How to deal with persistently low/high spenders in health plan payment systems?
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DOI: 10.1002/hec.4477
Abstract: Health insurance markets with community-rated premiums typically include risk adjustment (RA) to mitigate selection problems. Over the past decades, RA systems have evolved from simple demographic models to sophisticated morbidity-based models. Even the most sophisticated… read more here.
Keywords: plan payment; health; health plan; spending ... See more keywords
Data transformations to improve the performance of health plan payment methods.
Sign Up to like & getrecommendations! Published in 2019 at "Journal of health economics"
DOI: 10.1016/j.jhealeco.2019.05.005
Abstract: The conventional method for developing health care plan payment systems uses observed data to study alternative algorithms and set incentives for the health care system. In this paper, we take a different approach and transform… read more here.
Keywords: health plan; data transformations; health; plan payment ... See more keywords
United States Health Plan Cancer Concerns In 2018
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DOI: 10.1016/j.jval.2018.04.266
Abstract: • Oncology genomic tests were covered by 87.7% of plans (compared with 90.2% last year) • Cancer/oncology was consistently reported the top concern from medical and budgetary points of view (Figure 6) • Compared with… read more here.
Keywords: states health; united states; cancer; oncology ... See more keywords
Rethinking costs of psoriasis: 10% of patients account for nearly 40% of healthcare expenditures among enrollees with psoriasis in a U.S. health plan
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DOI: 10.1080/09546634.2017.1303566
Abstract: Abstract Objective: To examine characteristics, healthcare utilization and costs among patients with psoriasis who have high medical costs. Methods: This is a retrospective study of patients with psoriasis with continuous enrollment from 1 January 2011… read more here.
Keywords: psoriasis; healthcare expenditures; psoriasis related; health plan ... See more keywords
Adoption of local public health plan for better health and quality of life in Belgrade
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DOI: 10.1093/eurpub/ckaa166.1246
Abstract: Development of public health plan for the City of Belgrade, facilitate multisectoral participation and encourage local government to incorporate public health planning into integrated planning framework, including funding. According to Public Health Low, adopted in… read more here.
Keywords: health planning; public health; city; health ... See more keywords
The Diabetes Health Plan and Medication Adherence among Individuals with Low Incomes.
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DOI: 10.1111/1475-6773.13992
Abstract: OBJECTIVE To test the impact of the Diabetes Health Plan (DHP), a diabetes-specific insurance plan that lowers out-of-pocket costs for diabetes-related medications and clinical visits, on adherence to oral hypoglycemic medications among low-income adults with… read more here.
Keywords: health plan; adherence; medication adherence; diabetes health ... See more keywords
Trends in high deductible health plan enrolment and spending among commercially insured members with and without chronic conditions: a Natural Experiment for Translation in Diabetes (NEXT-D2) Study
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DOI: 10.1136/bmjopen-2020-044198
Abstract: Objectives To examine trends in high deductible health plan (HDHP) enrolment among members with diabetes and cardiovascular disease (CVD) compared with healthy members and compare out-of-pocket (OOP) and total spending for members with chronic conditions… read more here.
Keywords: deductible health; high deductible; trends high; study ... See more keywords
Local public health projectification in practice: a qualitative study of facilitators and barriers to a public health plan implementation.
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DOI: 10.1177/14034948221080402
Abstract: AIMS To identify factors perceived by local government employees to affect the implementation of a municipal public health plan. METHODS Qualitative individual interviews (n=13) were carried out. Participants were sampled from three districts in Oslo… read more here.
Keywords: health; plan implementation; health plan; public health ... See more keywords
Observational Analysis of a Generalized, Health Plan-led Community Health Worker Intervention in Medicaid
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DOI: 10.1177/21501319231153602
Abstract: Introduction/Objectives: In 2018, a Medicaid managed care plan launched a new community health worker (CHW) initiative in several counties within a state, designed to improve the health and quality of life of members who could… read more here.
Keywords: health; community health; plan led; health plan ... See more keywords
Low Rates of Colonoscopy Follow-up After a Positive Fecal Immunochemical Test in a Medicaid Health Plan Delivered Mailed Colorectal Cancer Screening Program
Sign Up to like & getrecommendations! Published in 2020 at "Journal of Primary Care & Community Health"
DOI: 10.1177/2150132720958525
Abstract: Background Follow-up colonoscopy after a positive fecal immunochemical test (FIT) is necessary for colorectal cancer (CRC) screening to be effective. We report colonoscopy follow-up rates after a positive FIT overall and by population characteristics in… read more here.
Keywords: colonoscopy; plan; test; health ... See more keywords
Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data
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DOI: 10.1186/s12890-018-0759-5
Abstract: BackgroundIdiopathic pulmonary fibrosis (IPF) is a rare life-threating interstitial lung disease (ILD). This study characterizes demographics, health care utilization, and comorbidities among elderly IPF patients and estimates prevalence and incidence rates for selected outcomes.MethodsCohort study… read more here.
Keywords: incidence rates; plan; pulmonary fibrosis; health ... See more keywords