Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment.
Medicare beneficiaries with diabetes use 2 to 3 times more brand-name drugs than a comparable group within the VA, at substantial excess cost.
States that choose not to expand Medicaid under federal health care reform will leave millions of their residents without health insurance and increase spending on the cost of treating uninsured residents, at least in the short term.
Most CA hospitals have adopted financial assistance policies to provide more affordable care for the uninsured. Ninety-seven percent of hospitals say they offer free care to uninsured patients with incomes at or below the federal poverty level.
The rising cost of Medicare can be cut through strategies such as increasing premiums and raising the eligibility age, but those moves could drive many elderly Americans from the program, leaving them with limited access to health services.
Research at a large firm found, on average, a 10% increase in an employee's out-of-pocket premium increases the probability of dropping coverage by approximately 1%, with married workers and lower-paid workers disproportionately more likely to drop coverage.
The recent passage of the Affordable Care Act has heightened the importance of workplace wellness programs. This paper used administrative data from 2002 to 2007 for PepsiCo's self-insured plan members to evaluate the effect of its wellness program on medical costs and utilization.
Based on insurance claims for nine common outpatient services in consumer-directed health plans (CDHPs), researchers found no evidence that those with lower expected medical expenses engaged in more price shopping. Consumers did not engage in more price shopping before reaching the CDHP deductible, either.
A study of Taiwan's system of universal National Health Insurance (NHI) found its introduction was associated in a reduction in deaths considered amenable to health care, particularly among those age groups least likely to have been insured previously.
This article examines the access to pension and health insurance benefits and employment status of older Mexican return migrants.
Programs that offer 30 days' worth of selected generic drugs for $4 have become important options for seniors to obtain affordable medications, but little is known about access to these programs and the characteristics of those who use them.
Many physician practices will face a set of critical decisions in the coming years that may contribute to the ultimate success or failure of the ACA.
Self-insurance rates will increase among small firms only under the hypothetical situation that generous stop-loss policies are available to them after implementation of the ACA. Even if many small firms choose to self insure under this situation, it will not increase the premiums charged in the insurance exchanges by more than a few tenths of a percent.
We examined whether access to benefits varies by level of childcare responsibilities among employed parents of children with special health care needs (CSHCN).
Payment reform affects market entry and exit, which in turn may affect market structure, access to care, quality and cost of care, and patient outcomes.
Specialty drugs account for a modest share of total healthcare spending, even among the highest cost patients. Even dramatic reductions in spending on specialty drugs would have only a modest effect on total healthcare costs.
Incentives to participate in wellness programs or reach health-related targets are popular, but could expose employers and insurers to litigation risk because incentives might violate state and federal insurance, anti-discrimination, or privacy laws.
Commercial health plans and Medicare are using cost profiles to identify which physicians account for more health care spending than others, while devising strategies to reward those who provide quality care at a lower cost. Doctors with less than 10 years of experience had 13.2 percent higher overall costs than those with 40 or more years of experience.
Racial/ethnic minorities report more difficulties in getting drugs and needed information through Medicare's Part D program. However, quality improvement efforts may reduce these disparities in beneficiary experience with prescription drug coverage.
This paper evaluates whether health plans in Germany's Social Health Insurance select on an easily observable predictor of risk: geography.