior year and how their health insurance status varies by child support award and receipt status and the mother's employment characteristics. The paper then examines what share of these children might have access to employer-sponsored health insurance through their mothers' employers whether or not they actually have this type of coverage. Finally, it asks what share is eligible for Medicaid and the State Children's Health Insurance Program, how much these programs can reduce the number of child support eligible children who are uninsured, and what opportunities and barriers are encountered by state officials in coordinating efforts to secure appropriate health insurance for children. (Contains 7 figures, 10 tables, and 30 references.) (SM)
- Published
- 2002
178. Part-Time Faculty: A Principled Perspective.
- Author
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Academic Senate for California Community Colleges, Sacramento.
- Abstract
This paper details the history of part-time faculty use in the California Community Colleges (CCCs). The status and use of part-time faculty hired on temporary assignments in the CCCs has been a long-standing and growing concern of the Academic Senate. In 1960, the ratio of full-time faculty to full-time students in the public junior colleges was 1/20; the current ratio is over 1/35, nearly doubling faculty responsibilities. Passage of the 60% law in 1967 reclassified any instructor teaching not more than 60% of the hours considered a full-time load as a temporary employee rather than a contract employee. Currently, 66.2% of faculty are part-time and they teach 46.1% of credit instruction. In addition to cataloging the legislation that has impacted part-time faculty status since 1967, this paper addresses state activity relating to part-time faculty issues: (1) hiring procedures; (2) health benefits; (3) student contact hours; and (4) comparable pay for comparable work. The paper concludes that the problems created by decades of arbitrary use and abuse of part-time faculty are complex and interdependent. During the 2000-2001 budget cycle, the Legislature and the Governor began to address the fundamental cause of the problems. The California Community College System must now try to formulate a comprehensive solution that avoids short-term and partial solutions that create new and unnecessary problems. (AUTH/NB)
- Published
- 2002
179. State's insurance plan takes paper route
- Subjects
Health insurance ,Business ,General interest ,Business, regional - Abstract
Byline: Cynthia McCormick Dec. 11--After problems with the state's health care enrollment website, insurance counselors are turning to low-tech tools -- paper and the fax machine -- to meet the [...]
- Published
- 2013
180. Machine learning based methods for ratemaking health care insurance.
- Author
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Ben Hamida, Amal, Kacem, Manel, de Peretti, Christian, and Belkacem, Lotfi
- Subjects
ARTIFICIAL neural networks ,MACHINE learning ,INSURANCE companies ,INSURANCE policies ,HEALTH insurance - Abstract
In insurance, proposing an accurate premium that is adjusted to the insured risk profile allows companies to better manage their portfolios and to be more competitive. Machine learning methods have recently been adopted for various improvements in insurance ratemaking, especially in the automobile industry. These models are specifically used to mine potential data information and to build a predictive model for a variable of interest using explanatory variables. In this paper, we aim to provide a pricing method for ratemaking individual healthcare insurance contracts using machine learning algorithms that are applied to a Tunisian healthcare insurance portfolio. We start with a simple Classification and Regression Tree, and we work toward more advanced methods that are Random Forest, Extreme gradient boosting, Support Vector Regression, and Artificial Neural network regression model. The predictive performance of these non-parametric methods is compared with the standard generalized linear model. Our results showed the applicability of machine learning in the healthcare insurance market and that the XGBoost algorithm outperforms the predictive capacity of the classical generalized linear model. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
181. Selected States Have a New Opportunity to Use More of Their SCHIP Funds for Outreach: Roughly 23 States Now Have More Than $100 Million in Federal SCHIP Matching Funds Available To Help Boost Enrollment.
- Author
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Center on Budget and Policy Priorities, Washington, DC., Broaddus, Matthew, Guyer, Jocelyn, and Ross, Donna Cohen
- Abstract
States originally had until September 30, 2000 to spend their first year of funds under the State Children's Health Insurance Program (SCHIP) or else lose any unspent funds. Funds remaining unused after 3 years were to be reallocated to states that had spent their SCHIP funds before the deadline. Only 12 states met the deadline, with many states reporting that they needed more time to design/initiate programs and to conduct outreach. In response, Congress passed the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) in December, 2000. Under this law, the 12 states that met the deadline received some reallocated funds, while the remaining 39 states were allowed to retain a share of their unspent funds. BIPA also created an option whereby the 39 states allowed to retain some of their unspent first-year SCHIP funds could spend up to 10 percent of these funds on outreach. After providing background on the SCHIP financing structure, this paper describes the modified reallocation process that Congress adopted in BIPA for unspent first-year SCHIP funds, the new 10 percent outreach option, and the accounting rules that may limit the ability of some states to take advantage of the option. The paper also contains state-by-state tables listing the states likely to be able to take advantage of the new outreach funding option, as well as rough estimates of the amount likely to be available for outreach in each of these states. The paper concludes by noting that for states with unspent SCHIP funds, BIPA extends their opportunity to use a share of these funds to provide health benefits to children. In addition, at least 23 states will be able to use federal SCHIP matching funds to strengthen and expand their outreach efforts. (KB)
- Published
- 2001
182. Session 1465 (Paper): SOCIAL ISOLATION AND MENTAL HEALTH.
- Subjects
SOCIAL isolation ,MENTAL health of older people ,PSYCHOSOCIAL factors ,WELL-being ,HEALTH of older people ,HEALTH insurance - Published
- 2021
183. Health and health services. -Paper presented to the NSW Nurses Association. Community Conference (1984)
- Author
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Herriott, Bruce
- Published
- 1984
184. 21 Million Children's Health: Our Shared Responsibility. The Medical Child Support Working Group's Report.
- Abstract
Although the child support enforcement program has been increasingly successful in obtaining health care coverage for children, changes in the labor market, family structure, health care delivery systems, and social welfare policy require new approaches to ensure that children obtain appropriate health care coverage. This report of the Medical Child Support Working Group identifies impediments to the effective enforcement of medical child support, and recommends solutions to these impediments. The report is organized into nine chapters. Chapter 1 addresses the scope of the problem. Chapter 2 provides an overview of the current system from the perspective of the Child Support Enforcement Program (IV-D) as well as from the perspective of the employer and plan community; this chapter also offers a new paradigm for ensuring health care coverage for all child support-eligible children. Chapter 3 offers a detailed analysis and comprehensive reform of how health care is included in a child support obligation and how that order is drafted. Chapter 4 discusses the National Medical Support Notice, the enforcement tool for IV-D medical support orders. Chapter 5 is a broader discussion of enforcement of the health care provisions in a child support order. Chapter 6 discusses improving coordination and communication among private and public health care coverage. Chapter 7 examines funding of child support activities directly related to medical support. Chapter 8 identifies additional strategies and research required to ensure ongoing improvements in assuring health care coverage for children in single parent families. Chapter 9 provides a brief conclusion to the report. Eight appendices include the list of 76 recommendations, a glossary of relevant terms, and a description of the legislative history of major medical support provisions. (KB)
- Published
- 2000
185. Planning the Beginning with the End in Mind: Evaluating Outreach and Enrollment Strategies, A Case Study. An Interview with Pat Redmond, Health Director, Philadelphia Citizens for Children and Youth, a NACA Member Organization. Issue Brief.
- Author
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National Association of Child Advocates, Washington, DC. and Schmid, Margaret
- Abstract
The State Children's Health Insurance Program (SCHIP) in 1997 signaled a major increase in time, energy, creativity, and money devoted to enrolling eligible children in health insurance programs. Child advocates and others have focused on developing outreach and enrollment strategies to bring the benefits of these new SCHIP programs to children and their families. Noting that knowing whether these strategies are working is as urgent as the strategies themselves, this issue brief discusses the role of participatory evaluation in keeping a clear focus on the purpose of the project and its learning objects in order to develop a program which can be evaluated for effectiveness, not only at the project's completion, but while the project is underway. Every project component--planning the activities, identifying the participants, developing the training, deciding on the data to be collected, and designing the tracking forms--needs to be measured against these questions: Why are we doing this project? and What do we want to know when the project is over? An interview with Pat Redmond, the health director at the Philadelphia Citizens for Children and Youth, is presented to illustrate how participatory evaluation leads to a project that can be evaluated for effectiveness. (KB)
- Published
- 2000
186. Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study
- Author
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Kusi, Anthony, Fenny, Ama, Arhinful, Daniel Kojo, Asante, Felix Ankomah, and Parmar, Divya
- Published
- 2018
- Full Text
- View/download PDF
187. E-service usage and satisfaction in Botswana
- Author
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Jaiyeoba, Olumide Olasimbo, Chimbise, Totwana Tito, and Roberts-Lombard, Mornay
- Published
- 2018
- Full Text
- View/download PDF
188. Customer’s patronage decision toward health insurance products : Mediation and multi-group moderation analysis
- Author
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Rahman, Muhammad Sabbir, Abdel Fattah, Fadi Abdel Muniem, Zaman, Mahmud, and Hassan, Hasliza
- Published
- 2018
- Full Text
- View/download PDF
189. Promising Ideas in Children's Health Insurance: Coordination with School Lunch Programs.
- Author
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Families USA Foundation, Washington, DC., Pulos, Vicky, and Lee, Lana
- Abstract
Noting that sending information about children's health insurance through the school system is a very effective way to generate applications and enrollment for state health insurance programs, this issue brief is the first in a series to examine some of the innovative methods used to offer more children affordable health care. The brief presents a rationale for coordinating children's health insurance with the National School Lunch Program, including the similarity between children eligible for the two programs. The brief also describes the National School Lunch Program (NSLP) and how it operates, including application requirements. Some pitfalls are identified in coordinating the two programs, such as issues related to confidentiality, program differences in definitions of household income, immigration status and eligibility, program differences in the amount of information needed, and additional administrative costs. The brief then describes the guidance provided by the United States Department of Agriculture about coordinating the NSLP and children's health insurance and describes actions of Colorado, Illinois, and Washington in coordinating the programs. The early lessons learned about successfully coordinating school lunch and children's health insurance are identified and related to school meal application forms, school activities, and Medicaid/CHIP agency activities. (Contains 15 endnotes.) (KB)
- Published
- 1999
190. Persuaded self-tracking with wearable technology: carrot or stick?
- Author
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Paluch, Stefanie and Tuzovic, Sven
- Published
- 2019
- Full Text
- View/download PDF
191. Colonial Life, GFOA White Paper Points Path to Benefits Cost Savings
- Subjects
Health care costs ,Health insurance ,Business, international ,Government Finance Officers Association - Abstract
July 28 -- Colonial Life & Accident Insurance Company, in partnership with the Government Finance Officers Association, released Monday a new research paper that shows employers they can save a [...]
- Published
- 2015
192. A critical review of the use of R2 in risk equalization research
- Author
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van de Ven, Wynand P. M. M. and van Kleef, Richard C.
- Published
- 2024
- Full Text
- View/download PDF
193. BridgeHealth White Paper Suggests Bundle-Priced Benefits to Guard Against Fiduciary Fraud Lawsuits
- Subjects
CIGNA Corp. ,Fiduciary duties ,Employers ,Litigation ,Medical care quality ,Fraud ,Health insurance ,Health maintenance organizations ,Lawsuit/litigation ,Health care industry ,Law - Abstract
2017 MAY 18 (NewsRx) -- By a News Reporter-Staff News Editor at Hospital Law Weekly -- BridgeHealth, a leading provider of high-quality, lower-cost, bundled surgical case rate benefit plans, says [...]
- Published
- 2017
194. Satisfaction and word-of-mouth moderated by choice: a service industry perspective
- Author
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Leon, Steven and Choi, Hoon
- Published
- 2020
- Full Text
- View/download PDF
195. The National Disability Insurance Scheme and Access to Education: Progressive or Coercive Policy Discourse?
- Author
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Whitburn, Ben, Moss, Julianne, and O'Mara, Joanne
- Abstract
This paper explores the experiences of a small group of families in Australia in relation to recent reform to disability policy by way of the National Disability Insurance Scheme (NDIS). Framed in critical disability perspectives of policy implementation research, the paper focuses on the extent to which the scheme articulates inclusive opportunities for children and young people with disabilities, particularly in relation to facilitating access to education. Interview data that illustrate families' expectations of the scheme and latter-day experiences, coercions and negotiations highlight the tensions that exist for scheme participants who draw on its provision to support their education. These first- and second-order policy effects indicate a welcome change to disability support in Australia, though the extent to which the scheme can advance inclusion for people with disabilities is uncertain, given the distance rendered between the policy and its participants and other service systems. The paper concludes with a theoretical discussion based on the analysis of how the NDIS is framed to interrelate with scheme participants and education and how it might be reframed for better outcomes.
- Published
- 2017
- Full Text
- View/download PDF
196. Ensuring Children's Access to Comprehensive Health Benefits: Effective Arguments for Child Advocates. Issue Brief.
- Author
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National Association of Child Advocates, Washington, DC. and Checkoway, Amy
- Abstract
Under Title XXI, the State Children's Health Insurance Program (CHIP), states have considerable flexibility to define the scope of benefits available to eligible children. Noting the importance of policymakers, advocates, service providers, and parents speaking out in support of children's need for the full range of necessary health care, this issue brief provides supporting information to use in encouraging states to offer comprehensive benefit packages. The brief focuses on the services considered to be "additional" or "other" in Title XXI: (1) mental health and substance abuse services; (2) ongoing therapies and rehabilitation; (3) dental care; (4) vision services; (5) hearing services; (6) family planning; and (7) home health care. Depending on the extent of the research available on specific services, the following types of information are provided: (1) the short- and long-term effectiveness of services; (2) cost-benefit analyses of providing services; and (3) actuarial cost estimates of adding services to basic benefit packages. Also included in the brief is a delineation of the Title XXI coverage requirements for children's health insurance. The brief concludes by noting that it is critical that states designing separate children's health coverage go above and beyond the basic benefits that are required and that providing such coverage improves children's lives, avoids the needs for more costly interventions later, and is the right approach to ensure access to appropriate health care for the nation's children. (Contains approximately 30 references.) (KB)
- Published
- 1998
197. Closing the Gap: Insuring Children in Illinois. Special Report.
- Author
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Voices for Illinois Children, Chicago., Nagle, Ami, and Havill, Andrea
- Abstract
Children who lack health insurance do not have access to preventive care, placing them at greater risk of serious illness. This special report of the Voices for Illinois Children describes federal and state efforts to address the problem of uninsured children and issues that will need to be monitored as Illinois begins to help children access health care. The report describes the development of the Children's Health Insurance Plan (CHIP) and states' requirements for participation in the plan. In addition, the report describes Illinois' two-phase approach to helping children access health care: (1) Medicaid expansion; and (2) KidCare, including eligibility, covered services, affordability, accessibility, continuous eligibility, program for insured children, and program evaluation. Characteristics of current state CHIP policies and plans are described regarding eligibility, program structure, services covered, cost-sharing, and outreach and enrollment. The report maintains that the key issues to be monitored regarding KidCare deal with parents' knowledge about the program, its affordability, and children's receipt of services. The report concludes with a table summarizing the provisions of KidCare's program for uninsured and insured children. (KB)
- Published
- 1998
198. Part-Time Faculty: %, !, ? or Statistics, Responses and Questions.
- Author
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Faculty Association of Community and Technical Colleges, WA. and Hollowell, Rex
- Abstract
This paper, from the Faculty Association of Community and Technical Colleges (FACTC) in Washington, addresses the issue of part-time faculty employment in the state's community colleges. In fall 1997, there were 3,019 full-time and 5,256 part-time instructors in Washington's two year colleges. Departments that rely most heavily on part-time faculty are those teaching basic skills, developmental, and college English. FACTC states that there are good reasons for employing part-time faculty, such as when a certain course should be taught and there is no one to teach it, and it is not offered often enough to warrant a full-time contract. But there are still too many part-time faculty filling positions that could utilize full-time faculty, and part-time instructors continue to be poorly paid and mistreated. And because many adjunct faculty teach at more than one college or have other second jobs in order to make a living wage, they do not have time to participate in conferences, do committee work, or do independent research and publishing. Thus, when a coveted full-time job is available, their vitae are lacking. FACTC suggests that the solution to the problem is complicated in its political, policy, and moral dimensions. The issue contends that the overdependence on part-time faculty adversely affects higher education. (NB)
- Published
- 1998
199. Department of Labor. Challenges in Ensuring Workforce Development and Worker Protection. Testimony before the Subcommittee on Human Resources, Committee on Government Reform and Oversight, House of Representatives.
- Author
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General Accounting Office, Washington, DC. Health, Education, and Human Services Div. and Joyner, Carlotta C.
- Abstract
In Fiscal Year 1997, the U.S. Department of Labor (DOL) has an estimated budget of $34.4 billion and is authorized 16,614 full-time-equivalent staff-years. DOL's many programs fall into two major categories: enhancing workers' skills through job training and ensuring worker protection. The DOL's work force development mission is being challenged by the federal government's patchwork of job training programs, which are characterized by overlap/duplication. Although the responsibility for delivering the employment training services required by recently passed welfare-to-work legislation rests with state and local governments, the DOL will likely be called upon to encourage/facilitate and integrate needed employment training services. For the past 2 years, the DOL has worked to use its resources more efficiently and make its worker protection efforts more service oriented. With regard to its worker protection mission, the DOL faces regulatory challenges in two specific areas: redesigning the wage determination process under the Davis-Bacon Act and developing and enforcing regulations regarding portability of employer-provided health insurance. In response to recent legislation designed to improve federal agencies' management practices, the DOL is working to improve its management practices, mission performance, financial reporting, and information management and use of information technology. (MN)
- Published
- 1997
200. Achieving Independence: The Challenge for the 21st Century. A Decade of Progress in Disability Policy--Setting an Agenda for the Future.
- Author
-
National Council on Disability, Washington, DC.
- Abstract
The National Council on Disability (NCD) held a National Summit on Disability Policy on April 27-29, 1996 at which 300 grassroots disability leaders gathered to discuss how to achieve independence in the next decade. Following an analysis of disability demographics and disability rights and culture, disability policy is assessed in 11 areas: policy coordination, civil rights, education, employment, social security and other income maintenance, health insurance and health care, long-term services in the community, technology, housing, transportation, and international issues. Recommendations were made in each policy area. The overarching themes of the recommendations were: (1) existing laws should be enforced; (2) people with disabilities should direct policy when they are affected by the outcome; (3) outreach and awareness campaigns must be launched to educate the public; (4) incentives for the inclusion of people with disabilities must be further developed and implemented; (5) principles of universal design should be universally applied; (6) systems, services, and supports for people with disabilities must be further developed as a part of the mainstream of community life; and (7) accurate data about people with disabilities should be regularly collected, analyzed, and reported. Appendices include recommendations for the NCD, a description of emerging issues, and remarks made by Marca Bristo, Chairperson of NCD, and Justin Dart at the national summit. (Contains approximately 80 references.) (CR)
- Published
- 1996
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