deductibles and coinsurance

Summary

Summary: Cost-sharing mechanisms that provide for payment by the insured of some portion of covered expenses. Deductibles are the amounts paid by the insured under a health insurance contract before benefits become payable; coinsurance is the provision under which the insured pays part of the medical bill, usually according to a fixed percentage, when benefits become payable.

Top Publications

  1. pmc Employee choice of a high-deductible health plan across multiple employers
    Judith R Lave
    University of Pittsburgh, Pittsburgh, PA 15261, USA
    Health Serv Res 46:138-54. 2011
  2. pmc Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment
    Jinnet Briggs Fowles
    Park Nicollet Institute, 3800 Park Nicollet Boulevard, Minneapolis, MN 55416, USA
    Health Serv Res 39:1141-58. 2004
  3. ncbi The decline in bulk-billing and increase in out-of-pocket costs for general practice consultations in rural areas of Australia, 1995-2001
    Anne F Young
    Research Centre for Gender and Health, University of Newcastle, Callaghan, NSW, Australia
    Med J Aust 178:122-6. 2003
  4. pmc Consumer awareness and strategies among families with high-deductible health plans
    Tracy A Lieu
    Center for Child Health Care Studies, 133 Brookline Ave, 6th Floor, Boston, MA, USA
    J Gen Intern Med 25:249-54. 2010
  5. pmc Health care use and decision making among lower-income families in high-deductible health plans
    Jeffrey T Kullgren
    VA Medical Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, 19104 6021, USA
    Arch Intern Med 170:1918-25. 2010
  6. pmc Perspectives from deductible plan enrollees: plan knowledge and anticipated care-seeking changes
    Mary Reed
    Division of Research, Center for Health Policy Studies, Oakland, California 94612, USA
    BMC Health Serv Res 9:244. 2009
  7. ncbi Do high-deductible health plans threaten quality of care?
    Thomas H Lee
    Partners HealthCare System, Boston, USA
    N Engl J Med 353:1202-4. 2005
  8. ncbi Health benefits in 2007: premium increases fall to an eight-year low, while offer rates and enrollment remain stable
    Gary Claxton
    Health Care Marketplace Project, Henry J Kaiser Family Foundation KFF, Washington, DC, USA
    Health Aff (Millwood) 26:1407-16. 2007
  9. ncbi Emergency department use and subsequent hospitalizations among members of a high-deductible health plan
    J Frank Wharam
    Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass 02215, USA
    JAMA 297:1093-102. 2007
  10. ncbi Consumer-directed health care
    M Gregg Bloche
    Georgetown University, Washington, DC, USA
    N Engl J Med 355:1756-9. 2006

Research Grants

  1. The Science of Medicare Reform
    DANA P contact GOLDMAN; Fiscal Year: 2010
  2. Parity, child mental health, and substance abuse
    ELLEN R MEARA; Fiscal Year: 2010
  3. Clinical and Social Implications of Cost Sharing for Cancer Drugs
    Yu Ning Wong; Fiscal Year: 2012
  4. Implementation of Federal Mental Health Parity
    Colleen L Barry; Fiscal Year: 2013
  5. COST CONTAINMENT & GROUP HEALTH INSURANCE BENEFIT GROWTH
    Douglas Coate; Fiscal Year: 1993
  6. Modeling Adherence to Psychotherapy for Depression
    Gregory Simon; Fiscal Year: 2009
  7. Effects of income-based drug charges on older Patients
    Sebastian Schneeweiss; Fiscal Year: 2006
  8. Remibursement Limits, Antidepressants, and Outcomes
    Philip Wang; Fiscal Year: 2005
  9. UNCOMPENSATED CARE FUNDS: THE SOLUTION FOR INDIGENT CARE
    Kimberly Rask; Fiscal Year: 1990
  10. Remibursement Limits, Antidepressants, and Outcomes
    Sebastian Schneeweiss; Fiscal Year: 2007

Detail Information

Publications238 found, 100 shown here

  1. pmc Employee choice of a high-deductible health plan across multiple employers
    Judith R Lave
    University of Pittsburgh, Pittsburgh, PA 15261, USA
    Health Serv Res 46:138-54. 2011
    ..To determine factors associated with selecting a high-deductible health plan (HDHP) rather than a preferred provider plan (PPO) and to examine switching and market segmentation after initial selection...
  2. pmc Early experience with employee choice of consumer-directed health plans and satisfaction with enrollment
    Jinnet Briggs Fowles
    Park Nicollet Institute, 3800 Park Nicollet Boulevard, Minneapolis, MN 55416, USA
    Health Serv Res 39:1141-58. 2004
    ..To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees...
  3. ncbi The decline in bulk-billing and increase in out-of-pocket costs for general practice consultations in rural areas of Australia, 1995-2001
    Anne F Young
    Research Centre for Gender and Health, University of Newcastle, Callaghan, NSW, Australia
    Med J Aust 178:122-6. 2003
    ..To describe the changes in bulk-billing and out-of-pocket costs for Australian general practice consultations over the period 1995-2001...
  4. pmc Consumer awareness and strategies among families with high-deductible health plans
    Tracy A Lieu
    Center for Child Health Care Studies, 133 Brookline Ave, 6th Floor, Boston, MA, USA
    J Gen Intern Med 25:249-54. 2010
    ....
  5. pmc Health care use and decision making among lower-income families in high-deductible health plans
    Jeffrey T Kullgren
    VA Medical Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, 19104 6021, USA
    Arch Intern Med 170:1918-25. 2010
    ..Lower-income families may face unique challenges in high-deductible health plans (HDHPs)...
  6. pmc Perspectives from deductible plan enrollees: plan knowledge and anticipated care-seeking changes
    Mary Reed
    Division of Research, Center for Health Policy Studies, Oakland, California 94612, USA
    BMC Health Serv Res 9:244. 2009
    ..We examined knowledge of deductible plan details among new enrollees, as well as anticipated care-seeking changes in response to the deductible...
  7. ncbi Do high-deductible health plans threaten quality of care?
    Thomas H Lee
    Partners HealthCare System, Boston, USA
    N Engl J Med 353:1202-4. 2005
  8. ncbi Health benefits in 2007: premium increases fall to an eight-year low, while offer rates and enrollment remain stable
    Gary Claxton
    Health Care Marketplace Project, Henry J Kaiser Family Foundation KFF, Washington, DC, USA
    Health Aff (Millwood) 26:1407-16. 2007
    ..Despite the comparatively modest increase in premiums during a period of strong economic growth, the percentage of workers obtaining coverage from their employer remained statistically unchanged...
  9. ncbi Emergency department use and subsequent hospitalizations among members of a high-deductible health plan
    J Frank Wharam
    Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Mass 02215, USA
    JAMA 297:1093-102. 2007
    ..High-deductible health plans have been promoted as a means of reducing overutilization but could also be related to worse outcomes if patients defer necessary care...
  10. ncbi Consumer-directed health care
    M Gregg Bloche
    Georgetown University, Washington, DC, USA
    N Engl J Med 355:1756-9. 2006
  11. pmc Consumer directed healthcare: except for the healthy and wealthy it's unwise
    Steffie Woolhandler
    The Department of Medicine, Cambridge Hospital, Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, USA
    J Gen Intern Med 22:879-81. 2007
    ..They offer little hope of slowing the growth of health care costs and add further bureaucratic costs and complexity to our health care financing system...
  12. ncbi Deductibles and health care expenditures: empirical estimates of price sensitivity based on administrative data
    René C J A van Vliet
    Institute of Health Policy and Management iBMG, Erasmus University Rotterdam, P O Box 1738, 3000 DR Rotterdam, The Netherlands
    Int J Health Care Finance Econ 4:283-305. 2004
    ..To estimate the price sensitivity of demand for health care by analysing the relation between deductibles and expenditures found in an administrative database...
  13. ncbi Driven to distress. Medical groups fret over expected billing challenges as more companies steer employees to consumer-driven health plants
    Michael Romano
    Mod Healthc 36:28-30. 2006
  14. pmc Consumer experiences in a consumer-driven health plan
    Jon B Christianson
    Carlson School of Management, Department of Healthcare Management, University of Minnesota, 321 19th Avenue South, Suite 3 149, Minneapolis, MN 55455, USA
    Health Serv Res 39:1123-40. 2004
    ..To assess the experience of enrollees in a consumer-driven health plan (CDHP)...
  15. pmc Commentary--Defined contribution health plans: attracting the healthy and well-off
    Gail Shearer
    Health Policy Analysis, Consumers Union, Washington Office, 1066 Connecticut Avenue NW, Suite 310, Washington, DC 20009, USA
    Health Serv Res 39:1159-66. 2004
  16. pmc Evaluation of the effect of a consumer-driven health plan on medical care expenditures and utilization
    Stephen T Parente
    Carlson School of Management, Department of Healthcare Management, University of Minnesota, 321 19th Avenue South, Suite 3 149, Minneapolis, MN 55455, USA
    Health Serv Res 39:1189-210. 2004
    ..To compare medical care costs and utilization in a consumer-driven health plan (CDHP) to other health insurance plans...
  17. pmc Commentary--Current MSA theory: well-meaning but futile
    George C Halvorson
    Kaiser Foundation Health Care, Inc
    Health Serv Res 39:1119-22. 2004
  18. pmc Employee choice of consumer-driven health insurance in a multiplan, multiproduct setting
    Stephen T Parente
    Carlson School of Management, Department of Healthcare Management, University of Minnesota, 321 19th Avenue South, Suite 3 149, Minneapolis, MN 55455, USA
    Health Serv Res 39:1091-112. 2004
    ..To determine who chooses a Consumer-Driven Health Plan (CDHP) in a multiplan, multiproduct setting, and, specifically, whether the CDHP attracts the sicker employees in a company's risk pool...
  19. pmc Tales from the new frontier: pioneers' experiences with consumer-driven health care
    Anthony T Lo Sasso
    Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA
    Health Serv Res 39:1071-90. 2004
    ..To conduct site visits to study the early experiences of firms offering consumer-driven health care (CDHC) plans to their employees and firms that provide CDHC products...
  20. ncbi "Consumer-driven" coverage: future or fad?
    Chip Kahn
    Hosp Outlook 6:10. 2003
  21. ncbi 3-tier drug benefit designs based on sound drug formulary principles will maximize favorable outcomes
    Frederic R Curtiss
    J Manag Care Pharm 10:83-4, 86. 2004
  22. ncbi Beyond the myths: finding benefit design solutions that address the true costs of high healthcare use
    Vincent J Willey
    HealthCore, Wilmington, Delaware, USA
    Am J Manag Care 14:S252-63. 2008
    ..Achieving savings in direct and indirect costs will require more than shifting coverage, which can lead to nonadherence and increase costs elsewhere...
  23. ncbi Cost cure-all? Or unhealthy shift?
    Kim Clark
    US News World Rep 135:38-9. 2003
  24. ncbi Pharmacy benefit starts to reflect push for consumer-directed care
    Tony Berberabe
    Manag Care 12:29-32. 2003
  25. ncbi Consumer-directed health care: too good to be true?
    MargaretAnn Cross
    Manag Care 12:18-25. 2003
  26. pmc Commentary--Looking at the effects of consumer-centric health plans on expenditures and utilization
    John Bertko
    Humana Inc, 500 W Main Street, Louisville, KY 40202, USA
    Health Serv Res 39:1211-8. 2004
  27. pmc Impact of multitiered copayments on the use and cost of prescription drugs among Medicare beneficiaries
    Boyd H Gilman
    Mathematica Policy Research Inc, 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, USA
    Health Serv Res 43:478-95. 2008
    ..To assess the impact of multitiered copayments on the cost and use of prescription drugs among Medicare beneficiaries...
  28. ncbi Coordinated care in a 'consumer-driven' health system
    Jill Mathews Yegian
    California HealthCare Foundation, Oakland, USA
    Health Aff (Millwood) 25:w531-6. 2006
    ....
  29. ncbi Consumer-directed health care: early evidence about effects on cost and quality
    Melinda Beeuwkes Buntin
    RAND, Arlington, Virginia, USA
    Health Aff (Millwood) 25:w516-30. 2006
    ..The early effects of CDHC on quality are mixed, with evidence of both appropriate and inappropriate changes in care use. Greater information about prices, quality, and treatment choices will be critical if CDHC is to achieve its goals...
  30. ncbi Consumer-driven health care. Why it won't solve what ails the United States health system
    Sara R Collins
    Commonwealth Fund, New York, NY 10021, USA
    J Leg Med 28:53-77. 2007
  31. pmc Value-based insurance design: a "clinically sensitive, fiscally responsible" approach to mitigate the adverse clinical effects of high-deductible consumer-directed health plans
    A Mark Fendrick
    J Gen Intern Med 22:890-1. 2007
  32. ncbi Consumer response to dual incentives under multitiered prescription drug formularies
    Boyd H Gilman
    Mathematica Policy Research, Inc, Cambridge, MA 02139, USA
    Am J Manag Care 13:353-9. 2007
    ....
  33. ncbi The case against excessive cost sharing
    Diana I Brixner
    University of Utah College of Pharmacy, Salt Lake City, UT 84108, USA
    Am J Manag Care 12:S162-4; discussion S167-72; quiz S173-6. 2006
  34. ncbi Weighing the risks of consumer-driven health plans for families
    Margaret A McManus
    American Academy of Pediatrics, Elk Grove Village, Illinois, USA
    Pediatrics 117:1420-4. 2006
  35. ncbi The relationship between older adults' knowledge of their drug coverage and medication cost problems
    John D Piette
    Department of Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan 48113, USA
    J Am Geriatr Soc 54:91-6. 2006
    ..To determine whether chronically ill patients have gaps in knowledge about their prescription drug coverage and establish the relationship between gaps and medication cost problems...
  36. ncbi Varying pharmacy benefits with clinical status: the case of cholesterol-lowering therapy
    Dana P Goldman
    RAND Corporation, Santa Monica, CA 90407 2138, USA
    Am J Manag Care 12:21-8. 2006
    ..To determine whether a pharmacy benefit that varies copayments for cholesterol-lowering (CL) therapy according to expected therapeutic benefit would improve compliance and reduce use of other services...
  37. ncbi Out-of-pocket pharmacy expenditures for veterans under medicare part D
    Randall W Rupper
    VA Salt Lake City Geriatrics Research, Education, and Clinical Center, Salt Lake City, Utah, USA
    Med Care 45:S77-80. 2007
    ..We sought to determine how these programs' different benefit structures and low-income assistance thresholds would affect pharmacy out-of-pocket expenses for veterans...
  38. ncbi Traditional plans preferred: poll
    Laura B Benko
    Mod Healthc 35:18. 2005
  39. ncbi Health savings accounts--the ownership society in health care
    James C Robinson
    Division of Health Policy and Management at the University of California, Berkeley, School of Public Health, USA
    N Engl J Med 353:1199-202. 2005
  40. ncbi Consumer-directed health care: it's not whether the glass is half-empty, but why
    Murray N Ross
    Kaiser Permanente Institute for Health Policy, Oakland, California, USA
    Health Aff (Millwood) 25:w552-4. 2006
    ..In a world where employers are seeking any port in a storm of unsustainable cost growth, it might be more useful to compare offering a consumer-directed plan to other options that employers could have chosen in constraining health costs...
  41. ncbi Tame your health insurance costs
    Ken Terry
    Med Econ 82:35-8, 40. 2005
  42. ncbi The undercovered class
    Matthew Weinstock
    Hosp Health Netw 81:32-6, 38, 1. 2007
    ..Soaring deductibles and gaping holes in coverage mean huge out-of-pocket expenses. When patients can't pay, providers are stuck. Now, some hospitals are helping patients understand up front just what their insurance covers...
  43. ncbi Many Americans dislike consumer-directed health coverage
    Kate Traynor
    Am J Health Syst Pharm 64:129-30. 2007
  44. ncbi Health benefits in 2003: premiums reach thirteen-year high as employers adopt new forms of cost sharing
    Jon Gabel
    Health Systems Studies, Health Research and Educational Trust, Washington, D C, USA
    Health Aff (Millwood) 22:117-26. 2003
    ..There was no change in the percentage of employers offering health plans to their workers. Employers indicate little confidence in any future strategies for controlling health care costs...
  45. ncbi Defined-contribution products and their influence on pharmacy benefit management
    Diane Giaquinta
    Manag Care Interface 16:36-8. 2003
  46. ncbi Control of prescription costs--is it possible?
    Patrick N Renaud
    Empl Benefits J 27:11-4. 2002
    ..The author considers two choices for controlling the cost of prescription drugs: Return the prescription drug program to the TPA, or implement plan design changes. Making changes to the buying habits of the public is key...
  47. ncbi Self-insurance in times of growing and retreating managed care
    Jon R Gabel
    Health System Studies, Health Research and Educational Trust HRET, Washington, DC, USA
    Health Aff (Millwood) 22:202-10. 2003
    ..Cost sharing is somewhat lower in self-insured PPO plans. During periods of rapid inflation, premiums increase more slowly for self-insured than for fully insured plans...
  48. ncbi The tough decisions that no one wants to make
    Joe Taylor
    Mercer Human Resource Consulting, Dallas, USA
    Benefits Q 19:19-29. 2003
    ....
  49. ncbi Employer-sponsored health insurance: pressing problems, incremental changes
    Sally Trude
    Center for Studying Health System Change, Washington, DC, USA
    Health Aff (Millwood) 21:66-75. 2002
    ..While dramatic changes in health benefits are unlikely in the short term, policymakers may want to watch for future erosions in health coverage...
  50. ncbi Employer-sponsored insurance: how much financial protection does it provide?
    Jon R Gabel
    Health Research and Education Trust, USA
    Med Care Res Rev 59:440-54. 2002
    ..Individuals who incur high costs pay a smaller share of the bill than do those with lower levels of spending. The generosity of employer-sponsored plans increased slightly in the 1990s...
  51. ncbi The state of consumer-centric care
    Clive Riddle
    MCOL, Modesto, California, USA
    Manag Care Interface 15:20-4. 2002
    ..Health plans are today faced with the challenge of rethinking their offerings--or even their basic program approach--to address this burgeoning trend...
  52. ncbi What's the fallout if patients pay? "Self-directed" health insurance plans mean patients have more choice than ever. Will they still choose you?
    Ken Terry
    Med Econ 80:32-4, 39-40. 2003
  53. ncbi The breaking point
    David Stires
    Fortune 147:104-6, 108, 110 passim. 2003
  54. ncbi Responding to consumer demand for choice, flexibility
    Mary Brainerd
    Healthplan 43:13-7. 2002
  55. ncbi "Build it and they will come?"
    Diane Giaquinta
    Manag Care Interface 15:44-5, 47. 2002
  56. ncbi Workers' decisions to take-up offered health insurance coverage: assessing the importance of out-of-pocket premium costs
    Philip F Cooper
    Center for Cost and Financing Studies, Agency for Healthcare Research and Quality, Rockville, MD 20852, USA
    Med Care 41:III35-III43. 2003
    ....
  57. ncbi Consumer driven healthcare and the birth of health reimbursement arrangements
    Randall K Abbott
    Manag Care Q 10:4-7. 2002
    ..Communication, education, and the use of Web-enabled technology are critical elements of this process...
  58. ncbi Health care costs of adults treated for attention-deficit/hyperactivity disorder who received alternative drug therapies
    Eric Q Wu
    Analysis Group, Inc, Boston, MA 02199, USA
    J Manag Care Pharm 13:561-9. 2007
    ....
  59. ncbi Relationship of the use and costs of physician office visits and prescription drugs to travel distance and increases in member cost share
    William T Cecil
    Health Policy Research, BlueCross BlueShield of Tennessee, 801 Pine St, 1E, Chattanooga, TN 37402, USA
    J Manag Care Pharm 12:665-76. 2006
    ..The prescription drug benefit is commonly designed and managed as a stand-alone health insurance product without consideration of how the design of other medical benefits may impact its use...
  60. ncbi Demand response of mental health services to cost sharing under managed care
    Chunling Lu
    Harvard Global Health Initiative, 104 Mt Auburn Street, Cambridge, MA 02138, USA
    J Ment Health Policy Econ 11:113-25. 2008
    ..The economics of parity under managed care needs to be under re-examination...
  61. ncbi Administrative claims analysis of the relationship between warfarin use and risk of hemorrhage including drug-drug and drug-disease interactions
    Kui Zhang
    Department of Research and Development, CaremarkRX, Hunt Valley, MD 21031, USA
    J Manag Care Pharm 12:640-8. 2006
    ..Warfarin is used most commonly for irregular heartbeat, after a heart attack, and after joint or heart valve replacement surgery...
  62. ncbi Neutropenia-related costs in patients treated with first-line chemotherapy for advanced non-small cell lung cancer
    Michael E Stokes
    United BioSource Corporation, 185 Dorval Ave, Ste 500, Dorval, QC, H9S 5J9, Canada
    J Manag Care Pharm 15:669-82. 2009
    ..Neutropenia-related complications often lead to increased use of costly health care including inpatient and outpatient services. Monitoring and treatment of neutropenia thus place an economic burden on the health care system...
  63. ncbi Trends in the prescription drug plans delivering the Medicare Part D prescription drug benefit
    Joel V Brill
    Predictive Health, LLC, Phoenix, AZ 85016, USA
    Am J Health Syst Pharm 64:S3-6; quiz S21-S23. 2007
    ....
  64. ncbi Rural-urban differences in health care benefits of a community-based sample of at-risk drinkers
    John C Fortney
    VA HSR and D Center for Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, USA
    J Rural Health 19:292-8. 2003
    ..Different types of health plan cost-containment strategies (eg, gatekeeping, selective contracting, and cost-sharing) may affect the utilization of behavioral health services differently in urban and rural areas...
  65. ncbi Costs of care associated with non-small-cell lung cancer in a commercially insured cohort
    B E Hillner
    Department of Internal Medicine, Medical College of Virginia and Massey Cancer Center, Virginia Commonwealth University, Richmond 23298 0170, USA
    J Clin Oncol 16:1420-4. 1998
    ..To examine the cost of incident cases of non-small-cell lung cancer (NSCLC) in a commercially insured cohort...
  66. ncbi Physician consideration of patients' out-of-pocket costs in making common clinical decisions
    Hoangmai H Pham
    Center for Studying Health System Change, 600 Maryland Avenue SW, Washington, DC 20024, USA
    Arch Intern Med 167:663-8. 2007
    ..Patients face growing cost-sharing through higher deductibles and other out-of-pocket (OP) expenses, with uncertain effects on clinical decision making...
  67. ncbi Differences between physical and behavioral health benefits in the health plans of at-risk drinkers
    John C Fortney
    Department of Veterans Affairs Health Services Research and Development Center for Healthcare and Outcomes Research, Little Rock, Arkansas, USA
    Psychiatr Serv 54:97-102. 2003
    ..The goal of this study was to describe the physical and behavioral health benefits of a representative community-based sample of at-risk drinkers potentially in need of behavioral health services...
  68. pmc The impact of cost sharing on antidepressant use among older adults in British Columbia
    Philip S Wang
    National Institute of Mental Health, Bethesda, MD 20892 9629, USA
    Psychiatr Serv 59:377-83. 2008
    ....
  69. ncbi Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from Quebec, Canada
    Paul Contoyannis
    Centre for Health Economics and Policy Analysis, McMaster University, Canada
    Health Econ 14:909-23. 2005
    ..Our preferred specification leads to expenditure elasticities that are in the low range of previous estimates (between -0.12 and -0.16). Naïve OLS estimates are between 1 and 4 times these magnitudes...
  70. pmc Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries
    Niteesh K Choudhry
    Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02120, USA
    Circulation 117:1261-8. 2008
    ....
  71. ncbi Effect of premium, copayments, and health status on the choice of health plans
    James M Naessens
    Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55902, USA
    Med Care 46:1033-40. 2008
    ..Explore effects of comorbidity and prior health care utilization on choice of employee health plans with different levels of cost sharing...
  72. ncbi 2007 costs and coverage of antiretrovirals under Medicare Part D for people with HIV/AIDS living in North Carolina
    Sohini Sengupta
    Department of Social Medicine, University of North Carolina at Chapel Hill, MacNider Hall, CB 7240, Chapel Hill, NC 27599 7240, USA
    N C Med J 69:6-13. 2008
    ..This analysis examines Medicare Part D antiretroviral coverage in 2007 for beneficiaries with HIV/AIDS in North Carolina, particularly those who did not qualify as dual eligibles or for a full low-income subsidy...
  73. pmc Reference drug programs: effectiveness and policy implications
    Sebastian Schneeweiss
    Harvard Medical School, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
    Health Policy 81:17-28. 2007
    ..This paper summarizes the mechanism and rationale of RDPs, presents evidence of their economic effectiveness and clinical safety, and concludes with some practical implications of implementing RDP policies...
  74. pmc Coverage of atypical antipsychotics among medicare drug plans in the state of washington: changes between 2007 and 2008
    Meng Yun Wu
    Department of Health Policy and Administration and Department of Pharmacotherapy, College of Pharmacy, Washington State University, Spokane Washington Institute for Mental Illness Research and Training, Spokane and Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
    Prim Care Companion J Clin Psychiatry 11:316-21. 2009
    ..To examine changes in the cost and coverage of atypical antipsychotics among Medicare prescription drug plans and Medicare advantage plans in the state of Washington...
  75. pmc Microdialysis assessment of peripheral metabolism in critical limb ischemia after endovascular revascularization
    Matteo Tozzi
    Vascular Surgery Department of Surgical Sciences, University of Insubria, Varese University Hospital, Varese, Italy
    Ann Surg Innov Res 3:17. 2009
    ..CONCLUSIONS: Restoration of glucose and glycerol circadian rhythm, coupled with low lactate concentration and lactate/pyruvate ratio seemed to be linked to good surgical outcome...
  76. pmc Complex home care: Part 2- family annual income, insurance premium, and out-of-pocket expenses
    Ubolrat Piamjariyakul
    University of Kansas School of Nursing, School of Nursing Building, Kansas City, KS, USA
    Nurs Econ 28:323-9. 2010
    ..Any changes that may increase the out-of-pocket costs or health insurance costs to these families can also have a negative long-term impact on society when greater numbers of patients declare bankruptcy or qualify for medical disability...
  77. ncbi Nearly half of families in high-deductible health plans whose members have chronic conditions face substantial financial burden
    Alison A Galbraith
    Center for Child Health Care Studies, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
    Health Aff (Millwood) 30:322-31. 2011
    ..As health reform efforts advance, policy makers must consider how to modify high-deductible plans to reduce the financial burden for families with chronic conditions...
  78. ncbi Publicly funded medical savings accounts: expenditure and distributional impacts in Ontario, Canada
    Jeremiah Hurley
    Department of Economics, McMaster University, Hamilton, Ont, Canada
    Health Econ 17:1129-51. 2008
    ..MSAs, however, are also predicted to have unavoidable negative distributional consequences with respect to both public expenditures and out-of-pocket spending...
  79. pmc Small group health insurance reform in Rhode Island: promises and pitfalls of the HEALTHpact plan
    Edward Alan Miller
    Department of Gerontology, John W McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, MA 02125, USA
    Health Serv Res 46:285-97. 2011
    ..This study analyzes what design elements inhibited enrollment in HEALTHpact...
  80. ncbi Medicare Part D in 2008: rising prices and growing confusion
    Paul J Flaer
    Robert Stempel School of Public Health, Florida International University, USA
    J Health Care Finance 34:89-92. 2008
    ..Return to the public hospital pharmacy system from the neighborhood pharmacy and Medicare Part D plan can mean significant savings to low-income or indigent patients...
  81. ncbi Ready for prime time? Make your financial assistance policy a class act
    Dennis Barry
    Vinson an Elkins, LLP, Washington, DC, USA
    Healthc Financ Manage 59:48-55. 2005
    ..The best course for hospitals is to have clearly defined financial assistance policies in place that reflect an awareness of all the related potential legal and regulatory concerns...
  82. pmc The mission of safety net organizations following national insurance reform
    Mark A Hall
    Center for Bioethics, Health and Society, Wake Forest University, Winston Salem, NC 27157 1063, USA
    J Gen Intern Med 26:802-5. 2011
    ....
  83. ncbi Trends in home phototherapy adoption in the US: monetary disincentives are only the tip of the iceberg
    Brad A Yentzer
    Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, North Carolina 27157 1071, USA
    J Dermatolog Treat 22:27-30. 2011
    ..It is likely that even more patients are never prescribed a home unit due to lack of physician training or frustration with meager and often inadequate reimbursements from insurance...
  84. ncbi Health benefits in 2010: premiums rise modestly, workers pay more toward coverage
    Gary Claxton
    Health Care Marketplace Project, Kaiser Family Foundation, Washington, DC, USA
    Health Aff (Millwood) 29:1942-50. 2010
    ..The change was largely driven by a thirteen-percentage-point increase in the number of firms with three to nine workers that offered benefits (up from 46 percent in 2009 to 59 percent in 2010). The reason for this increase is unclear...
  85. ncbi What does the Medicare prescription drug legislation mean for the American cardiologist?
    Janice B Schwartz
    Jewish Home of San Francisco and the Division of Clinical Pharmacology, University of California, San Francisco, CA 94112, USA
    Am J Geriatr Cardiol 14:317-24. 2005
    ..This article details the background, benefits, and expected impact of all of these aspects of the new Medicare Part D prescription drug benefit...
  86. ncbi Liability, insurance and medical practice
    Paul Fenn
    Nottingham University Business School, Jubilee Campus, Nottingham, UK
    J Health Econ 26:1057-70. 2007
    ..These results are consistent with hospitals reacting to the incentives provided by a clinical negligence compensation system...
  87. ncbi Reducing patient financial liability for hospitalizations: the physician role
    Edward A Ross
    Division of Nephrology, Hypertension, and Transplantation, University of Florida, Gainesville, Florida 32610 0224, USA
    J Hosp Med 5:160-2. 2010
    ..By participating in case management activities, physicians can have an important patient advocate role, and thereby minimize the financial burden to these individuals and their families...
  88. ncbi Redistributive effects in public health care financing
    Ivonne Honekamp
    Empirical Microeconomics, University of Bamberg, Feldkirchenstr 21, 96045 Bamberg, Germany
    Eur J Health Econ 9:405-16. 2008
    ..We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing...
  89. ncbi Alternative liability insurance: are you ready for a captive?
    Barry D Pressman
    S Mark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
    J Am Coll Radiol 3:194-9. 2006
    ..The authors discuss using deductibles, self-insured retentions, and the development of one's own insurance company, that is, a captive...
  90. pmc Cancer insurance policies in Japan and the United States
    C L Bennett
    Health Services Research and Development Division, Lakeside Veterans Affairs VA Medical Center, Chicago, IL, USA
    West J Med 168:17-22. 1998
    ..Understanding the factors that led to the success of cancer insurance in Japan may assist policymakers in evaluating cancer insurance policies as they become more prevalent in the United States...
  91. pmc Empirical models of demand for out-patient physician services and their relevance to the assessment of patient payment policies: a critical review of the literature
    Olga Skriabikova
    Department of Health Organization, Policy and Economics, Caphri, Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
    Int J Environ Res Public Health 7:2708-25. 2010
    ..Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes...
  92. ncbi What do health savings accounts mean for the emergency department?
    K John McConnell
    Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, USA
    Ann Emerg Med 46:536-40. 2005
    ..We note areas that emergency physicians should monitor as health savings accounts become more prominent...
  93. ncbi Optimal deductibles for outpatient services
    Karl Michael Ortmann
    Beuth Hochschule für Technik Berlin, University of Applied Sciences, Luxemburger Strasse 10, Berlin, Germany
    Eur J Health Econ 12:39-47. 2011
    ..Similarities and discrepancies with respect to results obtained in the RAND Health Insurance Experiment conducted in the United States from 1971 to 1982 are highlighted...
  94. ncbi Moral hazard and consumer-driven health care: a fundamentally flawed concept
    John P Geyman
    Department of Family Medicine, University of Washington School of Medicine, Seattle 98195, USA
    Int J Health Serv 37:333-51. 2007
    ..A case is made to reject moral hazard as an organizing rationale for health care, and the author offers some alternative approaches...
  95. ncbi Premium growth and its effect on employer-sponsored insurance
    Jessica Vistnes
    Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA
    Int J Health Care Finance Econ 11:55-81. 2011
    ..They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures...
  96. ncbi Children in need of Pharmacare: medication funding requests at the Toronto Hospital for Sick Children
    Wendy J Ungar
    Division of Population Health Sciences, Hospital for Sick Children, Toronto, ON
    Can J Public Health 94:121-6. 2003
    ....
  97. ncbi Mental health parity legislation
    Arlene Smaldone
    Columbia University School of Nursing, Mail Code 6, 630 West 168th Street, New York, NY 10032, USA
    J Psychosoc Nurs Ment Health Serv 48:26-34. 2010
    ....
  98. ncbi Using matched survey and administrative data to estimate eligibility for the Medicare Part D low-income subsidy program
    Erik Meijer
    RAND Corporation, Santa Monica, USA
    Soc Secur Bull 70:63-82. 2010
    ..A sensitivity analysis indicates that the use of administrative data has a relatively small effect on the estimates, but does suggest that measurement error is important to account for...
  99. ncbi Implementation of a consumer-directed approach in behavioral health care: problems and prospects
    Richard A LaBrie
    Harvard Medical School, Division on Addictions, Cambridge Health Alliance, 10 Presidents Landing, Medford, MA 12155, USA
    Psychiatr Serv 58:300-2. 2007
    ..This column describes important components of consumer-directed care and the unique barriers that behavioral health care creates for those components. Possible best practices are suggested for surmounting those barriers...
  100. ncbi High-deductible health insurance plans: efforts to sharpen a blunt instrument
    Mary Reed
    Division of Research, Kaiser Permanente, Oakland, California, USA
    Health Aff (Millwood) 28:1145-54. 2009
    ..Consumers need more information and decision support to understand their benefits and to differentiate when care is necessary, discretionary, or unnecessary...
  101. ncbi Estimating the cost of cancer: results on the basis of claims data analyses for cancer patients diagnosed with seven types of cancer during 1999 to 2000
    Stella Chang
    Medstat Inc, Washington, DC 20008, USA
    J Clin Oncol 22:3524-30. 2004
    ..We derive estimates of the costs of cancer using administrative databases, which include claims and employment-related information on individuals insured by private or Medicare supplemental health plans...

Research Grants44

  1. The Science of Medicare Reform
    DANA P contact GOLDMAN; Fiscal Year: 2010
    ....
  2. Parity, child mental health, and substance abuse
    ELLEN R MEARA; Fiscal Year: 2010
    ..abstract_text> ..
  3. Clinical and Social Implications of Cost Sharing for Cancer Drugs
    Yu Ning Wong; Fiscal Year: 2012
    ..Our results may suggest consideration of a novel benefit design that encourages patients to make decisions based on relative value, rather than cost alone. ..
  4. Implementation of Federal Mental Health Parity
    Colleen L Barry; Fiscal Year: 2013
    ..Findings from this study could provide valuable information on the potential effects of extending federal parity to this population. ..
  5. COST CONTAINMENT & GROUP HEALTH INSURANCE BENEFIT GROWTH
    Douglas Coate; Fiscal Year: 1993
    ..In addition, they contain data on the illness risk of each firm's insured employees...
  6. Modeling Adherence to Psychotherapy for Depression
    Gregory Simon; Fiscal Year: 2009
    ..The proposed research is one component of an ongoing comprehensive program to understand and increase consumer demand for effective depression treatment. ..
  7. Effects of income-based drug charges on older Patients
    Sebastian Schneeweiss; Fiscal Year: 2006
    ..abstract_text> ..
  8. Remibursement Limits, Antidepressants, and Outcomes
    Philip Wang; Fiscal Year: 2005
    ..We will also use other national and international forums to inform ongoing debates over drug coverage for vulnerable elderly patients with depression. ..
  9. UNCOMPENSATED CARE FUNDS: THE SOLUTION FOR INDIGENT CARE
    Kimberly Rask; Fiscal Year: 1990
    ..The impact of reimbursement funds on medical care utilization and the substitution of hospital-based services for non-hospital-based services will be examined using Tobit analysis...
  10. Remibursement Limits, Antidepressants, and Outcomes
    Sebastian Schneeweiss; Fiscal Year: 2007
    ..We will also use other national and international forums to inform ongoing debates over drug coverage for vulnerable elderly patients with depression. ..
  11. COSTS OF DRUG TREATMENT UNDER PRIVATE INSURANCE
    Roland Sturm; Fiscal Year: 2000
    ..Particular attention will be paid to differences between employed policyholders, their adult dependents, and their child dependents. ..
  12. MANAGED CARE AND ACCESS TO ALCOHOL TREATMENT SERVICES
    John Fortney; Fiscal Year: 2000
    ....
  13. Consumer Directed Health Plans and Use of Preventive Services
    Neeraj Sood; Fiscal Year: 2013
    ..3) Examine the effects of CHDPs on price shopping for preventive services including services with and without first dollar coverage. ..
  14. ECONOMICS OF CANCER
    Mark McClellan; Fiscal Year: 2000
    ....
  15. Using MEPS Data to Inform Public-Plan Consumerism
    Matthew Davis; Fiscal Year: 2007
    ..Findings will have immediate relevance for implementation of the HOA projects and other consumerism efforts. [unreadable] [unreadable] [unreadable]..
  16. DEMAND FOR ALCOHOL TREATMENT SERVICES
    JAYANTA BHATTACHARYRA; Fiscal Year: 2001
    ..For example, using our framework, we will be able to accurately estimate the costs of parity legislation for alcoholism treatment. ..
  17. Competitive Continuation of Insurance Financing of Integrative Medicine
    Paula Diehr; Fiscal Year: 2007
    ..Since the United States is the world's number one consumer of medical care, this study on the addition of new CAM benefits and the consequences is important. [unreadable] [unreadable]..
  18. Telemedicine-Based Collaborative Care to Reduce Rural Health Disparities
    John C Fortney; Fiscal Year: 2010
    ..This population is at high risk for experiencing health disparities and thus, interventions targeting this population have the potential to have a major impact. ..
  19. Effectiveness of patient lift equipment
    Hester Lipscomb; Fiscal Year: 2008
    ..The proposed work addresses several NIOSH priority areas including health care workers, back injuries, and intervention effectiveness research. ..
  20. A Comprehensive Database of Cost-Effectiveness Analyses
    Peter Neumann; Fiscal Year: 2003
    ..The web-based data should also understand the needs of different scientists to be understood and policymakers, and bridges to be built across disparate communities. ..
  21. Assessing Medical Need Among Children in Managed Care
    Paul Fishman; Fiscal Year: 2003
    ..Pediatric risk assessment research has also not explored opportunities to use all information available in managed care information systems. ..
  22. Vulnerable Populations and Special Protections in ACTUs
    Sohini Sengupta; Fiscal Year: 2007
    ..abstract_text> ..
  23. Oregon's Parity Law: Comprehensive Parity in Today's Healthcare Environment
    KENNETH MCCONNELL; Fiscal Year: 2009
    ..Our proposed research will provide insight about the tradeoffs between expanding coverage for mental health and substance abuse disorders and the total cost of care. ..
  24. Evaluation of Enteral Stent Placement Using Claims Data
    Sujha Subramanian; Fiscal Year: 2004
    ..abstract_text> ..
  25. Do Free Glucose Test Strips Increase Self-Monitoring?
    Andrew Karter; Fiscal Year: 2003
    ..Proposal strengths also include a longitudinal design, substantial statistical power, low cost data acquisition, and an ethnically diverse population with uniform access to care. ..
  26. WORK AND HEALTH DISPARITIES AMONG RURAL WOMEN
    Hester Lipscomb; Fiscal Year: 2004
    ..Education will also be targeted to medical providers in this geographic area on work exposures and conditions, exposure response, prevention, basic epidemiology, and ergonomics. ..
  27. Workplace Mental Health Benefits & Selective Contracting
    Anthony Losasso; Fiscal Year: 2002
    ..Our study will offer lessons from which other purchasers, including the federal government, may learn. ..
  28. SELECTION BIAS BY MEDICARE BENEFICIARIES WITH DIABETES
    Matthew Maciejewski; Fiscal Year: 2002
    ..Analyses will be conducted on a cohort of beneficiaries with diabetes in thc fee-for-service sector in 1992-1993, so results are not generalizable to people with diabetes who enrolled in Medicare HMOs prior to 1994...
  29. Long Term Cost and Outcomes of Breast Cancer Screening
    Paul Fishman; Fiscal Year: 2006
    ..The results of our study will help guide researchers and policy makers in planning and implementing brief interventions for a wide range of health behaviors. ..
  30. The Safety Net, Medicaid, and Child Health Outcomes
    Anthony Losasso; Fiscal Year: 2009
    ..A final area of study will examine how the relationship between the health care safety net and children's health outcomes differs by race and ethnicity. ..
  31. Cancer in Older Minority Populations
    Alfred Neugut; Fiscal Year: 2003
    ..Coordination of this P20 will be facilitated by the geographic proximity of the two institutions, their scientific strengths, and their commitment to similar programs. ..
  32. Health and Health Services Use in the HRS/AHEAD
    FREDRIC WOLINSKY; Fiscal Year: 2008
    ..Linear and non-linear regression and random effects models will also be used where appropriate. [unreadable] [unreadable]..
  33. COLORECTAL CANCER AND OTHER CANCERS OF THE GI TRACT
    Alfred Neugut; Fiscal Year: 2005
    ..abstract_text> ..
  34. Back Disorders in Union Carpenters
    Hester Lipscomb; Fiscal Year: 2006
    ..The project addresses a number of areas of expressed interest to NIOSH including construction workers, back disorders, surveillance methods and health services research. [unreadable] [unreadable]..
  35. Adverse Outcomes of Dual Use of Health Systems Among Older Male Veterans
    FREDRIC WOLINSKY; Fiscal Year: 2006
    ..unreadable] [unreadable] [unreadable] [unreadable]..
  36. IDENTIFICATION OF CLINICALLY RELEVANT CHANGES IN HRQOL
    FREDRIC WOLINSKY; Fiscal Year: 2002
    ..abstract_text> ..
  37. Continuity of Care and Health Outcomes: Does It Really Matter?
    FREDRIC WOLINSKY; Fiscal Year: 2008
    ..unreadable] [unreadable] [unreadable] [unreadable] [unreadable]..
  38. Financial Incentives and Variations in the Care of Medicare Beneficiaries
    Bruce E Landon; Fiscal Year: 2010
    ..Because patients will be clustered within physicians and physicians clustered within markets, we will use hierarchical analytic methods. ..
  39. MD Group Characteristics and Quality of Care for CHD
    Bruce Landon; Fiscal Year: 2003
    ..abstract_text> ..
  40. Effect of a Restrictive Formulary on Low Income Children
    JULIE URMIE; Fiscal Year: 2007
    ..Instrumental variable analysis will be used to examine the effect of changes in antidepressant prescribing patterns caused by the restrictive formulary on health care costs. [unreadable] [unreadable] [unreadable] [unreadable]..
  41. Ethnic Disparities in Diabetes Complications
    Andrew Karter; Fiscal Year: 2008
    ..abstract_text> ..
  42. The Spillover Effects of Health Insurance Coverage and Generosity
    Katherine Baicker; Fiscal Year: 2008
    ..unreadable] [unreadable] [unreadable]..
  43. Educational Disparities in Diabetes Complications
    Andrew Karter; Fiscal Year: 2006
    ..abstract_text> ..