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PubMed1982

Medicare program; inpatient hospital deductible for 1983--HHS. General notice.

This notice announces the inpatient hospital deductible and coinsurance amounts for calendar year 1983 under Medicare's Hospital Insurance Program. The Medicare statute specifies the formula to be used to determine these amounts. The inpatient hospital deductible will be $304. The daily coinsurance amounts will be: (a) $76 for the 61st through 90th days of hospitalization; (b) $152 for lifetime reserve days; and (c) $38 for the 21st through the 100th days of extended care services in a skilled nursing facility. Each figure represents an increase of approximately 17 percent over the corresponding 1982 figure.

Deductibles and Coinsurance↗
PubMed1983

Medicare program; inpatient hospital deductible for 1984--HHS. General notice.

This notice announces the inpatient hospital deductible and coinsurance amounts for calendar year 1984 under Medicare's Hospital Insurance Program. The Medicare statute specifies the formula to be used to determine these amounts. The inpatient hospital deductible will be $356. The daily coinsurance amounts will be: (a) $89 for the 61st through 90th days of hospitalization; (b) $178 for lifetime reserve days; and (c) $44.50 for the 21st through the 100th days of extended care services in a skilled nursing facility. Each figure represents an increase of approximately 17 percent over the corresponding 1983 figure.

Deductibles and Coinsurance↗
PubMed1984

Medicare program; inpatient hospital deductible and coinsurance amounts for 1985--HHS. Notice.

This notice announces the inpatient hospital deductible and coinsurance amounts for calendar year 1985 under Medicare's Hospital Insurance Program. The Medicare statute specifies the formula to be used to determine these amounts. The inpatient hospital deductible will be $400. The daily coinsurance amounts will be: (a) $100 for the 61st through 90th days of hospitalization; (b) $200 for lifetime reserve days; and (c) $50 for the 21st through the 100th days of extended care services in a skilled nursing facility. Each figure represents an increase of approximately 12 percent over the corresponding 1984 figure.

Deductibles and Coinsurance↗
PubMed1985

Medicare program; inpatient hospital deductible and coinsurance amounts for 1986--HCFA. Notice.

This notice announces the inpatient hospital deductible and coinsurance amounts for calendar year 1986 under Medicare's hospital insurance program. The Medicare statute specifies the formula to be used to determine these amounts. The inpatient hospital deductible will be $492. The daily coinsurance amounts will be: $123 for the 61st through 90th days of hospitalization; $246 for lifetime reserve days; and $61.50 for the 21st through the 100th days of extended care services in a skilled nursing facility. Each figure represents an increase of 23 percent over the corresponding 1985 figure.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

The need for single-payer catastrophic health insurance.

Both physicians and patients are becoming increasingly frustrated with the decreasing flexibility of our health-care system. Forty-one million citizens remain uninsured while ill patients in managed-care plans find themselves subject to bureaucratic hurdles in attempting to obtain necessary care. Rather than relying on the market place to provide affordable insurance to patients, physicians should embrace single-payer catastrophic coverage. A government insurance program should be enacted that covers all medical bills that exceed a $15,000 deductible annually for families and a $10,000 deductible annually for individuals. Patients could then purchase plans through the private sector to cover these deductibles. While such a plan would require a tax increase, premiums would decrease, health insurance would become more affordable to low wage earners, and more treatment decisions would be made by physicians and patients.

Connecticut↗
PubMed1977

The malpractice controversy and the quality of patient care.

The widespread doctor strikes of 1975 stimulated belated attention to a crisis in malpractice insurance. Most state legislatures responded only to a shadow crisis in insurance as they rallied to the defense of health care providers. The smouldering substantive crisis--the reality of malpractice--is now galvanizing institutions and professions into aggressive activities for quality assurance and renewal of trust between patient and doctor. New procedural experiments offer prospects for preserving economy and equity by containing the causes of malpractice suits within the health care system itself.

Costs and Cost Analysis↗
PubMedDate not supplied

Cost shifting: the final straw in federalization of health care.

While cost controls applied by Medicare and indemnity insurance programs initially helped curtail abusive medical billing practices, creative billing techniques have since resulted in runaway medical costs and rising insurance premiums. Employers have been forced to increase employee's contributions to health care by increasing deductibles, copayments, and coinsurance or by simply dropping health care benefits. If National Health Insurance comes to pass, and that is a cry now coming from major employers, it will be followed in time by federalization of all health care delivery systems, including Workers' Compensation. It is the providers who shift their fees into Workers' Compensation, which pays from the first dollar, who will cause the business community to petition Washington for relief. It will claim the need for cost controls in Workers' Compensation to keep American business competitive in world markets.

Cost Allocation↗
PubMed1989

Privacy Act of 1974; systems of records--HCFA. Notice of proposed new routine uses for existing systems of records.

One of the top priorities of the Department of Health and Human Services is to assure high quality and effective health care while pursuing strategies to contain or moderate health care costs and Medicare program expenditures. One such program to limit Medicare programs expenditures was the Medicare Secondary payer (MSP) provisions (42 U.S.C. 1395y(b)). The purpose of this routine use is to enable HCFA and other "entities responsible for payment" to engage in exchanges of information concerning primary or secondary responsibility for a Medicare beneficiary's health care expenses. This notice is not the basis for a mandatory reporting requirement for "entities responsible for making payment" as required by 42 U.S.C. 1395y(b). Currently no statute mandates this type of exchange of information, therefore, these exchanges of information are strictly voluntary. The Health Care Financing Administration (HFCA) is amending systems notices for (1) Carrier Medicare Claims Records HHS/HCFA/BOP No. 09-70-0501; (2) Health Insurance Master Record HHS/HCFA/BOP No. 09-70-0502 and (3) Intermediary Medicare Claims Records HHS/HCFA/BPO No. 09-70-0503, to add a new routine use. The proposed routine use will enhance our capability for identifying Medicare Secondary payer situations where Medicare can assume a position of reduced liability due to the presence of other entities responsible for making primary payment in accordance with 42 U.S.C. 1395y(b).

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Drug benefit decisions among older adults: a policy-capturing analysis.

PURPOSE: Under the Medicare Prescription Drug Improvement and Modernization Act, beneficiaries remaining in the traditional fee-for-service plan will face a variety of drug benefit options provided by private stand-alone prescription drug plans. Although these plans likely will differ with regard to a number of important attributes, little is known about older adults' judgment processes in this context. The objectives of this study were to 1) better understand the manner in which drug insurance attributes are weighted in older adults' judgments of drug benefit suitability, 2) explore variability in judgment strategies among seniors, and 3) assess seniors' insight into their judgment policies. METHODS: Three focus groups were conducted with 19 older adults to elicit important drug plan attributes. A policy-capturing study with 32 seniors, none of whom had participated in the focus groups, then was employed to quantify the impacts of these attributes on judgments of plan suitability. RESULTS: Focus group participants reported that copayment, monthly premium, deductible, formulary use, and mail-order pharmacy use were important drug insurance attributes. The policy-capturing study showed that deductibles and premiums were weighted most heavily in judgment formation. However, significant variability in judgment policies was apparent, with 3 distinct groups emerging from cluster analysis. The first emphasized deductibles and copayments, the second premiums and deductibles, and the third use of a mail-order pharmacy and deductibles. Study volunteers exhibited insight into the role of some plan attributes in their judgments, but not others. CONCLUSIONS: Cost-sharing provisions appear to be most important in older adults' evaluations of drug benefit plans. However, significant heterogeneity in attribute preferences also was apparent in this study. Older adults may not be cognizant of the manner in which some plan attributes affect their evaluations, suggesting a role for decision aids in this process.

Aged↗
PubMed1987

Socioeconomic factors and Medicare supplemental health insurance.

This analysis was conducted to determine how personal and community characteristics affect coverage by private insurance to supplement Medicare. Data from the 1980 National Medical Care Utilization and Expenditure Survey were used. After controlling for health status, it was found that supplemental coverage was positively associated with education, income, number of self-reported chronic conditions, being white, being married, and having a regular source of care. Private coverage was negatively associated with Medicaid coverage and age. The only community characteristic associated with supplemental coverage was region. Consideration of local medical resources and economic measures did not change that.

Data Collection↗