Making employees partners in the health care purchasing decision

Bringing employees into the health care purchasing decision as informed consumers allows employees and employers to work together to purchase high-quality, cost-effective care.     

The costs of behavioral health care coverage

Psychiatric and chemical dependency conditions can have significant financial implication for plan sponsors, but a variety of mechanisms are available to control these costs. The application of appropriately designed and implemented benefit designs in combination with managed behavioral health care protocols can have a significant return on investment for the plan sponsor.     

Managing health care costs in the small business environment

Managed care is bringing down health care costs. But few small business employers find the time to manage their own health, much less that of their employees. Despite time constraints and other factors, small business employers need to embrace managed care. A critical first step is to encourage and support the implementation of important medical management initiatives.     

Plan design innovations to control health care costs

Southern California Edison has achieved measurable success in health care cost management. Dr. Sokolov observes that the essence of SCE's problem-solving approach can be transferred to almost any organization.     

Complex home care: Part I--Utilization and costs to families for health care services each year

As many as 120 persons per million people in the United States are dependent on the lifelong, complex, technology-based care of home parenteral nutrition (HPN) infusions. However, data for costs paid by families for HPN-related health care services and for non-reimbursed expenditures are rarely tabulated and most often underestimated. The goals of this study were to describe health care services used by families to manage HPN, report the frequency of each service used annually, and estimate the average annual non-reimbursed costs to families for these health services. The numerous and varied types of services reported and the time required to coordinate and access HPN services illustrates the challenges faced by patients and their family caregivers. The lack of a coordinated and efficient system for delivering complex chronic care results in poorer outcomes for HPN patients and their families on-reimbursed costs and the extensive amount of time required to coordinate multi-professional services negatively impacts the clinical outcomes and quality of life of complex chronic home care.     

Population aging,the costs of health care for the elderly and growth

Employing an overlapping-generations model with endogenous growth in which altruistic young agents take care of the health level of their aged parents at risk of illness, this paper examines how population aging influences the long-run growth rate of the economy. We show that life expectancy, when relatively low (high), positively (negatively) affects economic growth. This paper also investigates public policy on long-term care and demonstrates the existence of an intergenerational conflict between current and future generations. We also point out that population aging may mitigate the extent of this conflict.     

Navajo nation public health nurses inspire thoughts on health care reform

The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing.     

Practical steps to controlling medical costs

There are no silver bullets to control medical costs. And some costs are beyond plan sponsors' control. But plan sponsors can reduce the annual medical trend by taking control of the high-cost drivers of medical expenses while, at the same time, improving employees' perception of the medical plan. Patient care management, disease management and health status improvement support (with member involvement) are key.     

Willingness and ability of Bulgarian consumers to pay for improved public health care services

An application of the contingent valuation method to the willingness and ability of Bulgarian consumers to pay for public health care services is presented. The study uses data from a household survey conducted in May–June 2000. The willingness and ability to pay for outpatient, inpatient and dental services is investigated. A combination of interval checklist and open-ended questions are used to elicit the willingness-to-pay amounts. The impact of the sociodemographic characteristics on the responses is examined by a generalized Tobit regression. Based on the regression equation, the welfare effects of various fee levels are simulated.