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PubMed2002

'Benefits cycle' replacing premium cycle as consumerism takes hold.

The traditional premium cycle of ups and downs in rates is giving way to a new phenomenon--driven by the advent of consumerism in health care--termed the "benefits cycle" by one consultant. Rather than shifts in rates, he argues, the future will see shifts in benefits packages.

Consumer Behavior↗
PubMed2002

Carving out care.

Explore the source record for details and available documents.

Cost-Benefit Analysis↗
PubMed1987

Third-party billing.

Explore the source record for details and available documents.

Cost-Benefit Analysis↗
PubMed2005

[Upgrade, expand, systematize--an analysis of the status of, the need for reform in, as well as innovative projects for follow-up care in rehabilitation under the German pension insurance scheme].

Rehabilitation benefits provided under the German Pension Insurance scheme are of central importance to insureds, in terms of protection in cases of loss or reduction of their earning capacity. Due to this safeguarding effect for the gainfully employed population, rehabilitation benefits at the same time are important to the insured community and to society as a whole. In 2003, some 846 000 insured persons had received medical and other benefits for rehabilitation. Designing these benefits to be as effective as possible is among the pre-eminent goals of the statutory pension insurance scheme. To this end, the statutory pension insurance institutes have initiated a quality assurance programme designed to enable utmost quality of the benefits provided. This programme in the first line covers inpatient medical rehabilitation of, as a rule, three weeks duration. An issue hardly investigated so far is sustainability of the effects achieved by these rehabilitation measures. Among the possibilities for ensuring lasting success are follow-up measures or benefits arranged for already during the in-patient stay, a service field which until recently had hardly been known in Germany. A stock-taking carried out in 2004 by the author and supported by LVA Schleswig-Holstein, a regional pension insurance institute, has for the first time realized an overview of this kind. Its essential findings are presented in this article, supplemented by a partial update vis-à-vis completion of the initial investigation.

Disability Evaluation↗
PubMed2000

Finance issue brief: mandated benefits: an overview.

Do mandates cost insurers, employers or policyholders more money? If so, who should pay? While many enrollees and some legislators argue that mandating coverage is necessary to ensure adequate benefits, insurers claim that the state laws requiring them to provide coverage for specified procedures, drugs or screenings increase premiums.

Humans↗
PubMed1997

Older Medicare enrolees' choices for insured services.

OBJECTIVES: The Medicare Trust Fund is expected to be bankrupt in the next decade, thus threatening the viability of the Medicare Program. We have ascertained what Medicare enrollees' priorities for insured services would be, and why, if it were fiscally necessary to limit Medicare benefits to maintain the viability of the Program. DESIGN: A cross-sectional survey using anonymous, inperson interviews and an innovative instrument to elicit choices. SETTING: General Internal Medicine outpatient clinic at a university teaching hospital. PARTICIPANTS: One hundred five adults, 65 years of age and older, who had primary care physician visits between July and September 1995. MEASUREMENTS: Desire to personally select insurance benefits, insurance benefit choices, and the reasons for selection or rejection of benefits. RESULTS: Subjects of various educational and economic backgrounds were able to carry out the selection process with relative case, and four-fifths of respondents preferred to make their own choices about insured services. The most frequently selected services were hospitalization, outpatient care, prescription drugs, eye care, and home care, in descending order. Subjects selected 52 different combinations of services. Only 2% of respondents picked the current Medicare service package. The reasons given for selection varied by service; cost and current or anticipated need for a service were the most frequently cited forces driving the choices made. CONCLUSION: These data suggest that Medicare enrollees prefer some element of choice about their health insurance coverage. Their choices vary widely and differ from the current Medicare package.

Aged↗