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Results for “Insurance Selection Bias”

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At least 343 records · Page 19Linked to original sources
PubMed1991

Loss of private health insurance among homosexual men with AIDS.

In this study we analyze information on self-reported health insurance coverage, HIV screening by insurers, and loss of health insurance. We distributed questionnaires to gay male participants in the Baltimore and Los Angeles sites of the Multicenter AIDS Cohort Study and to leukemia patients and gay AIDS patients seen at the Johns Hopkins Hospital. In this unusually well-educated and well-insured group, 90% of participants without AIDS had private health insurance coverage, compared with only 64% of participants with AIDS. Persons with AIDS (PWAs) were 33 times as likely to have Medicaid as persons without AIDS, and PWAs were 5 times as likely to have lost health coverage altogether as persons without AIDS.

AIDS Serodiagnosis↗
PubMed1991

Private health insurance and medical care utilization: evidence from the Medicare population.

This paper examines the impact of supplemental health insurance policy ownership on the use of health care services by the elderly. It employs a data base consisting of Medicare claims data from over 2,000 beneficiaries in six states, actual copies of their supplemental insurance policies, and detailed survey information. The results show that policy ownership has a substantial, positive impact on service usage and costs, particularly for beneficiaries in fair or poor health. The greatest impact was found for policies that provide first-dollar coverage.

Aged↗
PubMed1990

Multiple choice health insurance: the lessons and challenge to private insurers.

A health policy consultant with 20 years of experience in public and private health insurance, and particularly multiple choice systems, suggests the evidence is in on our national effort to contain costs through competition, HMOs, and multiple choice health plans. Specifically, we have learned that 1) multiple choice plans are not containing costs for employers, 2) while group and staff model HMOs contain costs, few have cut employers' costs in multiple choice health plans, and 3) group and staff model HMOs' capacity to contain costs has not been matched by insurers' managed care plans. Three options for insurers and HMOs to offer employers are outlined. The options are aimed at changing the behavior of providers so they offer lower cost health care.

Community Participation↗
PubMed1989

Restructuring the Federal Employees Health Benefits Program: the private sector option.

The Federal Employees Health Benefits Program (FEHBP) needs to contain its costs. This paper recommends reforms of FEHBP that would substantially lower costs. As a first step, FEHBP should offer each employee a high and low option from a single conventional carrier, plus several HMO alternatives. FEHBP's practice of offering employees a choice of conventional carriers is virtually unheard of in the private sector. Cost control is more likely when carriers compete for employment groups rather than for individual employees. In addition, my analysis suggests that FEHBP should self-insure, competitively select third-party administrators (TPAs), one for each region of the country, aggressively manage program costs through preadmission certification and DRGs, and allow Medicare-eligible annuitants to enroll in Medicare HMOs and receive the government contribution. All of these reforms have been successfully implemented elsewhere, either by private employers or state or federal governments. These reforms would yield savings of at least $500 million annually for taxpayers and additional savings for federal employees.

Cost Control↗
PubMed1995

Genetic discrimination.

Explore the source record for details and available documents.

Genetic Predisposition to Disease↗
PubMed1995

German risk structure compensation: enhancing equity and effectiveness.

Prior to the 1992 German Health Care Structure Reform Law, Germany experienced inequitable and inefficient competition among its health insurers, known as "sickness funds." That situation was due to limitations on individuals' choice of insurer and the resulting risk segmentation. In 1994, the country implemented risk structure compensation to increase equity among sickness funds and enhance efficiency. This article describes the German risk structure compensation mechanism and its effects, and points out implications for the U.S. insurance market.

Adult↗
PubMed1995

Risk selection in the health care market: a workshop overview.

In a voluntary health insurance market, risk selection poses serious and increasing problems. Responding to this concern, the Robert Wood Johnson Foundation sponsored an invitational meeting for public and private decision makers to understand the incentives for risk selection in the health insurance market and to discuss options for reducing risk selection practices. The meeting, held October 6, 1994, provided a framework for exploring this timely issue and served as a vehicle for understanding how health care reforms, such as insurance market regulation and risk adjustment mechanisms, both can reduce and exacerbate incentives for risk selection. This article sets the context for the three commissioned papers that follow; it summarizes the ideas presented and issues identified for future consideration. Failure to address risk selection will continue to have serious consequences both for access to care for vulnerable populations and for the financial viability of health plans.

Actuarial Analysis↗