Economic Incentives to Reduce Employee Smoking: A Health Insurance Surcharge for Tobacco Using State of Kansas Employees

1989 ◽  
Vol 4 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Maurice Penner
Keyword(s):  
Health Insurance ◽  
Cigarette Smoking ◽  
Health Plan ◽  
Economic Incentives ◽  
The State ◽  
Morbidity And Mortality ◽  
Group Health ◽  
Employee Group ◽  
State Employee

Cigarette smoking has been clearly established as the single most important, preventable cause of morbidity and mortality. Employers are actively working to reduce smoking among current employees, and a growing number will not hire smokers. While most efforts have focused on either 1) helping smokers overcome their habit, or 2) banning or severely limiting worksite smoking, very little has been done to provide strong economic incentives for current employees to give up smoking. This paper reports on the planning and implementation of a $10 per month surcharge added to employee contributions for health insurance for persons employed by the State of Kansas. Family coverage is not affected. Also discussed is a similiar effort in the Colorado state employee group health plan.

scholarly journals Changes in spending and service use after a state autism insurance mandate

Autism ◽  
2017 ◽  
Vol 23 (1) ◽  
pp. 167-174 ◽  
Author(s):  
Brendan Saloner ◽  
Colleen L Barry
Keyword(s):  
Autism Spectrum Disorder ◽  
Confidence Interval ◽  
Health Plan ◽  
Service Use ◽  
Autism Spectrum ◽  
Employee Health ◽  
The State ◽  
Spectrum Disorder ◽  
Disorder Treatment ◽  
State Employee

Almost all states have insurance coverage mandates for childhood autism spectrum disorder treatment, yet little is known about how mandates affect spending and service use. We evaluated a 2011 Kansas law mandating comprehensive coverage of autism spectrum disorder treatments in the State Employee Health Plan. Data were extracted from the Kansas All-Payer Claims Database from 2009 to 2013 for enrollees of State Employee Health Plan and private health plans. The sample included children aged 0–18 years with >2 claims with an autism spectrum disorder diagnosis insured through State Employee Health Plan or a comparison group enrolled through private health plans. We estimated differences-in-differences regression models to compare trends among State Employee Health Plan to privately insured children. Average annual total spending on autism spectrum disorder services increased by US$912 (95% confidence interval: US$331–US$1492) and average annual out-of-pocket spending on autism spectrum disorder services increased by US$138 (95% confidence interval: US$53–US$223) among diagnosed children in the State Employee Health Plan relative to the comparison group following the mandate, representing 92% and 75% increases over baseline total and out-of-pocket autism spectrum disorder spending, respectively. Average annual quantity of outpatient autism spectrum disorder services increased by 15.0 services (95% confidence interval: 8.4–21.6) among children in the State Employee Health Plan, more than doubling the baseline average. Implementation of a comprehensive autism spectrum disorder mandate in the Kansas State Employee Health Plan was associated with substantial increases in service use and spending for autism spectrum disorder treatment among autism spectrum disorder–diagnosed children.

Impact of health plan reforms in Washington on employment decisions

2019 ◽  
Vol 18 (04) ◽  
pp. 579-593
Author(s):  
Norma B. Coe
Keyword(s):  
Labor Market ◽  
Health Insurance ◽  
The State ◽  
Fee For Service ◽  
Payment Reform ◽  
Employment Decisions ◽  
Bundled Payment ◽  
State Employment ◽  
State Employees ◽  
State Employee

AbstractThe State of Washington, as part of a State Innovation Model (SIM) grant, is changing the payment model within state employee health insurance plans. The system is moving away from traditional fee-for-service reimbursement to value-based payment, through insurance design (the creation of accountable care network insurance products) and bundled payment strategies. New plans were rolled out January 2016 (enrollment occurred in late 2015), with the stated goal of getting 80% of state employees covered by plans that contain value-based purchasing within the next 5 years. The goal of payment reform is to improve member experience, member health, and cut costs. However, changing health insurance during employment can directly and indirectly change labor market outcomes. Decreasing costs of insurance could lead people to remain in the state-employment sector longer. However, it could also influence retirement timing, through changing the relative costs of insurance and through improving health.This paper examines who switches to value-based insurance, where the insurance explicitly decreases premiums without changing out-of-pocket costs. We find that the peak age for switching insurance plans is 35–45, even among the subsample of individuals who would not need to change their usual sources of care. Second, we look at the labor market activity – both leaving the state-employee sector and retiring from state-employment – and find that younger workers with value-based insurance plans are less likely to leave state employment. Further, we find evidence of value-based insurance, available at a reduced cost to both employees and retirees, leads to a shifting downward in the distribution of retirement age. While these findings support the existence of both the price and income effects, the effect sizes are rather small.

scholarly journals Expanding Access through Public Coverage: Permitting Families to Use Tax Credits to Buy into Medicaid or SCHIP

2001 ◽  
Vol 38 (2) ◽  
pp. 146-158 ◽  
Author(s):  
Alan R. Weil
Keyword(s):  
Health Insurance ◽  
Health Plan ◽  
Low Income ◽  
Health Program ◽  
The State ◽  
Tax Credits ◽  
Tax Credit ◽  
Flow Problems ◽  
Insurance Program ◽  
Low Income Families

A new tax credit to help low-income families and individuals purchase health insurance can address the problem of affordability, but will not overcome other barriers these populations face in obtaining coverage. This paper proposes that families have the option of using a new tax credit to buy into a state-administered system such as Medicaid or the State Children's Health Insurance Program. This option has three advantages. First, it allows families to remain with a single health program and health plan as their income fluctuates. Second, it provides an alternative to the complex and confusing individual insurance market. This alternative is community rated, does not use underwriting, and allows health plan behavior to be monitored closely by the state. Third, it allows the state to act as a financial buffer—helping overcome the barrier to participation that cash-flow problems and year-end reconciliation concerns are likely to create among a low-income population. Many people would want to use their tax credit in the private market, but the buy-in option increases the likelihood that the tax credit approach would succeed.

scholarly journals Variations in Cigarette Smoking and Quit Attempts by Health Insurance Among US Adults in 41 States and 2 Jurisdictions, 2014

2018 ◽  
Vol 133 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Shillpa Naavaal ◽  
Ann Malarcher ◽  
Xin Xu ◽  
Lei Zhang ◽  
Stephen Babb
Keyword(s):  
Health Insurance ◽  
Cigarette Smoking ◽  
Black People ◽  
Private Insurance ◽  
State Level ◽  
The State ◽  
Behavioral Risk ◽  
Quit Attempt ◽  
Quit Attempts ◽  
The Impact

Objectives: Information on the impact of health insurance on smoking and quit attempts at the state level is limited. We examined the state-specific prevalence of cigarette smoking and past-year quit attempts among adults aged 18-64 by health insurance and other individual- and state-level factors. Methods: We used data from 41 states, the District of Columbia, and Puerto Rico, the jurisdictions that administered the Health Care Access module of the 2014 Behavioral Risk Factor Surveillance System. Data on quit attempts included current smokers with a past-year quit attempt and former smokers who quit during the past year. Results: Overall, smoking prevalence ranged from 14.6% among those with private insurance to 34.7% among Medicaid enrollees, and past-year quit-attempt prevalence ranged from 66.4% among the uninsured to 71.5% among Medicaid enrollees. By insurance group, differences in the prevalence of state-specific past-year quit attempts ranged from 15 to 26 percentage points. Regardless of insurance type, people who were non-Hispanic white and had lower education levels were less likely to attempt quitting than were Hispanic people, non-Hispanic black people, and adults with more than a high school education. Conclusions: We found disparities in smoking and quit attempts by insurance status and state. Opportunities exist to increase access to cessation treatments through comprehensive state tobacco control programs and improved cessation insurance coverage, coupled with promotion of covered cessation treatments.

Labor Market Concentration and Worker Contributions to Health Insurance Premiums

2021 ◽  
pp. 107755872110129
Author(s):  
Mark K. Meiselbach ◽  
Matthew D. Eisenberg ◽  
Ge Bai ◽  
Aditi Sen ◽  
Gerard F. Anderson
Keyword(s):  
Labor Market ◽  
Health Insurance ◽  
Labor Markets ◽  
Health Plan ◽  
Fixed Effects ◽  
Health Benefits ◽  
Market Concentration ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Health Insurance Premiums

In concentrated labor markets, where workers have fewer employers to choose from, employers may exploit their monopsony power by contributing less to workers’ health benefits. This study examined if labor market concentration was associated with higher worker contributions to health plan premiums. We combined publicly available data from the Census to calculate labor market concentration and the Medical Expenditure Panel Survey Insurance/Employer Component to determine premium contributions from 2010 to 2016 for metropolitan areas. After controlling for year fixed-effects and market characteristics, we found that higher labor market concentration was associated with higher worker contributions to health plan premiums, lower take-home income, and no change in employer contributions to premiums, consistent with the hypothesis that greater labor market concentration is associated with less generous health benefits. When evaluating the effects of mergers and acquisitions on labor markets, regulatory agencies should critically assess worker contributions to health insurance premiums.

scholarly journals Trends over time in enrollment in non-group health insurance plans by tobacco use in the United States

2017 ◽  
Vol 7 ◽  
pp. 46-49 ◽  
Author(s):  
Michael F. Pesko ◽  
Johanna Catherine Maclean ◽  
Cameron M. Kaplan ◽  
Steven C. Hill
Keyword(s):  
United States ◽  
Health Insurance ◽  
Tobacco Use ◽  
The United States ◽  
Group Health ◽  
Trends Over Time ◽  
Group Health Insurance ◽  
Over Time

Healthcare of the Netherlands

2022 ◽  
pp. 67-69
Author(s):  
Elena Vladimirovna Frolova ◽  
Keyword(s):  
Health Insurance ◽  
The Netherlands ◽  
Western Europe ◽  
Private Insurance ◽  
The State ◽  
Insurance Companies ◽  
Malignant Neoplasms ◽  
Average Life Expectancy ◽  
Medical Reform ◽  
Cause Of Deaths

The Netherlands is a state located in Western Europe bordering Germany and Belgium. The population of the country is just over 17million people. In terms of GDP, theNetherlands is among the twenty richest countries in the world, and in terms of exports, it is in the top ten. The average life expectancy in theNetherlands is 81.4 years; in the structure ofmortality, malignant neoplasms come out on top, which distinguishes the state from other European countries, where the main cause of deaths is cardiovascular diseases. The compulsory health insurance system was introduced in the country in 2006 after the medical reform. A distinctive feature of the Dutch healthcare system is its relative autonomy from the state, which performs only the function of an external controller, and all other powers belong to the municipal authorities. As a result, several private insurance companies have been admitted to health insurance in the Netherlands, which create healthy competition among themselves, thereby contributing to better quality and more affordable healthcare.

THE ROLE OF SELF-HELP IN PATIENTS SOLIDAR RESPONSIBILITY TO OWN HEALTH

Vestnik ◽  
2021 ◽  
pp. 328-331
Author(s):  
С.К. Молдабаев ◽  
С.А. Мамырбекова ◽  
Д.Н. Маханбеткулова
Keyword(s):  
Health Insurance ◽  
The State ◽  
Shared Responsibility ◽  
Self Management ◽  
Health Insurance System ◽  
Insurance System ◽  
Self Help ◽  
Compulsory Health Insurance ◽  
The Republic

Согласно Концепции Государственной программы улучшения здоровья населения на 2020-2025 годы в рамках дальнейшего внедрения системы ОСМС в РК одним из основных задач госудаства является повышение солидарной ответственности граждан за свое здоровье. Существующая солидарная ответственность должна побуждать пациентов развивать навыки самопомощи/самоменеджмента с целью лучшего управления собственным здоровьем. Цель исследования. Анализ роли самоменеджмента пациентов в системе солидарной ответственности за свое здоровье. Материал и методы. Данный обзор основывается на материалах ВОЗ и статей зарубежных и отечественных исследователей. Выводы. На сегодняшний день, в системе здравоохранения Казахстана одним из основных моментов является солидарная ответственность государства, пациента и работодателя. Ведь каждый гражданин должен принимать важные решения, которые оказывают существенное влияние на состояние его здоровья. Поэтому стратегии по повышению грамотности пациентов, их вовлеченность в процесс принятия решений и развитие самоменеджмента должны быть одними из фундаментальных стержней существующей системы ОСМС и политики здравоохранения. According to the Concept of the State Program for improving the health of the population for 2020-2025, as part of the further implementation of the compulsory health insurance system in the Republic of Kazakhstan, one of the main tasks of the state is to increase the joint responsibility of citizens for their health. The existing shared responsibility should encourage patients to develop self-help / self-management skills in order to better manage their own health. Purpose of the study. Analysis of the role of patients' self-management in the system of joint responsibility for their health. Material and methods. This review is based on WHO materials and articles of foreign and domestic researchers. Findings. Today, in the health care system of Kazakhstan, one of the main points is the joint responsibility of the state, the patient and the employer. After all, every citizen must make important decisions that have a significant impact on his health. Therefore, strategies to improve patient literacy, their involvement in the decision-making process and the development of self-management should be one of the fundamental pillars of the existing compulsory health insurance system and health policy.

BPJS Kesehatan Memberikan Jaminan Kesehatan Terhadap Pasien Atau Masyarakat

2021 ◽  
Vol 7 (2) ◽  
pp. 146-154
Author(s):  
Aidha Puteri Mustikasari
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
The State ◽  
Universal Health Care ◽  
Universal Health Insurance ◽  
Universal Health ◽  
Provide Health Insurance

Abstrak. Kepesertaan BPJS Kesehatan pada tahun 2020 tidak akan mencakup 90% penduduk Indonesia, namun rencana Universal Health Care Implementation (UHC) telah direncanakan sejak tahun sebelumnya. Di masa pandemi Covid, sejumlah besar status kepesertaan BPJS Kesehatan  dicabut karena terlambat, padahal masyarakat membutuhkan layanan kesehatan dan asuransi dengan kondisi yang ada. Kajian ini bersifat norma deskriptif , dibahas dalam konteks kepesertaan BPJS kesehatan, dan cukup  menggunakan prinsip asuransi dengan hanya memberikan jaminan kepada peserta, tetapi negara mengikuti kewajiban UUD 1945 yaitu memberikan jaminan kesehatan dan pelayanan kepada warga negara. Untuk mendukung keberadaan jaminan kesehatan universal, Indonesia perlu menerapkan formulir kepesertaan dan  sanksi untuk ketentuan wajib  peserta jaminan sosial yang efektif dan efisien. Abstract. BPJS Health membership in 2020 will not cover 90% of Indonesia's population, but the Universal Health Care Implementation (UHC) plan has been planned since the previous year. During the Covid pandemic, a large number of BPJS Health membership statuses were revoked because they were late, even though people needed health services and insurance with the existing conditions. This study is descriptive in nature, discussed in the context of BPJS health participation, and it is sufficient to use the insurance principle by only providing guarantees to participants, but the state follows the obligations of the 1945 Constitution, namely to provide health insurance and services to citizens. To support the existence of universal health insurance, Indonesia needs to implement an effective and efficient membership form and sanctions for mandatory provisions for social security participants.

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