An Economic Analysis of the Joint Purchasing Safety Zone

1995 ◽  
Vol 23 (2) ◽  
pp. 177-185
Author(s):  
Roger D. Blair ◽  
Jill Boylston Herndon
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Insurance Coverage ◽  
Consumer Price Index ◽  
Health Insurance Coverage ◽  
Societal Implications ◽  
Care Providers ◽  
Care Costs

It is undeniable that health care costs have been increasing at an alarming rate. During the ten-year period between 1983 and 1993, the medical care component of the Consumer Price Index (CPI) rose at an average annual rate of 10 percent while the overall CPI increased by only 4.5 percent per year. These dramatic increases have obvious societal implications. For those without health insurance, a serious illness may mean personal bankruptcy. For those with health insurance coverage, premiums are rising while coverage is shrinking. Employers are struggling to continue providing health insurance to their employees. Irrespective of whose fault it really is, much of the blame has been directed at health care providers.Faced with mounting criticism regarding the costs of delivering health care, the industry struck back. It claimed that collaboration—not competition—was necessary to reduce health care costs and improve efficiency, but that antitrust uncertainty deterred such collaborative efforts.

Life Themes: A Method to Understand Terminal Illness

1995 ◽  
Vol 31 (3) ◽  
pp. 189-206 ◽  
Author(s):  
Debbie Messer Zlatin
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Terminal Illness ◽  
Terminally Ill ◽  
Care Providers ◽  
Incurable Cancer ◽  
Doctor Patient Communication ◽  
The Patient’S View ◽  
Care Costs

As health care costs in general soar, the high cost of terminal care is questioned. Yet little is known about what kinds of medical care terminally ill persons, themselves, want. To explore the patient's view, I conducted a qualitative study of eight patients with incurable cancer to answer the question, “How do terminally ill persons understand their illnesses and treatments?” Analysis of interview transcripts indicated that study participants created illness-understandings within the context of their daily life experiences via life themes. Since life themes integrate and give meaning to illness events in both emic and etic ways and help to explain patients' coping strategies, it is recommended that health care providers elicit patients' life themes and use them in their approaches to diagnosis and treatment. The possible benefits of the life theme method are more balanced doctor/patient communication, improved patient satisfaction and quality of life, and the containment of health care costs.

Holes in the Health Insurance System-Who Lacks Coverage and Why

2004 ◽  
Vol 32 (3) ◽  
pp. 390-396 ◽  
Author(s):  
Catherine Hoffman ◽  
Diane Rowland ◽  
Alicia L. Carbaugh
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Insurance System ◽  
Major Health ◽  
Insurance System ◽  
Current Health ◽  
Private And Public ◽  
Care Costs

Lack of health insurance coverage is a large and growing problem for millions of American families. Rising health care costs and economic insecurity continue to threaten the bedrock of the health insurance system - employer-sponsored coverage - while states’ fiscal situations and the escalating federal deficit complicate any efforts at reform. Providing health insurance coverage to the millions of uninsured remains a major health care challenge for the nation and understanding the current health insurance environment, who the uninsured are, and why they are uninsured is critical when considering health care reform. This paper aims to define the problem of the uninsured, providing an overview of the uninsured in America and the roles and limits of private and public insurance. Following this discussion, the paper describes the current health insurance environment and examines the prospects for improving coverage.

User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What's Health Got to Do With It?)

1995 ◽  
Vol 14 (2) ◽  
pp. 360-390 ◽  
Author(s):  
Robert G. Evans ◽  
Morris L. Barer ◽  
Greg L. Stoddart
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Final Analysis ◽  
User Fees ◽  
Care Providers ◽  
Positive Effects ◽  
The Face ◽  
Care Costs

ABSTRACTCalls for user fees in Canadian health care go back as far as the debate leading up to the establishment of Canada's national hospital insurance program in the late 1950s. Although the rationales have shifted around somewhat, some of the more consistent claims have been that user fees are necessary as a source of additional revenue for a badly underfunded system, that they are necessary to control runaway health care costs, and that they will deter unnecessary use (read abuse) of the system. But the real reasons that user fees have been such hardy survivors of the health policy wars, bear little relation to the claims commonly made for them. Their introduction in the financing of hospital or medical care in Canada would be to the benefit of a number of groups, and not just those one usually thinks of. We show that those who are healthy, and wealthy, would join health care providers (and possibly insurers) as net beneficiaries of a reintroduction of user fees for hospital and medical care in Canada. The flip side of this is that those who are indigent and ill will bear the brunt of the redistribution (for that is really what user fees are all about), and seniors feature prominently in those latter groups. Claims of other positive effects of user fees, such as reducing total health care costs, or improving appropriateness or accessibility, simply do not stand up in the face of the available evidence. In the final analysis, therefore, whether one is for or against user fees reduces to whether one is for or against the resulting income redistribution.

Utilization of EHR Provider Prompts to Maximize Adult Pertussis Immunization Rates

2016 ◽  
Vol 9 (2) ◽  
pp. 183-188
Author(s):  
Susan D’Agostino
Keyword(s):  
Health Insurance ◽  
Health Care Providers ◽  
Whooping Cough ◽  
Insurance Coverage ◽  
Intervention Group ◽  
Health Insurance Coverage ◽  
Control Group ◽  
Care Providers ◽  
Design Data ◽  
Clinical Reminder

Pertussis, commonly known as whooping cough, is a highly contagious but preventable bacterial infection. The increased prevalence may be attributable to the low rate of adults being vaccinated against the disease. The purpose of this pilot study was to examine how a computerized clinical reminder assists in improving adherence to adult pertussis immunization Centers for Disease Control and Prevention (CDC) guidelines. The study utilized a nonrandomized intervention-control design. Data were extracted from baseline patient electronic health records (EHRs; N = 352) and from patient EHRs used for intervention and control (n = 120); these were drawn from 2 primary care practices affiliated with an urban teaching hospital. Additional data collected concerned patient demographics, type of office visit, and health insurance coverage as related to pertussis vaccinations. Results indicated that a higher percentage of patients in the intervention group received the Tdap vaccination when compared to the baseline (p < .01) but not the control group (p = .47). Age (p = .04) and type of health insurance coverage (p = .03) influenced Tdap vaccination rates, whereas visit type approached significance (p = .08) and gender had no influence. The EHR clinical reminder may influence health care providers’ adherence to CDC recommendations for administering adult pertussis immunizations.

Cancer history, health insurance coverage, and cost-related medication nonadherence and medication cost-coping strategies in the United States.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 68-68
Author(s):  
Jingxuan Zhao ◽  
Zhiyuan Zheng ◽  
Xuesong Han ◽  
Amy J. Davidoff ◽  
Matthew P. Banegas ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cancer Survivors ◽  
Coping Strategies ◽  
Health Care Providers ◽  
Prescription Drugs ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Care Providers ◽  
Cancer History

68 Background: Policy makers, health care providers and patients are increasingly concerned about rising costs for prescription drugs and cost-related medication non-adherence (CRN). This study aims to evaluate the relationship between cancer history and CRN as well as cost-coping strategies, by health insurance coverage. Methods: We used the National Health Interview Survey data from 2013-2016 to identify adults age 18-64 with (n = 3 599) and without (n = 56 909) a cancer history. Cost-related changes in medication use included a) CRN (skipping, taking less or delaying medication because of cost), and b) cost-coping strategies (requesting lower cost medication or using alternative therapies to save money). Separate multivariable logistic regressions were used to calculate the adjusted percentages of CRN and cost-coping strategies associated with cancer history, stratified by health insurance. Results: Cancer survivors reported higher percentages of CRN (14.5% vs. 12.1%, P < .001) and were slightly more likely to report using cost-coping strategies (24.4% vs. 22.8%, P = .060) compared with adults without a cancer history. The magnitude of differences in CRN by cancer history varied by insurance type (any private 10.2% vs. 8.6%, P = .034; public only 17.9% vs. 14.2%, P = .010; uninsured 41.0% vs. 33.2%, P = .064). Among the privately insured, the difference in CRN by cancer history was greatest among those enrolled in high deductible health plans (HDHP) without health saving accounts (HSA) (16.9% vs. 10.9%, P = .002). Regardless of cancer history, CRN and use of cost-coping strategies were highest for those uninsured, enrolled in HDHP and without HSA, and without prescription drugs coverage under their health plan (all P < .001). Conclusions: Cancer survivors are prone to CRN and more likely to use cost-coping strategies to minimize financial hardship. Expanding options for health insurance coverage and use of HSA, and prescription drug coverage may be effective strategies to address CRN.

Freestanding Emergency Centers: Regulation and Reimbursement

1985 ◽  
Vol 11 (1) ◽  
pp. 105-129
Author(s):  
Mitchell Katzman
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Health Care Market ◽  
Care Providers ◽  
Emergency Rooms ◽  
Hospital Emergency ◽  
Efficient Manner ◽  
Additional Layer ◽  
Care Costs

AbstractThe freestanding emergency center, which combines the functions of a doctor's office and a hospital emergency room, has emerged as a new provider of health care. These centers have generated considerable controversy over their role in the health care market. Proponents argue that freestanding emergency centers reduce costs by providing care in a more efficient manner and cause other health care providers such as hospital emergency rooms to reduce costs and improve service. Opponents argue that the centers create an additional layer of health care which duplicates existing services and increases total health care costs. This Note examines the controversial issues of licensure, regulation and reimbursement. The Note concludes that freestanding emergency centers can help to reduce health care costs and discusses the steps that should be taken to aid centers in achieving this goal.

Pharmaceutical Manufacturers and Self-Regulation of Drug Advertising and Promotion

1992 ◽  
Vol 22 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Gerald J. Mossinghoff
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Government Regulation ◽  
Care Quality ◽  
Care Providers ◽  
Care Costs ◽  
Advertising And Promotion

Contrary to critics' contentions that pharmaceutical promotion and advertising hurts medical care and raises health care costs, the opposite is true. Advertising and promotion improves health care quality by keeping health care providers up to date about the best medicines for preventing, treating and curing diseases. This knowledge reduces the need for more expensive medical care and helps restore good health, which lowers overall health care costs. The article cites a number of instances in which advertising and promotional efforts by pharmaceutical companies have increased awareness of health problems amenable to pharmaceutical intervention, with positive results. Pharmaceutical company support of medical journals and continuing medical education has been an important resource for the dissemination of new medical knowledge. Government regulation of pharmaceutical advertising and promotion is strict. The research-based pharmaceutical industry has adopted guidelines that prohibit many of the activities critics have referred to as abuses. Further government regulation would be unnecessary and unwise.

scholarly journals Exploring the Provider Preferences of Multiracial Patients

2019 ◽  
Vol 7 (4) ◽  
pp. 479-483
Author(s):  
Cyndy R Snyder ◽  
Anjali R Truitt
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cultural Sensitivity ◽  
Health Care Professionals ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Primary Care Providers ◽  
Care Providers ◽  
Patient Provider Communication ◽  
Race Concordance

Background: Patient–provider race concordance has been argued as one way to improve patient–provider communication, patient satisfaction, and even patient outcomes. However, much of this literature focuses on or assumes that both patients and providers identify with only one race. Objective: The purpose of this study was to understand multiracial patients’ preferences in choosing a health-care provider. Methods: We conducted 15 interviews and 3 focus groups. We performed a directed content analysis to understand participants’ expressed preferences. Results: Thirty-one participants shared their health-care preferences. Participants described proximity to their homes or work, convenience in terms of availability, and health insurance coverage as reasons for selecting a provider. The majority articulated preferences related to provider gender and race. However, participants noted key barriers to receiving care from their preferred providers. Conclusion: This study highlights the preferences for health-care providers and the factors influencing those preferences and decisions among multiracial individuals. Findings illustrate the need to increase health workforce diversity, especially among primary care providers. Findings also show the need for increased empathy and cultural sensitivity among health-care professionals.

A Shared Responsibility: U.S. Employers and the Provision of Health Insurance to Employees

2005 ◽  
Vol 42 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Sara R. Collins ◽  
Karen Davis ◽  
Alice Ho
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Lower Cost ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Shared Responsibility ◽  
Comprehensive System ◽  
Natural Risk ◽  
Care Costs ◽  
The U.S

Employer-based health insurance is the backbone of the U.S. system of health insurance coverage. Yet it has been slowly eroding, and if these trends continue greater numbers of Americans are likely to be uninsured or without affordable coverage. Employer coverage has marked advantages, including benefits to employers and a natural risk pool that offers better benefits at lower cost than individual coverage, and is highly valued by employees. The shift of health care costs from employers who do not cover their workers to other parts of the economy is substantial. Very little attention has been given to policies that might strengthen and expand employer coverage. It will be important to shore up employer coverage both to curb its recent erosion and to build toward a more comprehensive system of health insurance.

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