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Results for “Insurance Benefits”

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PubMed1994

The effects of insurance benefits coverage on functional and psychosocial outcomes after spinal cord injury.

This retrospective study examined the effects of type of payor (ie, catastrophic, Medicaid, and private) and extent of benefits and independent living (IL) resources received on functional and psychosocial outcomes after spinal cord injury (SCI). One hundred seventy SCI persons with dates of injury from 1985 to 1990 and who were on average 4 years after their initial discharge from rehabilitation participated in the study. Benefits and resources received from discharge to 2 years post-injury in housing, transportation, personal care assistance (PCA), and equipment were assessed. Outcome variables included measures of psychological distress, self-esteem, and participation in physical and work/school activities. Extent of benefits received after SCI was found to be both a function of source of payor and of subject's neurological classification. While an effect of total benefits received could not be detected on SCI subjects post-discharge physical activity, and benefits paid by self only were associated with physical activity. Transportation benefits received and type of payor were positively associated with work/school outcomes. Younger subjects, sponsored by private payors, and with incomplete injuries were more likely to be working or going to school after SCI. Benefits and payor were also associated with psychological distress. Privately sponsored subjects were less distressed, whereas those sponsored by Medicaid were most distressed. Extent of benefits received was found to be inversely associated with distress and self-esteem. Persons with lower self-esteem received more postdischarge benefits, whereas those who paid for their own benefits and those who received communication equipment benefits paid by insurance, reported higher self-esteem. Implications for possible policy changes based on these results are discussed.

Activities of Daily Living↗
PubMed1993

The effect of insurance benefit changes on use of child and adolescent outpatient mental health services.

Use of outpatient mental health services by dependent children younger than 18 years of age enrolled in the Blue Cross and Blue Shield Federal Employees Plan (FEP) is examined in 1978 and 1983 focusing on a cut in benefits and a shift from high- to low-option plan enrollment between those years. While use rates increased from 2.13% to 2.76% by 1983, the average number of visits decreased from 18.9 to 12.8. High-option plan use exceeded low-option plan use in both years--2.26% versus 0.81% in 1978 and 3.58% versus 1.93% in 1983. In addition to benefit plan, ethnicity, parent's education, type of provider, and type of treatment setting also significantly predicted amount of use. Despite the strong evidence of the effects of benefit coverage, it is likely that need exceeded use even in this insured population of children and adolescents. Implications of the findings are discussed in the context of recent dramatic changes in mental service delivery including privatization, managed care initiatives to cut costs, and growing pressures for national health insurance.

Adolescent↗
PubMed1986

Consumer knowledge of Medicare and supplemental health insurance benefits.

In this article, data from a recent study funded by the Health Care Financing Administration are used to examine the level of knowledge about health care insurance coverage among Medicare beneficiaries. Two related categories of this knowledge are analyzed: knowledge of the Medicare program itself and knowledge of supplemental health insurance policies owned by program beneficiaries. The results indicate that Medicare beneficiaries typically do not have high levels of knowledge either about Medicare or about their supplemental health insurance. Also analyzed are the factors that affect knowledge levels.

Age Factors↗
PubMed2002

Hypertrophic cardiomyopathy: risk factors for life and living benefits insurance.

BACKGROUND: The clinical course of hypertrophic cardiomyopathy (HCM) is highly variable. Patients may remain asymptomatic throughout life, develop progressive and ultimately fatal heart failure, or die prematurely due to sudden death. This article reviews Western and Asian literature on HCM, including recent studies of large, regionally based cohorts that reflect the full spectrum of disease. The intent is to estimate HCM-related morbidity and mortality rates in the general population and identify risk factors for life and living benefits insurance. RESULTS: Clinical studies have identified risk factors that are associated with a higher incidence of sudden death, such as non-sustained ventricular tachycardia, left ventricular wall thickness, and family history of sudden death. For many of these factors, there was a nonlinear relationship between mortality risk and the number of risk factors (ie, each additional risk factor was associated with a disproportionately greater risk of sudden death). Natural history studies of patients with HCM reported total HCM-related mortality rates of 1.8% per year for ages 5 to 15 years, 1.0% to 1.5% for ages 16 to 65, 3.9% for ages 66 to 75, and 4.7% for ages above 75 years. Sudden death rates varied from 0.5% to 1.5% per year for most age groups, with children and adolescents experiencing sudden death rates near the top of this range. With regard to morbidity, patients progressed from New York Heart Association functional class I or II to III/IV at a rate of 1% to 2% per year, with higher progression rates in people aged 65 years or older. Risk varied with genotype and was generally similar in Western and Asian populations. CONCLUSION: Despite improvements in diagnosis and treatment, HCM is still associated with considerable morbidity and mortality.

Adolescent↗
PubMed2004

The effect of mandating complementary and alternative medicine services on insurance benefits in Washington State.

OBJECTIVES: Washington was the first state to require insurance companies to cover all categories of licensed providers. The purpose of this paper was to examine the effect of Washington's law on coverage decisions of major health plans. DESIGN: The study uses literature and document review as well as key informant interviews. SETTINGS/LOCATION: The study focuses on legislation and other legal activity in the state of Washington. The key informant interviews are focused on the decisions of three major health plans. RESULTS: Although the law had a major effect on complementary and alternative medicine (CAM) coverage in Washington, the impact on the use of CAM services and expenditures has been bounded by changing market forces. CONCLUSIONS: CAM providers face scientific tests of measurable efficacy and market tests of consumer value. In this economic environment, CAM stakeholders will have to work hard to maintain their political gains.

Complementary Therapies↗
PubMed2007

National estimates of mental health insurance benefits.

This article presents estimates of the proportion of the U.S. population that had mental health benefits in 1999, of the extent of their coverage, and of the proportion that were enrolled in health plans subject to the Mental Health Parity Act of 1996 (MHPA). Findings indicate that over three-quarters (76%) of the U.S. population had mental health benefits as part of their health insurance. Approximately 18% of the population had no mental health benefits, and for the remaining 6%, mental health benefits could not be determined. Of the 18% with no mental health benefits, most (84%) had no health insurance whatsoever, while the remainder (16%) had health insurance that did not cover mental health benefits. Estimates of the generosity of coverage indicate that 44% of the population had benefits that included prescription drugs, and that provided at least 30 inpatient days and 20 outpatient visits for psychiatric care. For 12% of the population, benefit generosity could not be determined. Finally, study results suggest that the MHPA affected only 42% of the U.S. population.

Health Care Surveys↗