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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.↗
PubMed1990

The politics of universal access: the Massachusetts Health Security Act of 1988.

This article analyzes the passage of an unprecedented state law, promising every resident access to affordable health insurance. The Massachusetts Health Security Act of 1988 was the product of a set of political and financial pressures that had been developing for nearly a decade. Hospital, insurance, and business interests were unable to reach a new accommodation on hospital payment. This logjam created the opportunity for a policy breakthrough, but did not inherently lend itself to progressive reform. It was consumer activism that forced the traditional powers in health policy to address the interests of the uninsured. By imposing a more public-interest agenda on the process, consumers were able to change the configuration of the stalemate, but could not resolve it. The particular terms of the stalemate, however, made possible a new, more aggressive role for state government in health policy. Unable to satisfy their competing interests within a policy framework that had universal access as a goal, traditionally powerful interest groups found themselves increasingly dependent on the state to broker a new agreement. While the many concessions made to these groups are likely to prove to be the bill's undoing, the unraveling of the agreement will not end the story. The same pressures which led to passage of the Massachusetts law and which are now causing other states to act will continue to exert their effect until a more durable solution is found.

Health Services Accessibility↗
PubMed1993

Use rates under President Clinton's health reform plan.

During the 1992 presidential debates there was considerable rhetoric on health reform. Based on the broad principles now available concerning President Clinton's plan, this article compares differences in hospital and physician use rates of the now uninsured, who would be covered by his proposal, to those who have been traditionally enrolled in health insurance plans. Numerous studies illustrate that these new insurees have historically needed more and received less health care than the insured. Hospitals and physicians will be under pressure to provide a greater volume of benefits. It is predicted that these future estimated use rates will be more akin to the Canadian single-payor rather than the German multipayor national health insurance plan.

Adolescent↗
PubMed1998

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1999--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1999 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae used to determine these amounts. The inpatient hospital deductible will be $768. The daily coinsurance amounts will be: (a) $192 for the 61st through 90th day of hospitalization in a benefit period; (b) $384 for lifetime reserve days; and (c) $96 for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

[Promotion of home medical care and ways to provide medicines to patients at home].

The Medicare Security Law and Fee Schedule for Medical Services have undergone revisions in accordance with the changes in society, and these were introduced on the premise that home medical care be promoted. If home medical care is promoted, it is expected that a considerable proportion of persons who are now hospitalized and depend heavily on medicare will be transferred home, partly because of the shortening of the maximum insured hospitalization time. Thus, it will become necessary to provide medicines including injectables such as TPN to patients at home. Generally speaking, medicines for patients at home are provided by nearby pharmacists based on prescriptions written by the physician in charge of a patient. However, with regard to injectables such as TPN that require aseptic environments for preparation, such requirements can not yet be met satisfactorily owing to a shortage of sufficient provisions at pharmacies and of sufficient technical skills on the part of pharmacists. Currently, there are only 27 pharmacies which are officially recognized as being sufficiently equipped to prepare injectables in aseptic environments, and pharmacists who actually prepare TPN drugs in aseptic environments account for about one third of this number. The current number of pharmacists will obviously not meet the demand for medicines from patients at home, which will undergo a sharp rise in the near future. Accordingly, it is essential to increase the number of pharmacists nationwide who are sufficiently equipped to manage injectables such as TPN in aseptic conditions.

Drug Prescriptions↗
PubMed1992

A controlled auction market is a practical solution to the shortage of transplantable organs.

All attempts relying on pure altruism to meet the demand for transplantable donor organs have failed and continue to fail. The incentive of commercialization of an organ market would seem to be the only practical solution at this time. It is almost impossible to set fixed prices for such priceless items as human organs. The only fair, honest, and feasible approach is the establishment of a free and voluntary national or international auction system under the strict supervision and control of an exclusive, specially created administrative entity free of governmental or other partisan interference. The resultant flow of funds could be enormous and would enhance the welfare of all strata of society. Wealthy buyers would be removed from current waiting lists; the donor pool greatly expanded to perhaps surplus; the resultant money used to relieve the financial burdens on families involved, hospitals, insurance companies--and also used to buy organs for the indigent on waiting lists, pay for surgeries and hospitalization, and thereby increase the income and surgical experience of more surgeons. This proposed new system should include all live as well as brain-dead donors, cadavers and consenting individuals facing purposeful and pointless destruction by judicial execution.

Altruism↗
PubMed2004

The association between hospital readmission and insurance provider among adults with asthma.

CONTEXT: Asthma is ranked as the ninth most common chronic condition in the U.S., and its annual direct costs from hospital services alone are estimated at $3.1 billion. Hospitalization rates due to asthma reveal several disparities and may be attributed to recent changes in the healthcare delivery system, including the penetration of managed care. OBJECTIVE: To examine the relationship between 7-day hospital readmission and insurance provider among adults with asthma. DDESIGN: A retrospective cohort study that included patients aged 18-64 with a principal diagnosis of asthma, who were discharged from acute nonfederal hospitals in New Jersey between 1 January 1993 and 31 December 1996. In the absence of unique patient identifiers, a linkage system was used to match subsequent readmissions for the same patient to the first admission. MMAIN OUTCOME MEASURE: Seven-day readmission. RESULTS: Results showed a significantly increased risk of 7-day readmission for managed care patients as compared to indemnity patients (OR= 1.67, 1.10-2.53). Shorter lengths of stay were associated with greater odds of readmission (LOS=0: OR=5.17, 2.49-10.75, LOS=1: OR=2.30, 1.30-4.07). CONCLUSIONS: Managed care patients have shorter lengths of stay as compared to indemnity patients, which leads to an increased risk of returning to the hospital within a short period of time. In trying to provide cost-effective patient care, we may be discharging patients prematurely.

Adolescent↗
PubMed2003

Cost-effectiveness of testing for human immunodeficiency virus and hepatitis C virus among blood transfusion recipients.

OBJECTIVE: To choose the most cost-effective option for detecting human immunodeficiency virus (HIV-1) and hepatitis C virus (HCV) among blood transfusion recipients. DESIGN: Cost-effectiveness analysis. Effectiveness was expressed as the number of HIV-1 or HCV infections detected, regardless of whether they were related to transfusion. To estimate costs, we assumed hospital insurance would cover costs related to detection and compensation, when granted. SETTING: A 2,890-bed acute care teaching hospital in Bordeaux, France. METHODS: Eight options were defined, from the simplest, which would be to do nothing, to a maximal approach, which would be to keep a serum sample in a serum library for a lookback and perform tests for antibody to HIV-1 and to HCV before and 3 months after transfusion. Data on probabilities and costs were taken from the literature and experiences of French hospitals. RESULTS: The most cost-effective option was to perform viral antibody testing before transfusions (option 3), which would detect 27 infections per 1,000 patients, for an expenditure of US $1,260 per detected patient Option 6, obtaining a serum sample before transfusion and performing tests for antibody to HIV-1 and to HCV 3 months after transfusion, had a similar cost-effectiveness ratio but detected only 16 infections per 1,000 patients. Performing tests before and 3 months after transfusion (option 4), compared with option 3, would detect 1 additional infection for an additional cost of US $8,322. CONCLUSION: The most cost-effective options are not specific to blood transfusion recipients and might be more suited to all hospitalized patients.

AIDS Serodiagnosis↗
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.↗
PubMed1991

Medicare program; inpatient hospital deductible and hospital and skilled nursing facility coinsurance amounts for 1992--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and skilled nursing facility coinsurance amounts for services furnished in calendar year 1992 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $652. The daily coinsurance amounts will be: (a) $163 for the 61st through 90th days of hospitalization in a benefit period; (b) $326 for lifetime reserve days; and (c) $81.50 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.↗
PubMed1992

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1993--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1993 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $676. The daily coinsurance amounts will be: (a) $169 for the 61st through 90th days of hospitalization in a benefit period; (b) $338 for lifetime reserve days; and (c) $84.50 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.↗
PubMed1993

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1994--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1994 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $696. The daily coinsurance amounts will be: (a) $174 for the 61st through 90th days of hospitalization in a benefit period; (b) $348 for lifetime reserve days; and (c) $87 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.↗
PubMed1994

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1995--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1995 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $716. The daily coinsurance amounts will be: (a) $179 for the 61st through 90th days of hospitalization in a benefit period; (b) $358 for lifetime reserve days; and (c) $89.50 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.↗
PubMed1995

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1996--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1996 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $736. The daily coinsurance amounts will be: (a) $184 for the 61st through 90th days of hospitalization in a benefit period; (b) $368 for lifetime reserve days; and (c) $92 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.↗
PubMed1996

Medicare program; inpatient hospital deductible and hospital and extended care services coinsurance amounts for 1997--HCFA. Notice.

This notice announces the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 1997 under Medicare's hospital insurance program (Medicare Part A). The Medicare statute specifies the formulae to be used to determine these amounts. The inpatient hospital deductible will be $760. The daily coinsurance amounts will be: (1) $190 for the 61st through 90th days of hospitalization in a benefit period; (b) $380 for lifetime reserve days; and (c) $95 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.↗