scholarly journals Impact of brand drug discount cards on private insurer, government and patient expenditures

2019 ◽  
Vol 191 (45) ◽  
pp. E1237-E1241 ◽  
Author(s):  
Michael R. Law ◽  
Fiona K.I. Chan ◽  
Mark Harrison ◽  
Heather C. Worthington
Keyword(s):  
Private Insurer

The Natural and Mechanical Methods of Assessing Solvency Reserves in Life Assurance

1967 ◽  
Vol 93 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Hans Ammeter
Keyword(s):  
Good Deal ◽  
Common Market ◽  
Private Insurer ◽  
Life Assurance ◽  
Life Insurers ◽  
Mechanical Methods ◽  
The Common ◽  
Insurance Business

The problem of solvency in insurance is at present under a good deal of discussion in various interested quarters, both national and international. It is principally a question of finding criteria for determining the size of the solvency margin which a private insurer must have in the form of free reserves to be considered solvent. A criterion must produce a margin which is both sufficient and suitable: it must be valid not only for a model portfolio but for any portfolio. Consequently, only insurers with the prescribed margin would be considered solvent and authorized to write insurance business. In recent years, particularly because of the directives promulgated by the Common Market authorities, it has largely been a question of the solvency of non-life insurers.

No Significant Association between Anesthesia Group Concentration and Private Insurer Payments in the United States

2015 ◽  
Vol 123 (3) ◽  
pp. 507-514 ◽  
Author(s):  
Eric C. Sun ◽  
Franklin Dexter ◽  
Alex Macario ◽  
Thomas R. Miller ◽  
Laurence C. Baker
Keyword(s):  
United States ◽  
Claims Data ◽  
The United States ◽  
Market Concentration ◽  
Physician Services ◽  
Difference In Differences ◽  
Private Insurer ◽  
Anesthesia Group ◽  
Medicare Claims Data ◽  
Group Concentration

Abstract Background: Markets for physician services are becoming increasingly concentrated, with many areas being dominated by a few groups. Antitrust authorities are concerned that increasing concentration will lead to inappropriately high payments for physician services from private insurers. The authors examined the association between market concentration and private insurer payments for anesthesia services. Methods: The authors obtained data on average payments from private insurers for five commonly used anesthesia Current Procedure Terminology codes for physicians located in 229 counties in the United States between 2002 and 2010. The authors calculated a measure of market concentration (the Herfindahl–Hirschman Index [HHI]) for anesthesiologists in each county using Medicare claims data. The authors then estimated the association between market concentration and private insurer payments using a difference-in-differences approach to minimize confounding. Results: Private insurer payments to anesthesiologists in more concentrated markets were not significantly different from payments in less concentrated markets. Compared with the 25% of counties with the least concentration (counties with an HHI in the 0th to 25th percentile), payments in counties in the 25th to 50th percentile of HHI were approximately 0.51% less (95% CI, −2.3 to 1.3%, P = 0.95), whereas payments in counties in the 50th to 75th percentile of HHI were approximately 2.8% less (95% CI, −6.7 to 1.4%, P = 0.41) and payments in counties in the 75th to 100th percentile were approximately 3.1% less (95% CI, −8.1 to 1.2%, P = 0.32). Conclusion: Increasing market concentration of anesthesia groups is not associated with significantly greater payments from private insurers.

The Medically Examined Applicant for Private Insurance and his/her Right to Informed Consent: A Comparative Analysis

2011 ◽  
Vol 18 (3) ◽  
pp. 319-330
Author(s):  
Sarah Defloor
Keyword(s):  
Comparative Analysis ◽  
Informed Consent ◽  
Medical Information ◽  
Private Insurance ◽  
Insurance Contract ◽  
Medical Examination ◽  
Insurance Law ◽  
Private Insurer ◽  
Legal Coercion ◽  
The Right

AbstractWithin the context of health and insurance law, an important question that arises is “to what extent is an applicant for private insurance truly capable of giving his/her ‘free’ and informed consent for a medical examination?”. It should be borne in mind that it is the private insurer who requires a medical examination in order to gather medical information, and, moreover, that the insurer will not be inclined to conclude or carry out an insurance contract without this medical information. A distinction has to be made between not being free by legal coercion and not being (completely) free by factual circumstances. Exercising the right to informed consent involves exactly weighing up the consequences of the decision. Hence the applicant must be put in a position of being able to weigh up the consequences and take them into consideration.

scholarly journals Independent Factors Affecting Patient Compliance to Private Insurer-Funded Health Case Management in Canada

2016 ◽  
Vol 19 (3) ◽  
pp. A34
Author(s):  
W Chen ◽  
Y Krupitsky ◽  
B Currie ◽  
R Lunny ◽  
A Baumgartner ◽  
...  
Keyword(s):  
Case Management ◽  
Patient Compliance ◽  
Factors Affecting ◽  
Private Insurer

PUBLIC AND PRIVATE INSURER DESIGNATION OF TRANSPLANTATION PROGRAMS1

1992 ◽  
Vol 53 (5) ◽  
pp. 1041-1046 ◽  
Author(s):  
Roger W. Evans
Keyword(s):  
Public And Private ◽  
Private Insurer

scholarly journals Value-Based Physician Payment in Oncology: Public and Private Insurer Initiatives

2017 ◽  
Vol 95 (1) ◽  
pp. 184-203 ◽  
Author(s):  
JAMES C. ROBINSON
Keyword(s):  
Physician Payment ◽  
Public And Private ◽  
Private Insurer

GAO Finds Variations in Private Insurer Payments for Costly Procedures

JAMA ◽  
2015 ◽  
Vol 313 (10) ◽  
pp. 1004
Author(s):  
Rita Rubin
Keyword(s):  
Private Insurer

scholarly journals Declines in Opioid Prescribing After a Private Insurer Policy Change — Massachusetts, 2011–2015

2016 ◽  
Vol 65 (41) ◽  
pp. 1125-1131 ◽  
Author(s):  
Macarena C. García ◽  
Anton B. Dodek ◽  
Tom Kowalski ◽  
John Fallon ◽  
Scott H. Lee ◽  
...  
Keyword(s):  
Policy Change ◽  
Opioid Prescribing ◽  
Private Insurer

scholarly journals Developing Transparent Health Care Reimbursement Auditing Procedures

2013 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Yonah Wilamowsky ◽  
Aliza Rotenstein ◽  
Sheldon Epstein
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Medical Records ◽  
Care Providers ◽  
Private Insurer ◽  
Large Sets ◽  
Health Care Records ◽  
Health Care Reimbursement

The continued computerization of health care records has enabled easier sampling and analysis of large sets of medical records, making it easier than ever for Medicare, Medicaid and other private insurers to use statistical audits to determine and demand return of alleged overpayments to health care providers. However, there are sometimes statistical difficulties with the audits, and there is frequently not sufficient transparency in the procedures or their application to reproduce the results in order to determine whether they have been carried out correctly. This paper addresses concerns in sampling and analysis of data records by looking at the case of a specific audit of a medical practice carried out by a private insurer. If done properly, statistical audits can be a very useful tool, but often the methodologies are vague and the implementation is either wrong or not explained fully enough to reproduce and analyze.

Sign in / Sign up

Export Citation Format

Share Document