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Health Insurance
by Ermanno PitaccoHealth Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and 'protection products', more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i. e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short introduction to actuarial models for long-term care insurance products is also provided. Advanced undergraduate and graduate students in actuarial sciences; graduate students in economics, business and finance; and professionals and technicians operating in insurance and pension areas will find this book of benefit.
Health Insurance in the United States of America: Austrian Perspectives on Interventionism before ObamaCare (Routledge Focus on Economics and Finance)
by Łukasz JasińskiThe U.S. health care system is dominated by private and public (governmental) insurance which makes it difficult for many Americans to imagine access to health care without it. The health care system in the USA is sometimes mistakenly referred to as market-based, partly because of the previous lack of compulsory insurance.As this book shows, however, even before ObamaCare it was a system heavily influenced by the government. This short and accessible book demonstrates that governmental long-term interventionism in the American health insurance market has led to many contemporary serious problems, such as significant and uncontrolled increases in health care costs, rising health insurance prices, marginalization of direct payments, limited competition, and problems with uninsured Americans. Many observers wrongly blame the market for this state of affairs and demand more regulation, which further deteriorates the situation. The study is divided into two parts: an analysis of the history of interventions (and their effects) in the private health insurance market, and an analysis of the genesis and evolution of governmental Medicare and Medicaid insurance. Thus, the book constitutes a unique synthesis of Austrian theory of interventionism and the history of health insurance in the USA.This book is vital reading for health economists, managers, and policymakers, as well as those interested in the Austrian approach to economics.
Health Insurance Politics in Japan: Policy Development, Government, and the Japan Medical Association (The Culture and Politics of Health Care Work)
by Takakazu YamagishiJapan is the fastest aging country, with the largest super-aged society in the world and growing larger by the day, yet its universal health care costs are relatively low. In Health Insurance Politics in Japan, Takakazu Yamagishi draws back the curtain for an international audience and investigates how Japan has been able to control health care costs through health insurance politics.Covering the period from the Meiji Restoration to the Abe Administration, Yamagishi uses a historical institutionalist approach to examine the driving force behind the development of health insurance policies in Japan. Yamagishi pays special attention to the roles of government and medical professionals, the main actors of the policymaking and medical worlds, in this development. Health Insurance Politics in Japan pushes Japan into the spotlight of the international conversation about health care reform.
Health Insurance Reforms in Asia: Financial Pressures, Policy Initiatives And Popular Responses In Hong Kong, Shanghai And Singapore
by Sabrina Ching LukThis book empirically examines health care financing reforms and popular responses in three major cities in East Asia: Shanghai, Singapore, and Hong Kong. It adopts a new revised version of the theory of historical institutionalism to compare and explain the divergent reform paths in these three places over the past three decades. It also examines forces that propel institutional change. The book provides three detailed case studies on the development of health care financing reforms and the politics of implementing them. It shows that health care systems in Shanghai, Singapore, and Hong Kong were the products of Western presence in the nineteenth century. It illustrates how greater attention is paid to the roles played by ideas, actors, and environmental triggers without abandoning the core assumptions that political institutions and policy feedback remain central to impact health care financing reforms. It shows that health care financing reform is shaped by a complex interplay of forces over time. It also provides the most updated material about health care financing reforms in Shanghai, Singapore, and Hong Kong. The central argument of this book is that health care financing reform is both an evolving process responding to changing circumstances and a political process revealing an intricate interplay of power relationships and diverse interests. It shows that institutional changes in health care financing system can be incremental but transformative in nature. It argues that social policies will continue to develop and welfare states will continue to adapt and evolve in order to cope with new risks and needs. This book sheds new lights on understanding the politics of health care financing reform and sources and modes of institutional change.
Health Insurance, Third Edition (Aupha/hap Book Ser.)
by Michael A. MorriseyHealth insurance is the machinery that makes the financing of the US health system run. But what's going on under the hood? Health Insurance helps readers learn the underlying assumptions, facts, and variables that drive decision-making and choices on the payer side. Picking up where introductory economics courses often leave off, the book presents the foundational economic principles of health insurance to clarify insurance-related policy and management issues. Author Michael A. Morrisey clearly explains complex concepts such as adverse selection, moral hazard, managed care, and employer-sponsored health insurance. Also addressed are risk adjustment, demand, health savings accounts, selective contracting, the diversity of health insurance markets, and the functioning of Medicare and Medicaid. The book is distinguished by its in-depth discussion of research in health insurance, both cutting edge and classic. This third edition has been substantially revised to reflect the rapid evolution of the healthcare field stemming from the Affordable Care Act (ACA). Throughout, the most recent available data is used. Though health insurance has been a major player in the American healthcare system for decades, it's hardly static. This new edition of Health Insurance keeps pace with the changes, while also offering a thorough foundation on the basics.
Health Insurance Today: A Practical Approach
by Janet I. BeikHealth Insurance Today, A Practical Approach, 6th Edition gives you a solid understanding of health insurance, its types and sources, and the ethical and legal issues surrounding it. This new edition incorporates the latest information surrounding ICD-10, the Patient Protection and Affordable Care Act, and other timely federal influencers, as it guides you through the important arenas of health insurance such as claims submission methods, the claims process, coding, reimbursement, hospital billing, and more. Plus, with hands-on UB-04 and CMS-1500 (02-12) case studies on Evolve, you will come away with a clear understanding and working knowledge of the latest advances and issues in health insurance.
Health Insurance Today: A Practical Approach
by Janet I. BeikLearn to comprehend the complexities of health insurance! Using a reader-friendly approach, Health Insurance Today, A Practical Approach, 6th Edition gives you a solid understanding of health insurance, its types and sources, and the ethical and legal issues surrounding it. This new edition incorporates the latest information surrounding ICD-10, the Patient Protection and Affordable Care Act, and other timely federal influencers, as it guides you through the important arenas of health insurance such as claims submission methods, the claims process, coding, reimbursement, hospital billing, and more. Plus, with hands-on UB-04 and CMS-1500 (02-12) case studies on Evolve, you will come away with a clear understanding and working knowledge of the latest advances and issues in health insurance.
Health IT and EHRs: Principles and Practice
by Margret K. AmatayakulThis sixth edition is being renamed Health IT and EHRs as a result of the expanded scope of the technology needed for all health information collection and use. The sixth edition is also focused more on serving as a textbook in addition to serving as a reference work for readers who work in any health setting, whether a healthcare provider organization, vendor, health plan, or policy-maker. The book introduces the full scope of health IT in chronological fashion, covering the information systems development life cycle, strategic planning, goal setting workflow and process mapping, change management, vendor selection, project management, and implementation, training, and ongoing maintenance of EHR and other health IT systems. It also addresses the essential elements of data infrastructure, information technology, privacy and security, and interoperability for all forms of health IT. Finally, there is considerable expansion in chapters covering techniques to achieve value with health IT in various acute care, ambulatory care, and specialty care settings as well as for consumer health IT, enterprise content and record management as an EHR bridge technology, revenue cycle management, and population health. Those familiar with the fifth edition of Electronic Health Records: A Practical Guide for Professionals and Organizations will find that some of the chapters have been moved around, consolidated, or expanded in the sixth edition. Two chapters have been added, on revenue cycle management and population health, given expanded interest in integrating information on clinical, administrative or financial, and social determinants of health.
Health IT as a Tool for Prevention in Public Health Policies
by Divya Srinivasan SridharHealth IT as a Tool for Prevention in Public Health Policies examines the current state of Health Information Technology (HIT) in the United States. It investigates the converging problems of chronic disease, societal welfare, childhood obesity, and the lack of healthcare for the economically disadvantaged in the U.S. It considers various providers
Health Leads: Reaching for Impact (A)
by Sarah Appleby V. Kasturi RanganExplores strategies to achieve system-level impact for a nonprofit focused on addressing patients' basic social needs through healthcare institutions. Founded in 1996 with a volunteer-staffed help desk at Boston Medical Center connecting low-income patients with basic resources like heating assistance, job training, and childcare programs, by 2013 the nonprofit had grown to 6 cities and 1,000 volunteers serving over 11,000 patients annually. At the end of a successful "proof plan" period, Health Leads Co-Founder and CEO Rebecca Onie and her team faced the question of how to make meeting patients' social needs a standard part of health care in the U.S.: replicate Health Leads' proven model or instigate a social care movement?
Health Leads: Reaching for Impact (Abridged)
by Sarah Appleby V. Kasturi RanganA nonprofit in the healthcare arena explores strategies to achieve system-level impact. Founded in 1996 with a volunteer-staffed help desk at Boston Medical Center connecting low-income patients with basic resources like heating assistance, job training, and childcare programs, by 2013 the nonprofit had grown to 6 cities and 1,000 volunteers serving over 11,000 patients annually. At the end of a successful "proof plan" period, Health Leads Co-Founder and CEO Rebecca Onie and her team faced the question of how to make meeting patients' social needs a standard part of health care in the U.S.: replicate Health Leads' proven model or instigate a social care movement?
Health Leads: Reaching for Impact (B)
by Sarah Appleby V. Kasturi RanganThe B case documents the development of a strategy to achieve system-level impact in a rapidly changing healthcare landscape for a nonprofit focused on addressing patients' basic social needs through healthcare institutions. Founded in 1996 with a volunteer-staffed help desk at Boston Medical Center connecting low-income patients with basic resources like heating assistance, job training, and childcare programs, by 2013 the nonprofit had grown to 6 cities and 1,000 volunteers serving over 11,000 patients annually. At the end of a successful "proof plan" period, Health Leads Co-Founder and CEO Rebecca Onie and her team faced the question of how to make meeting patients' social needs a standard part of health care in the U.S.: replicate Health Leads' proven model or instigate a social care movement?
Health of South Asians in the United States: An Evidence-Based Guide for Policy and Program Development
by Memoona Hasnain Punam Parikh Nitasha Chaudhary NagarajLeading scholars and practitioners come together in this contributed volume to present the most current evidence on cutting edge health issues for South Asian Americans, the fastest growing Asian American population. The book spans a variety of health topics while examining disparities and special health needs for this population. Subjects discussed include: cancer, obesity, HIV/AIDS, women's health, LGBTQ health and mental health. Health of South Asians in the United States presents research-based recommendations to help determine priorities for prevention, diagnosis, treatment, education, and policies which will optimize the health and well-being of South Asian American communities in the United States. Although aimed at both students, healthcare professionals and policy makers, this book will prove to be useful to anyone interested in the health and well-being of the South Asian communities in the United States.
Health Operations Management: Patient Flow Logistics in Health Care
by Jan Vissers Roger BeechHealth operations management is defined as ‘the analysis, design, planning, and control of all of the steps necessary to provide a service for a client’. In other words, it is concerned with identifying the needs of clients, usually patients, and designing and delivering services to meet their needs in the most effective and efficient manner. Addressing this key healthcare industry challenge, this informative textbook crosses geographical boundaries to outline the logical steps of health operations management, focusing on the management of patient flows and resources. Until now, healthcare professionals, practitioners and students interested in this topical issue consulted general operations management textbooks, but with discussions of related fields (such as healthcare quality assurance and performance management) this dedicated volume now provides a much more relevant read. Featuring theoretical framework and practical case studies, this book also covers subjects such as hospital planning and supply chain management in healthcare, and will be a valuable reference for students and researchers in the fields of healthcare management, operations management and patient flow logistics.
Health Organizations: Theory, Behavior, and Development
by James A. Johnson Caren C. RossowOrganizations are complex human systems that have evolved over time and continue to do so in an increasingly globalized, information enriched, technology intensive era such as the 21st century. This is especially so following the Affordable Care Act legislation and regulations in the U.S. <p><p> The new Second Edition of Health Organizations: Theory, Behavior, and Development addresses these changes by integrating new content throughout every chapter and topic area. This book will help the student and practitioner put to use theories of organization and knowledge of organization behavior in ways that foster change in productive and sustainable ways resulting in better outcomes. Students will learn systematic planned approaches for organization development and team building and by examining power, influence, conflict, motivation, and leadership in the context of health service delivery. <p> The Second Edition introduces new elements including: chapter overviews; film learning exercises; key terms; case studies; chapter discussion questions; in-class exercises; online learning activities; key interviews with leaders and managers; appendix; study guide; and other supporting ancillaries.
Health Policy and the Public Interest
by Lok-sang HoThis book is written with an acute awareness of the need for new insight to ensure (1) universal protection in basic healthcare; (2) providing choice; (3) efficient production and consumption of healthcare services; (4) financial sustainability of the healthcare system. Defining the public interest as the welfare of the "representative individual" with no vested interest who imagines himself to have equal chance of being anyone in society, this book explores alternative ways of finance and delivery, the optimal interface between the public healthcare sector and the private healthcare sector, and that between public insurance and private insurance. The book includes a theoretical but non-technical section that distinguishes between the stock of health and functional health, proposes a utility maximizing/behavioural framework to explain behaviour and the role of health policy and investigates the nature of risk and alternative insurance mechanisms. The book illustrates with a number of country studies, covering a large range of healthcare systems from the American and the European systems to various Asian systems as well as those of Australia and New Zealand. The survey of country experiences reinforces the theoretical conclusions about the role of the public healthcare sector and social insurance and that of the private market. The book highlights the importance of and the workability of "pricing right" and "capping right": pricing standard or basic healthcare services at the right price can contain both demand-side and supply-side moral hazard and lead to more efficient production and consumption of healthcare services; capping annual eligible healthcare expenses will provide effective protection against financial risks. The proposal of lifetime healthcare supplement offers greater choice. Private caregivers and insurers supplement the public healthcare system by offering more choices and premium services, as well as additional protection.
Health Reform: Public Success, Private Failure (Routledge Studies in Governance and Change in the Global Era)
by Daniel Drache Terry SullivanHealth Reform explores the challenges facing health care provision in the advanced economies. The book exposes the limitations of market-led health reform and demonstrates the indispensable role of a vibrant public authority in the renewal of modern health care systems. Issues covered include: * cost-containment and privatisation strategies in an international perspective * the role of business and the private sector in setting the agenda for health care reform * the restructuring of Anglo-Saxon health systems and the shift in state/market boundaries in Canada, the USA, the UK and Australia * the frontier of health care reform in terms of health and social cohesion *the role of patient choice in health care reform.
Health Research Governance in Africa: Law, Ethics, and Regulation (Biomedical Law and Ethics Library)
by Cheluchi Onyemelukwe-OnuobiaThe globalisation of research has resulted in the increased location of research involving humans in developing countries. Countries in Africa, along with China and India, have seen research grow significantly. With emerging infectious diseases, such as Ebola and Zika, emphasising the risk of public health crises throughout the world, a further increase in health research, including clinical research in developing countries, which are often the sites of these diseases, becomes inevitable. This growth raises questions about domestic regulation and the governance of health research. This book presents a comprehensive and systemic view of the regulation of research involving humans in African countries. It employs case studies from four countries in which research activities continue to rise, and which have taken steps to regulate health research activity: South Africa, Nigeria, Kenya, and Egypt. The book examines the historical and political contexts of these governance efforts. It describes the research context, some of the research taking place, and the current challenges. It also looks at the governance mechanisms, ranging from domestic ethical guidelines to legal frameworks, the strengthening of existing regulatory agencies to the role of professional regulatory bodies. The book analyses the adequacy of current governance arrangements within African countries, and puts forward recommendations to improve the emerging governance systems for health research in African and other developing countries. It book will be a valuable resource for academics, researchers, practitioners and policy-makers working in the areas of health research, biomedical ethics, health law and regulation in developing countries.
Health Rights of Older People: Comparative Perspectives in Southeast Asia (Routledge-GRIPS Development Forum Studies)
by Long Thanh Giang Theresa W. DevasahayamThe book examines the health rights of older persons who are more likely potentially to face various disadvantages in terms of healthcare access and affordability, thereby impacting on health outcomes. The point of departure in the analyses is that the health security of older persons is guaranteed only if a country approaches the health of its citizens out of moral obligation, viewing health and well-being as a right rather than an entitlement. Data from five countries in the ASEAN region are analysed with the intent of highlighting the health inequalities and barriers at the societal and individual levels, on the one hand, as well as the gaps at the health and healthcare policy and programmatic levels within each country, on the other. It is also intended that the analyses of the data from the selected countries which represent different stages of development, and thus income levels, provide a useful comparative framework for policymakers in the ASEAN region.
Health Sector, State and Decentralised Institutions in India
by Shailender Kumar HoodaThis book describes the transition in Indian healthcare system since independence and contributes to the ongoing debate within development and institutional economics on the approaches towards reform in the public health system. The institutional reform perspective focuses on examining the effective utilisation of allotted resources and improvements in delivery through decentralisation in governance by ensuring higher participation of elected governments and local communities in politics, policymaking and delivery of health services. It discusses the economic (resource) reforms to explain the relevance and expansion of state interventionism along with its influence on the health sector, accountability and allocative efficiency. The author also explores the connections between neoliberal thought and privatisation in health sector, and examines the greater role of insurance-based financing and their implications for health service access and delivery. The book offers ways to address long-standing systemic and structural problems that confront the Indian healthcare system. Based on large-scale surveys and diverse empirical data on the Indian economy, this book will be of great interest to researchers, students and teachers of health economics, governance and institutional economics, political economy, sociology, public policy, regional studies and development studies. This will be useful to policymakers, health economists, social scientists, public health experts and professionals, and government and nongovernment institutions.
Health Service Marketing Management in Africa
by Robert Ebo Hinson Kofi Osei-Frimpong Ogechi Adeola Lydia AziatoHealth Service Marketing Management in Africa (978-0-429-40085-8, K402492) Shelving Guide: Business & Management / Marketing Management The application of marketing to healthcare is a fascinating field that will likely have more impact on society than any other field of marketing. It’s been theorized that an intrinsically unstable environment characterizes this very relevant emerging field, hence raising new questions. Changing regulations, discoveries, and new health treatments continuously appear and give rise to such questions. Advancements in technology not only improve healthcare delivery systems but also provide avenues for customers to seek information regarding their health conditions and influence their participatory behaviors or changing roles in the service delivery. Increasingly, there is a shift from a doctor-led approach to a more patient-centered approach. In Africa, the importance of marketing-driven practices in improving the delivery of healthcare services cannot be overemphasized. The issue of healthcare delivery and management is significant for policymakers, private sector players, and consumers of health-related services in developing economy contexts. Scholars have strongly argued in favor of marketing and value creation in healthcare service delivery in Africa. Each country in Africa has its own issues. For example, long waiting times, unavailable medications, and unfriendly staff are just a sampling of issues affecting the acceptability of healthcare services. These examples highlight the need to utilize marketing and value creation tools in the delivery of healthcare services. Furthermore, there is a need for the integration of service marketing and management principles to enhance the delivery of quality healthcare across Africa and other developing economies which is the critical focus of this book. This book responds to calls for quality healthcare service management practices or processes from developing economy perspectives. Focusing primarily on African and other developing economy contexts, this book covers seven thematic areas: strategy in healthcare; marketing imperatives in healthcare management; product and pricing management in healthcare; distribution and marketing communications in healthcare; managing people in healthcare; physical evidence and service quality management in healthcare; and process management in healthcare.
Health Stop (B): The Medical Offices
by Regina E. HerzlingerDescribes the long waiting time experienced by customers in Health Stops and asks students to specify the changes in its business model which could help solve the problem.
Health Stop (B): The Medical Offices
by Regina E. HerzlingerDescribes the long waiting time experienced by customers in Health Stops and asks students to specify the changes in its business model which could help solve the problem.
Health Stop Retail Medical Centers (A): Strategy
by Regina E. Herzlinger Joyce Lallman Nancy M. KaneReviews the different business models of for-profit chains that provide ambulatory health care services and asks the students to evaluate which is most likely to do good and do well. It is an effective case for introducing the framework for how to evaluate health care innovations.