Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets
DOWNLOAD
Download Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets PDF/ePub or read online books in Mobi eBooks. Click Download or Read Online button to get Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets book now. This website allows unlimited access to, at the time of writing, more than 1.5 million titles, including hundreds of thousands of titles in various foreign languages. If the content not found or just blank you must refresh this page
Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets
DOWNLOAD
Author : Thomas G. McGuire
language : en
Publisher: Academic Press
Release Date : 2018-08-06
Risk Adjustment Risk Sharing And Premium Regulation In Health Insurance Markets written by Thomas G. McGuire and has been published by Academic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-08-06 with Business & Economics categories.
Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the world, including Australia, Belgium, Chile, China, Columbia, Germany, Ireland, Israel, the Netherlands, Russia, Switzerland and the United States. Authors discuss the evolution of these payment schemes, along with ongoing reforms and key lessons on the design of health plan payment. Provides a conceptual toolkit that describes the goals, design and evaluation of health plan payment systems in the context of policy paradigms, such as efficiency, affordability, fairness and avoidance of risk selection Brings together international experience from many different countries that apply regulated competition in different ways Delivers a practical toolkit for the evaluation of health plan payment modalities from the standpoint of efficiency and fairness
State Health Insurance Market Reform
DOWNLOAD
Author : Joel C. Cantor
language : en
Publisher: Routledge
Release Date : 2012-09-25
State Health Insurance Market Reform written by Joel C. Cantor and has been published by Routledge this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-09-25 with Business & Economics categories.
In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.
Regulated Competition In Health Insurance Markets
DOWNLOAD
Author : Rudy C. Douven
language : en
Publisher:
Release Date : 2000
Regulated Competition In Health Insurance Markets written by Rudy C. Douven and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2000 with Competition categories.
Models Of Health Plan Payment And Quality Reporting
DOWNLOAD
Author : Jacob Glazer
language : en
Publisher: World Scientific Publishing Company
Release Date : 2016-12-22
Models Of Health Plan Payment And Quality Reporting written by Jacob Glazer and has been published by World Scientific Publishing Company this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-12-22 with Business & Economics categories.
The book pulls together a series of articles by the authors that initiated the research areas of "optimal risk adjustment" and "optimal quality reporting." The papers present the basic theoretical models and link them to empirical application. Design of health insurance premiums to achieve efficient and fair outcomes is also covered. The chapters in the book also cover the intellectual development of approaches to health insurance regulation, beginning with more abstract models to those with explicit empirical and policy applications.
Employment And Health Benefits
DOWNLOAD
Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 1993-02-01
Employment And Health Benefits written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1993-02-01 with Medical categories.
The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Pooling Health Insurance Risks
DOWNLOAD
Author : Mark V. Pauly
language : en
Publisher: American Enterprise Institute
Release Date : 1999
Pooling Health Insurance Risks written by Mark V. Pauly and has been published by American Enterprise Institute this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Business & Economics categories.
Uncertainty about risks to health virtually requires that people have health insurance. But how is the cost of premiums determined? Should rates vary according to some indicators of risk? How much do premiums vary with risk? Do the young and the healthy actually subsidize the old and the unhealthy?
Reforming Private Health Insurance
DOWNLOAD
Author : Mark A. Hall
language : en
Publisher: A E I Press
Release Date : 1994
Reforming Private Health Insurance written by Mark A. Hall and has been published by A E I Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 1994 with Health care reform categories.
Between 1987 and 1991, the portion of Americans covered by individually purchased health insurance dropped 40per cent. Assuming the US will continue to rely on private financing for health care, the author clarifies benefits to society from an efficient health insurance market.
Healthcare Risk Adjustment And Predictive Modeling
DOWNLOAD
Author : Ian G. Duncan
language : en
Publisher: ACTEX Publications
Release Date : 2011
Healthcare Risk Adjustment And Predictive Modeling written by Ian G. Duncan and has been published by ACTEX Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with Business & Economics categories.
This text is listed on the Course of Reading for SOA Fellowship study in the Group & Health specialty track. Healthcare Risk Adjustment and Predictive Modeling provides a comprehensive guide to healthcare actuaries and other professionals interested in healthcare data analytics, risk adjustment and predictive modeling. The book first introduces the topic with discussions of health risk, available data, clinical identification algorithms for diagnostic grouping and the use of grouper models. The second part of the book presents the concept of data mining and some of the common approaches used by modelers. The third and final section covers a number of predictive modeling and risk adjustment case-studies, with examples from Medicaid, Medicare, disability, depression diagnosis and provider reimbursement, as well as the use of predictive modeling and risk adjustment outside the U.S. For readers who wish to experiment with their own models, the book also provides access to a test dataset.
Care Without Coverage
DOWNLOAD
Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2002-06-20
Care Without Coverage written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2002-06-20 with Medical categories.
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Health Care Utilization As A Proxy In Disability Determination
DOWNLOAD
Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2018-04-02
Health Care Utilization As A Proxy In Disability Determination written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-04-02 with Medical categories.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.