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PubMed2002

Wall Street comes to Washington: market watchers and policy analysts evaluate the health care system.

Consumers will pay more for health care as employers respond to a third year of double-digit insurance premium increases in 2003. Firms will shift more costs to workers through higher deductibles and copayments to protect their bottom lines and increase worker awareness of the cost of care, according to a panel of market and health policy experts at the Center for Studying Health System Change's (HSC) seventh annual Wall Street roundtable. But don't look for large employers to make radical changes to workers' health benefits. So far, most employers are cautiously eyeing new insurance products, including consumer-driven health plans and tiered hospital and physician networks. As costs continue spiraling upward, a hospital building boom is underway, raising concerns about a new medical arms race and increased costs.

Cost Sharing↗
PubMed1980

The Mental and Nervous Disorder Utilization and Cost Survey: an analysis of insurance for mental disorders.

The Mental and Nervous Disorder Utilization and Cost Survey in Washington, D.C., has yielded useful information about outpatient utilization within an insurance plan with broad mental health coverage, as well as evidence that a comprehensive benefit with a low deductible and copayment can be offered and reasonably utilized. From the results of this survey and a substudy of claims made during 1977, the authors conclude that psychiatric diagnostic information submitted on insurance claim forms may often be inaccurate, primarily because of providers' concerns about confidentiality; such information is of little use for peer review or claims review. The authors state that caution must be exercised in generalizing from the experience under this plan to speculate about outpatient utilization which might result from broad coverage on a national level.

Ambulatory Care↗
PubMed1979

Private health insurance plans in 1977: coverage, enrollment, and financial experience.

The private health insurance industry collected $47.1 billion in premiums in 1977 and returned $41.6 billion in benefits to their subscribers. Premiums rose 16.3 percent as a direct consequence of rapid claims growth in 1976. After operating expenses were deducted, the industry showed a small, $.4 billion underwriting loss. About 78 percent of the population were insured for hospital care, and about 76 percent for surgical services. Smaller percentages had coverage for other types of care. An estimated 61.8 percent of the aged bought private hospital insurance, and 47.1 percent bought surgical insurance, mostly to supplement Medicare benefits. About 12 percent of persons under age 65 had no protection against the cost of hospital care either through private insurance or a public program such as Medicare or Medicaid.

Data Collection↗
PubMedDate not supplied

North Carolina high-risk insurance pools.

Imagine this: You are a 58-year-old man. You have worked all your life, paid taxes, and helped support your family. Two years ago you had a mild heart attack. Your wife has diabetes and high blood pressure. Luckily, you had health insurance through your job that helped you pay for the hospitalization, doctor's visits, and necessary medications for you and your wife. With a new diet, exercise, and the medications, you both are doing well managing your health problems. A little over a year ago, you lost your insurance when your company downsized. You found another job, but your current employer doesn't offer insurance. Your wife also works, but she works for a small employer that does not offer coverage. So, you pay approximately dollar 600/month for continuation coverage (COBRA) for your wife and yourself through your former employer. Last month, you found out your COBRA coverage is about to end. You want to continue to buy insurance coverage, but you were told that purchasing a comprehensive policy with a dollar 1,000 deductible (70% coinsurance) that covers your needed medications would cost more than dollar 4,000/month for your wife and yourself.

Fees and Charges↗
PubMedDate not supplied

Cost of insurance policies for investigator-initiated cancer clinical trials in Italy.

BACKGROUND: Clinical trials with non-profit promoters are frequently performed in oncology and represent a highly valuable source of information. METHODS: To describe the costs of insurance policies and their determinants, data were collected from 12 Italian non-profit promoters of cancer trials. The cost of policies was expressed as per-patient premium. RESULTS: Sixty-two quotations issued by only two companies were collected, relative to 44 trials proposed for quotation between December 1998 and February 2003. Only the date of quotation was significantly associated with the cost (P = 0.0003) of quotations by Company A for policies with a deductible, with cost increasing over time. Date of quotation (P = 0.0002), sample size (P = 0.008) and number of study arms (P = 0.02) were independently associated with the cost of no-deductible policies quoted by Company A. Only the number of study arms was significantly associated with cost (P = 0.0001) in no-deductible policies quoted by Company B. CONCLUSION: There is insufficient competition among companies for insurance of cancer trials with non-profit promoters. Many variables that affect the trial risk profile from a clinical perspective are not associated with insurance cost. Date of quotation is among the strongest determinants of the cost, which has sharply increased over time. This trend may become a serious problem for non-profit promoters of cancer clinical trials.

Clinical Trials as Topic↗
PubMed2004

Wall street comes to Washington.

While health care cost trends likely will continue slowing through the end of 2004, the longer-term outlook for a sustained slowdown in underlying costs and private health insurance premiums largely depends on the strength of the economy, according to market and health policy experts at the Center for Studying Health System Change's (HSC) ninth annual Wall Street roundtable. Even as cost growth slows, insurers are practicing pricing discipline to keep premium trends ahead of cost trends to maintain profitability. Employers will continue to shift costs to workers through higher deductibles, copayments and coinsurance, but an improving economy could temper this trend as labor markets tighten. Employers remain skeptical of new health insurance products, including tiered-provider networks and consumer-driven health plans. Although growth in hospital use has slowed, the industry remains in the throes of a building boom. Increased payments to managed care plans could reinvigorate private plan participation in Medicare, but concerns about the federal budget deficit could prompt Congress to roll back rate increases.

Community Participation↗
PubMed2006

Consumer decision making in the individual health insurance market.

This paper summarizes the results from a study of consumer decision making in California's individual health insurance market. We conclude that price subsidies will have only modest effects on participation and that efforts to reduce nonprice barriers might be just as effective. We also find that there is substantial pooling in the individual market and that it increases over time because people who become sick can continue coverage without new underwriting. Finally, we show that people prefer more-generous benefits and that it is difficult to induce people in poor health to enroll in high-deductible health plans.

California↗