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PubMedDate not supplied

The changing face of pharmacy benefit design.

Employers, health plans, and pharmacy benefit managers-seeking to reduce rapid growth in pharmacy spending-have embraced multi-tier pharmacy benefit packages that use differential copayments to steer beneficiaries toward low-cost drugs. The consensus of fifteen pharmacy benefit design experts whom we interviewed is that such plans will become more prevalent and that the techniques these plans use to promote low-cost drugs will intensify. The effect on health outcomes depends on whether the high-cost drugs whose use is being discouraged have close, low-cost substitutes.

Deductibles and Coinsurance↗
PubMed1992

How much insurance is enough? What to look for in a long term care insurance policy.

LTC insurance is a valuable financial tool to help pay for pending LTC. However, LTC insurance is not for everyone. For those who could benefit from a policy, questions arise as to how much to buy and what consumer options to purchase in a policy. Insurance is most appropriate for couples with assets of $110,000 or more, excluding their house, car, and personal belongings. Single persons with a need to protect assets should have at least $40,000 in assets. These individuals have smaller need for LTC insurance to protect assets for their children. How much insurance to buy depends on the cost of LTC and the financial resources of the person. Premiums for LTC insurance are level. A company cannot raise the premiums for an individual, but may request an increase for a class of people. With the potential that premiums may increase and that buying power of income may decline, the policy should be affordable both at time of purchase and in future. Policies pay a specified benefit amount for a specified benefit period. In deciding how much insurance to buy, it is advisable to buy a higher benefit amount for a shorter benefit period. This provides the greatest likelihood of receiving the policy's maximum benefit. The deductible amount should be between 20 and 100 days. In selecting a policy, the most important criterion is the company itself.(ABSTRACT TRUNCATED AT 250 WORDS)

Decision Making↗
PubMed2002

Collect copays on the 'back end' of the visit.

Patients should be directed to a separate area after the ED visit for collection of copay payments. Discuss copays at registration, but collect them only at discharge. Train staff in how to avoid EMTALA violations. Patients are more willing to give copays if they are satisfied with the care they received.

Deductibles and Coinsurance↗
PubMed1990

Termination of health benefits for Pittston mine workers: impact on the health and security of miners and their families.

Mine workers represented by the United Mine Workers of America (UMWA) have had comprehensive medical care coverage since 1950. On February 1, 1988, UMWA employees of the Pittston Coal Group had their health care benefits abruptly terminated. Renewal of these benefits became a major reason for the subsequent UMWA strike against Pittston. In December, 1989, physician interviewers were organized to document the human experience of this termination of health care benefits. This report summarizes these interviews, and concludes that the UMWA experience in the Pittston coal fields is one example of the barriers to health care experienced by an increasing proportion of the United States population.

Adolescent↗
PubMed1996

Chiropractic and medical costs of low back care.

This study compares health insurance payments and patient utilization patterns for episodes of care for common lumbar and low back conditions treated by chiropractic and medical providers. Using 2 years of insurance claims data, this study examines 6,183 patients who had episodes with medical or chiropractic first-contact providers. Multiple regression analysis, to control for differences in patient, clinical, and insurance characteristics, indicates that total insurance payments were substantially greater for episodes with a medical first-contact provider. Most of the cost differences were because of higher inpatient payments for such cases. Analysis of recurrent episodes indicates that chiropractic providers retain more patients for subsequent episodes and that patient exposure to a different provider type during early episodes significantly affects retention rates for later episodes. Patients choosing chiropractic and medical care were comparable on measures of severity and in lapse time between episodes. The lower costs for episodes in which chiropractors serve as initial contact providers along with the favorable satisfaction and quality indicators for patients suggest that chiropractic deserves careful consideration in gatekeeper strategies adopted by employers and third-party payers to control health care spending. More research is needed, especially in developing alternative measures of health status and outcomes.

Adult↗