Trends: Access To Care In Medicare HMOs, 1996

Nelson, Lyle; Brown, Randall; Gold, Marsha; Ciemnecki, Anne; Docteur, Elizabeth

doi:10.1377/hlthaff.16.2.148

Cited by 56 publications

(33 citation statements)

References 3 publications

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“…These results are consistent with previous research demonstrating that persons with disability report poorer access to needed services 5. However, both primary variables (disability and satisfaction with access) are likely to be have been measured with a fair amount of random misclassification, which would suggest our results have underestimated the association.…”

Section: Discussionsupporting

confidence: 92%

Disability and satisfaction with access to health care

Fouts

Andersen²,

Hagglund³

2000

Journal of Epidemiology &Amp; Community Health

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Section: Discussionsupporting

confidence: 92%

Disability and satisfaction with access to health care

Fouts

Andersen²,

Hagglund³

2000

Journal of Epidemiology &Amp; Community Health

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“…Although the findings in the literature do not warrant final conclusions, sickness funds could encounter strong financial incentives to be unresponsive to the preferences of the chronically ill, and this would be cause for concern. 4 Second, to the extent that some sickness funds attract low-risk consumers, these selection activities result in market segmentation, wherein high-risk patients are left in plans with high premiums and low-risk patients self-select into plans with low premiums. That is, selection may threaten solidarity.…”

Section: Relevance Of Health-based Risk Adjustmentmentioning

confidence: 99%

Health-Adjusted Premium Subsidies In The Netherlands

Ven¹,

Vliet²,

Lamers³

2004

Health Affairs

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ABSTRACT:The Dutch government has decided to proceed with managed competition in health care. In this paper we report on progress made with health-based risk adjustment, a key issue in managed competition. In 2004 both Diagnostic Cost Groups (DCGs) computed from hospital diagnoses only and Pharmacy-based Cost Groups (PCGs) computed from outpatient prescription drugs are used to set the premium subsidies for competing risk-bearing sickness funds. These health-based risk adjusters appear to be effective and complementary. Risk selection is not a major problem in the Netherlands. Despite the progress made, we are still faced with a full research agenda for risk adjustment in the coming years. In 19 8 8 t h e d u tc h g ov e r n m e n t began to implement radical marketoriented reforms in health care. Central government planning was to be replaced by a system of managed (or regulated) competition.1 Competing health insurers were to act as prudent buyers of care on behalf of their members. However, the transformation of a centrally planned health care system into managed competition appeared to be politically, technically, and institutionally complex. Workable competition cannot be introduced overnight. It requires prolonged investments in developing an adequate system of risk adjustment, product classification and quality management, an appropriate consumer information system, and, last but not least, an effective competition policy. None of these preconditions was in place in 1988, which explains the substantial time gap between the adoption of the market-oriented reform plans and their actual implementation.In the past fifteen years, however, successive governments consistently worked to realize these preconditions. Much progress has been made-for example, with respect to competition policy and risk adjustment. In this paper, as a follow-up to our earlier paper, we report on progress toward health-based risk adjustment in the Netherlands in the past decade. First, we discuss some key elements of the Dutch financing system and the rele-

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“…In general, this research indicates that U.S. racial and ethnic minorities are less likely to receive even routine medical procedures and experience a lower quality of health services. [84][85][86][87][88][89] For example, relative to whites, African Americans are less likely to receive appropriate cardiac medication (e.g., thrombolytic therapy, aspirin, and beta blockers) or to undergo coronary artery bypass surgery, even when variations in such factors as insurance status, income, age, comorbid conditions, and symptom expression are taken into account. Individuals may be vulnerable by virtue of their financial circumstances or geographic location.…”

Section: How Can We Best Address the Emergency Carementioning

confidence: 99%

Measuring and Improving Quality in Emergency Medicine

Graff

2002

Academic Emergency Medicine

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The findings are presented of a consensus committee created to address the measuring and improving of quality in emergency medicine. The objective of the committee was to critically evaluate how quality in emergency medicine can be measured and how quality improvement projects can positively affect the care of emergency patients. Medical quality is defined as ''the care health professionals would want to receive if they got sick.'' The literature of quality improvement in emergency medicine is reviewed and analyzed. A summary list of measures of quality is included with four categories: condition-specific diseases, diagnostic syndromes, tasks/procedures, and department efficiency/efficacy. Methods and tools for quantifying these measures are examined as well as their accuracy in assessing quality and adjusting for differences in environment, and patient populations. Successful strategies for changing physician behavior are detailed as well as barriers to change. Examples are given of successful quality improvement efforts. Also examined is how to address the emergency care needs of vulnerable populations such as older persons, women, those without health insurance, and ethnic minorities.

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Trends: Access To Care In Medicare HMOs, 1996

Cited by 56 publications

References 3 publications

Disability and satisfaction with access to health care

Disability and satisfaction with access to health care

Health-Adjusted Premium Subsidies In The Netherlands

Measuring and Improving Quality in Emergency Medicine

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