PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Insurance Benefits”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed2006

Assessing mental disability in minors.

Forensic psychiatry devotes a great deal of attention to the "imprecise" and "insufficiently scientific" nature of psychiatric disability assessment, and, for this reason, it is vitally important to establish a reliable method of assessing different levels of disability. The assessment of mental disability in minors is unique in that it involves developmental aspects, which affect the formation and outcome of the disability. The relationship between disability and development is reciprocal: disability can affect development, thereby intensifying the degree of disability, while development affects integration of the disability into the personality and self-image, thereby preventing or reducing the transformation of disability into handicap. Only an understanding of both the psychopathological structure and its interaction with developmental elements can lead to an accurate assessment of the degree of disability. Such an understanding is vital to the proper practice of forensic psychiatry. We hereby propose a new formula for disability quantification which provides an arithmetical means for the calculation of disability percentages in minors, and we recommend its use in the assessment of demands for National Insurance benefits and compensation claims. The relationship between this new formula and the existing Children's Global Assessment Scale (CGAS) functional scale, when tested retrospectively on 50 clinical reports composed by the writers of this article, showed a good correlation in the results obtained independently by each writer. Two case studies are presented here. A further evaluation by objective evaluators is necessary in order to construct a model for a final objective evaluation of disability in children and adolescents.

Adolescent↗
PubMed2006

The nuts and bolts of PDPs.

This issue brief provides an overview of Medicare prescription drug plans (PDPs), with a focus on fundamentals such as enrollment, premiums, formularies, cost sharing, prices, payment, cost management, and appeals and grievance processes. It also highlights major changes to the PDP landscape between 2006 and 2007.

Cost Control↗
PubMed2006

Hurricanes provide impetus for health system reform in Louisiana.

The clear lesson, for Louisiana and any other state that is contemplating the potential disruption of health care following large-scale dislocations caused by either natural or man-made major disasters, is that proper mechanisms must be put in place before the event. This is necessary to provide greater portability of health care coverage and alternatively, temporary finance that coverage. Our Louisiana State Medical Society's plan Health Access Louisiana will help Louisiana recover from the devastating effects of Hurricanes Katrina and Rita and serve as a model for the reform of our healthcare coverage system for our country. We firmly believe the devastation in Louisiana presents a unique opportunity to rebuild a healthcare system from scratch. The new system will not be a modification of the old system, which did not work, but a system which effectively and economically offers equal access to high quality healthcare for all.

Disasters↗
PubMedDate not supplied

Reaching out to retirees.

The numbers pertaining to the approaching demographic boom in health-care-related expenditures are eye-popping: Health-related financial products to help retiring baby boomers deal with out-of-pocket costs alone will generate up to 80 billion dollars in revenues and 8-12 billion dollars in pre-tax profits by 2014. But health insurers will have to refocus their efforts if they want to take full advantage of this opportunity. (For more, see "Turning Subscribers Into Customers: The Future Is Now" in the July/August issue, the first in this two-part series.) Two areas are critical: product innovation to provide comprehensive solutions that meet seniors' needs more effectively, and advice-based distribution that creates privileged customer relationships.

Health Services Needs and Demand↗
PubMed1991

[Development of loss-of-limb coverage in private accident insurance].

The oldest known private accident insurance is recorded in the maritime law of Wisby of 1541. Defoe is the first to propose a compensation scale for loss of limbs in the 17th century. It is taken over in a modified character by all insurance companies being founded in Europe and North America since 1850. The structure of the present insurance conditions originates in the conditions of 1920. Since then the loss of the right and left upper limb is rated equally. The compensation scale is changed again in 1961, the loss of extremities is valued higher and the loss of sense of smelling and tasting is considered.

Persons with Disabilities↗
PubMed1990

[Ambulatory surgery in the United States. Reasons of its existence and future].

Ambulatory surgery has been gaining momentum in the United States over the past decade. This does not result from an initiative taken by the medical profession, but from a government plan aimed at checking the soaring costs of medical care. Since this rise was chiefly caused by hospital costs, the attempted savings have primarily affected our privilege of admitting the patients to hospital as we wanted. It has become impossible to admit a patient to hospital for diagnostic testing. Even for major surgery (such as resection of the esophagus, duodenopancreatotomy, etc.), the patient comes to hospital on the very morning of the operation. In addition, the medical mutual benefit insurance companies, in particular, the HMOs, have decided that some operations must be performed without any stay in hospital. This has resulted in the creation of ambulatory surgery units, which were either integrated in hospital surgery departments, or independent, and of which we discuss the pros and cons. In addition, an infrastructure aimed at facilitating postoperative care at home or in smaller private units has been set up. Laparoscopic surgery has further increased the percentage of ambulatory operations. There certainly will be no retreat now.

Ambulatory Surgical Procedures↗
PubMed1990

Managed care is utilization review.

The role of utilization review (UR) as a form of managed care is described. As technology has advanced, the use of diagnostic and therapeutic services has increased and care delivery has shifted to outpatient settings, but the increase in healthcare costs has not slowed. The shift to delivery of medical care outside the hospital setting has increased the need for effective UR in both inpatient and outpatient settings. UR is performed not only by private UR organizations and through external review programs of insurance carriers but also through care-providers' internal programs. UR has been driven by increased medical costs and by redesign of insurance benefit plans to include financial incentives and penalties and copayments. UR has attempted to control the use of hospital services through preadmission certification and concurrent review, requirements for second surgical opinions, and medical case management, which is the identification before or during hospitalization of patients who could safely receive treatment outside the hospital. In-patient mental health and substance-abuse programs have been the subject of intensive review because of high expenditures for such services. Practice indicators are being developed that will be used for prospective determination of treatment plans. As UR techniques improve, management of care in all organized health-care settings will intensify.

Drug Utilization↗
PubMed1990

Health insurance coverage of Minnesota farm families.

This study of 1,482 farm families assesses the extent and cost of health insurance coverage among Minnesota farm families and finds that these families are buying less insurance coverage than urban families, while paying a higher proportion of their income for these premiums. More than three-fourths of the farm families surveyed buy their health insurance plan themselves and pay for it out of pocket. Their plans, on average, are slightly less expensive than employer-provided plans in urban areas, but they provide much less coverage and have more copayments and deductibles. Unlike their urban counterparts, who often choose health plans for convenience of location or freedom to choose physicians, farmers generally choose plans on the basis of costs and services provided. About 7 percent of farm families are without insurance, and many others are underinsured because they cannot afford to purchase an adequate plan.

Cost Control↗