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PubMed1980

Copayment for pharmaceutical services in a Medicaid program.

Copayment for prescription drugs in a Medicaid drug program is an increasingly popular mechanism to finance dispensing fee increases. There is, however, reason to expect such a provision to alter physician prescribing habits. Furthermore, the copayment, although small in dollar amount, may create an economic barrier to indigent program recipients obtaining the necessary medication to maintain their well-being. A sample of pharmacy providers in the South Carolina Medicaid drug program was surveyed to ascertain their perspective toward the copayment provision. The response rate from the 200 randomly chosen practitioners was 91%. The theory that copayment creates an economic barrier to the consumption of necessary pharmaceuticals could not be supported. However, providers in high volume Medicaid pharmacies reported physicians altered their prescribing behavior to prescribe a larger quantity of doses per prescription. In general, pharmacists reported a high degree of satisfaction with the copayment provision.

Attitude of Health Personnel↗
PubMedDate not supplied

Containing costs.

Explore the source record for details and available documents.

Cost Control↗
PubMed1984

Corporate benefit policies and health insurance costs.

We tested the hypothesis that health insurance premium costs per employee are lower for employee groups where multiple health plans are offered and the employer pays a level dollar amount of the chosen premium than for employee groups where these two conditions are not met. Proposed national legislation relies on these conditions to create a competitive health care market. Data on 56 employee groups in 1981 and 66 employee groups in 1982 were collected from two surveys of large employers in Minnesota. Regression analysis of premium data from both surveys rejected the hypothesis. Indemnity plans in multiplan groups were cheaper if the employer paid a level dollar contribution versus a level percent (including 100) contribution. However, groups offered only an indemnity plan had lower premiums than groups meeting the two legislative conditions. These findings apply to both individual and family coverage premiums and are not caused by systematic differences in benefit provisions, employee demographics or factors influencing loading charges. Our findings cast doubt on attempts to achieve health care competition by legislative changes in insurance options and contribution methods.

Deductibles and Coinsurance↗
PubMed1990

Medicare program; inpatient hospital deductible and hospital and skilled nursing facility coinsurance amounts for 1991--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and skilled nursing facility coinsurance amounts for services furnished in calendar year 1991 under Medicare's hospital insurance program (part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $628. The daily coinsurance amounts will be: (a) $157 for the 61st through 90th days of hospitalization in a benefit period; (b) $314 for lifetime reserve days; and (c) $78.50 for the 21st through 100th days of extended care services in a skilled nursing facility in a benefit period.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2005

What do health savings accounts mean for the emergency department?

The insurance market is evolving, with increased emphasis on plans with high deductibles and a large degree of coinsurance. This article serves as an introduction to the defining characteristics of consumer-driven health care plans and their associated health savings accounts. We discuss the most recent evidence on the adoption of these plans and their effects on use and reimbursement. Compared to many specialties, the emergency department (ED) may be insulated from extensive shopping and price negotiation, because visits to the ED are often for urgent and time-sensitive conditions. However, ED utilization patterns may change if cost-conscious health savings account holders forgo other necessary medical care, or if they seek out substitutes to the ED for less urgent problems. In the long run, the ED may feel the impact of changes that stem from 2 areas: the ability of health savings accounts to control the increase in health care costs, and the potential of health savings accounts to replace or undermine more comprehensive health insurance plans. We note areas that emergency physicians should monitor as health savings accounts become more prominent.

Emergency Service, Hospital↗