Minnesota Medical Association Medicare fee reimbursement study. August, 1985.
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Questions concerning the effectiveness of therapeutic intervention designed to modify the function of an individual's visual system have been raised by professional groups, consumer groups, insurance carriers, students, educators, as well as "pure" scientists. This paper examines the available literature in order to answer the question, "Is there evidence that 'orthoptics' or 'vision therapy' causes changes in an individual's accommodative or vergence eye movement systems?" This review neither examines alternative methods of causing these changes nor provides information concerning which particular techniques are most effective, although the literature does provide such information. Certain conditions are explained to aid the student and lay-reader in understanding the literature cited. The literature cited substantiates that visual therapy can modify visual functions and also points out the relationship of these changes to the relief of certain symptoms.
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The use of assistive devices by children has become widespread and has been supported financially by insurance carriers and governments. However, there has been little evaluation of the utilization of these devices. To determine utilization of, satisfaction with, and perceived value of the aid, an independent evaluator contacted 502 families who had used a provincial government funding program to obtain an assistive device. High levels of use, satisfaction, and perceived value were reported, indicating that a decentralized funding program can provide aids effectively.
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More improvement in the scope than in the quality of private health insurance coverage took place during 1975. Four-fifths of the population under age 65 was covered for hospital and surgical care, and nearly that proportion was protected against the costs of physicians' in-hospital visits, X-ray and laboratory examinations, and prescribed out-of-hospital drugs. The $33.6 billion in premiums paid by consumers resulted in the return of only $28.9 billion in benefits, which covered just 44% of their total personal health care expenditures. Major-medical insurance, held by an estimated 43% of the population, helped to overcome some of the deficiencies of private insurance--dollar limitations on health care services, ceilings on the duration of hospital stays, and exclusions for some types of care. It also provided economic protection against catastrophic expenses. Premiums and subscription income rose faster than benefits as private insurers attempted to keep their coverage in line with rising health care costs. The overall underwriting gain was due largely to a $952.4 million gain in group business by the insurance companies.
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As part of hospitals' continuing efforts to control costs, many have begun to consider implementing self-insured hospitalization programs for their employees. Not only can self-insurance provide cash flow savings and actual cost savings but it can also promote prevention among hospital employees.
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The Direct Service Contract encourages hospital employees to use their own hospital for medical services. The plan benefits the hospital, cuts costs, and raises employee morale.
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