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Journal Article
Journal of Health Politics, Policy and Law (1 February 1994) 19 (1): 7–26.
Published: 01 February 1994
... link clinical guidelines to reimbursement, will likely prevail. We examine the utilization review programs of Medicare Part B carriers and the carriers' attempts to use clinical guidelines to determine medical necessity for the purpose of payment. We find that because the utilization review programs...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1993) 18 (3): 695–722.
Published: 01 June 1993
... remain as fiscal intermediaries. Doctors and hospitals would continue to work much as they do now. They would prosper from more utilization, few bad debts, and less administrative trouble. The payment and work of doctors would be governed by collective negotiations between the insurance carriers and the...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2002) 27 (1): 5–30.
Published: 01 February 2002
... employers to provide their employees with a choice of health carriers, a fixed-dollar strategy (defined contribution), and quality information to make appropriate choices among carriers, managed competition offers to remedy imperfections in both the consumer and provider sides of the market for health...
Journal Article
Journal of Health Politics, Policy and Law (1 June 1977) 2 (3): 319–334.
Published: 01 June 1977
... commissioner; the anticipated passage of national health insurance; and the increased competition from commercial insurance carriers, specialty health care data and management firms and state governments. In concluding, the question is raised whether society should invest further in the future of Blue Cross, a...
Journal Article
Journal of Health Politics, Policy and Law (1 February 1995) 20 (1): 31–48.
Published: 01 February 1995
...Peter D. Fox; Thomas Rice; Lisa Alecxih Congress enacted legislation in 1990 that dramatically changed the rules for selling supplemental health insurance, or “Medigap” policies, to the elderly. Most notably, policy coverage was standardized. Insurance carriers are allowed to sell only the ten...
Journal Article
Journal of Health Politics, Policy and Law (1 April 2002) 27 (2): 243–260.
Published: 01 April 2002
... to school for protection. Current proposals for preventing school violence include punishing the violence-prone, expulsion for weapon carriers, and creating a culture of nonviolence through various behavioral methods like conflict resolution. None of these proposals address the issue of lethal...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1994) 19 (4): 705–727.
Published: 01 August 1994
...William A. Glaser Insuring a population and managing its money require a comprehensive health care financing system. Many issues must be resolved, particularly the roles of the medical profession and its relationship with organizations of laymen in insurance carriers and in government. The spread...
Journal Article
Journal of Health Politics, Policy and Law (1 October 2014) 39 (5): 1089–1098.
Published: 01 October 2014
... risk profile of Arkansas's health insurance marketplace, the private option will also encourage entry of and competition among private carriers. If it succeeds in keeping insurance premiums below the level they would otherwise be in the marketplace, Arkansas's private option could reduce subsidy costs...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2015) 40 (1): 227–232.
Published: 01 February 2015
... churn in any given year is significant, and they often are significant utilizers of health care services. They could experience disruption in care in several ways: (1) changing carrier; (2) changing provider because of network differences; (3) a disruption in ongoing services, even when the benefit is...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2000) 25 (1): 45–70.
Published: 01 February 2000
... types of individuals. Currently, most state individual health insurance markets are charac- terized by many carriers (indemnity companies and managed care orga- nizations) selling policies. However, these carriers often limit competi- tion by each...
Journal Article
Journal of Health Politics, Policy and Law (1 December 2014) 39 (6): 1277–1288.
Published: 01 December 2014
... experienced higher health risks and disease burden relative to other states, placing heavy demand on stressed delivery system networks. In addition, the private insurance market was dominated by a single carrier and a minimally regulated marketplace, resulting in risk segmentation for both the individual and...
Journal Article
Journal of Health Politics, Policy and Law (1 April 1984) 9 (2): 261–267.
Published: 01 April 1984
... and by the customers of those insurance carriers who pay in full unilaterally established hospital prices: in effect, self-pay patients and customers of these insurance carriers pay a surcharge or an implicit excise tax above the cost of the services they have received; this surcharge allows...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2002) 27 (1): 37–48.
Published: 01 February 2002
... arranges beneficiary multiple choice of plan. FEHBP and CalPERS, for example, are exchanges.) Third, the goal is the reorganization of the delivery system. It is not merely carriers competing. Ten carriers each offering practically all the providers in an area is not “competition” in this sense. The...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2000) 25 (1): 197–204.
Published: 01 February 2000
... market. The New Hampshire Experience Prior to the enactment of the New Hampshire nongroup market reforms, there were approximately a dozen carriers participating in the market. However, Blue Cross Blue Shield of New Hampshire (BCBSNH) and Golden Rule...
Journal Article
Journal of Health Politics, Policy and Law (1 August 2016) 41 (4): 781–801.
Published: 01 August 2016
... participation by insurance carriers in the individual market, with the expectation of vigorous market competition. Second, opponents seeking to replace the ACA continue to advocate for insurance reform based on the use of the individual insurance market together with income-related tax credits or vouchers for...
Journal Article
Journal of Health Politics, Policy and Law (1 April 1982) 7 (2): 366–379.
Published: 01 April 1982
... incentives and disincentives regarding access to care and cost of care that are created by employer-based health insurance. This paper will focus primarily on the administration of employer-based health insurance plans (e.g., type of carrier, financial arrangements be- tween employer and...
Journal Article
Journal of Health Politics, Policy and Law (1 October 2002) 27 (5): 885–888.
Published: 01 October 2002
... preceding twelve months; (A) total number of copies printed, 2100; (B.1) sales through dealers and carriers, street vendors and counter sales, 0; (B.2) paid mail subscriptions, 1571; (C) total paid circulation, 1571; (D) sam- ples, complimentary, and other free copies, 102; (E) free distribution out...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1993) 18 (4): 1045–1050.
Published: 01 August 1993
.... Extent and Nature of Circulation: Average number of copies of each issue published during the preceding twelve months; (A) total number of copies printed, 3,016; (B. 1) sales through dealers and carriers, street vendors and counter sales, 0; (B .2) paid mail subscriptions, 2,319; (C) total paid...
Journal Article
Journal of Health Politics, Policy and Law (1 February 2014) 39 (1): 237–238.
Published: 01 February 2014
..., which I suspect all three authors would embrace. First, new technologies are arriving fast. This past month, I mailed off a vial of saliva to 23andme.com. For ninety-nine dollars, the firm provides key information such as whether one is a carrier for BRCA mutations. Millions of Americans...
Journal Article
Journal of Health Politics, Policy and Law (1 August 1983) 7 (4): 974–976.
Published: 01 August 1983
... Consumer-Choice Health Plan or the Stockman-Gephardt bill contain minimum benefit mandates. In addition, some proposals mandate increased choice programs. Depending on the specific proposal, employers might have to offer three different plans by three different carriers. Such provisions...