Healthcare providers of multiple option plans may be confronted with special market segmentation problems. This study demonstrates how cluster analysis may be used for discovering distinct patterns of preference for m...
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Focuses on a study which examined the process of choosing a health care plan and provider within the United States' health care system. Indepth look at the consumer's choice of a health insurance plan; Complex...
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Focuses on a study which examined the process of choosing a health care plan and provider within the United States' health care system. Indepth look at the consumer's choice of a health insurance plan; Complexity associated with this process; Reference to other studies pertaining to this issue.
Substance abuse (SA) care has been excluded from recent federal and state legislation mandating equal benefits for mental health and medical care ("parity"), largely because of cost concerns. This article st...
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Substance abuse (SA) care has been excluded from recent federal and state legislation mandating equal benefits for mental health and medical care ("parity"), largely because of cost concerns. This article studies how many patients are affected by SA coverage limits and the likely implications of limits on insurance payments, using 1996-97 claims from 25 managed care plans with unlimited SA benefits. Changing even stringent limits on annual SA benefits has a small absolute effect on overall insurance costs under managed care, evert though a large percentage of SA patients are affected. Removing an annual limit of $10,000 per year on SA care is estimated to increase insurance payments by about 6 cents per member per year, removing a limit of $1,000 increases payments by about $3.40. As long as care is comprehensively managed, "parity" for SA in employer-sponsored health plans is nor very costly.
作者：
Parker, R.A.Truth
LtdSM Newton 02459 Massachusetts United States
BACKGROUND: In an earlier article the use of the Quality Improvement Ratio (QuIR) was proposed as a way to assess whether an intervention improves preventive health practices. With this method, only members of a healt...
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BACKGROUND: In an earlier article the use of the Quality Improvement Ratio (QuIR) was proposed as a way to assess whether an intervention improves preventive health practices. With this method, only members of a health plan observed both before and after an intervention are analyzed. Members observed in only one of the two periods are not included in the QuIR analysis. However, since membership in health plans is constantly changing, the QuIR analysis may exclude a substantial proportion of the total number of members studied. METHOD: To overcome this problem, an extension to the QuIR analysis, termed the Extended QuIR method, has been developed. Members are classified into two separate groups: those with data in both periods and those with data in only a single period. Members providing data in both periods are analyzed using the QuIR. Members studied in only a single period are analyzed using single-period analysis, described in this article. If the results of the two separate tests are consistent, both suggesting an improvement over time or both suggesting a deterioration, then the results of the two tests can be combined into an overall test to assess whether a change over time occurred. CONCLUSION: The Extended QuIR method, which combines the results of two separate analyses, should help clarify the effect of an intervention on improving preventive health practices in the overall population.
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