Health Systems in Developing Countries IAA Health Section Colloquium. Lisa Beichl International Health Consultant
|
|
|
- Stephen Todd
- 5 years ago
- Views:
Transcription
1 Health Systems in Developing Countries IAA Health Section Colloquium Lisa Beichl International Health Consultant
2 Health Systems in Developing Countries Facets of health systems Stakeholder Behavior Malaria, Medical Tourism Moving forward
3 Considerations about health systems in developing countries Country Public expenditure on health as a % of total expenditure on health (2003 WHO) Private expenditure on health as a % of total expenditure on health (2003 WHO) Total expenditure on health as a % of GDP (2003 WHO) Botswana 3.3% 2.3% 5.6% Mexico 2.9% 3.3% 6.2% Peru 2.1% 2.3% 4.4% Turkey 5.4% 2.2% 7.6% Denmark 7.5% 1.5% 9% U.K. 6.9% 1.1% 8%
4 Access issues in developing countries Country # of doctors/1000 (WHO 2003) # of nurses/1000 (WHO 2003) Botswana Mexico Peru Turkey Denmark U.K
5 Country Burden of Disease, HIV/AIDS Years of life lost to communicable diseases (WHO 2002) % of population living below poverty (WHO 2002) HIV prevalence adults % (WHO 2003) Botswana 93.1% 30.7% 37.3% Mexico 26.9% 9.9% 0.3% Peru 43.1% 18.1% 0.5% Turkey 31.1% N/A N/A Denmark 3.8% N/A 0.2% U.K. 9.5% N/A 0.2%
6 Quality? Data available from hospital perspective (fragmented). Difficult to define quality, readmission rates, length of stay? Absence of standard protocols, evidence based medicine?
7 Reforms focused on ensuring access to care Tend to see extension of the scope of social protection in case of illness and improvements in institutional efficiency. Often see a increased privatization when economic conditions allow.
8 Health Systems in Developing Countries Facets of health systems Stakeholder Behavior Malaria, Medical Tourism Moving forward
9 Providers Public Sector Agencies Government Insurer/ Reinsurer Individual Agent/Broker Employer
10 Providers Public Sector Agencies Government Insurer/ Reinsurer Individual
11 Government needs to take the lead Sees the big picture Understands the complexity of the various stakeholders Is guiding an overall direction But is also limited by itself
12 Governments and Public Aid Groups take the lead, but that brings challenges Country Corruption Perception Index (5 is the threshold) Index of Freedom (Heritage Foundation, 2006) Botswana Mexico Peru Turkey Denmark U.K
13 Health Systems in Developing Countries Facets of health systems Stakeholder Behavior Malaria, Medical Tourism Moving forward
14 All Stakeholders have an interest in managing malaria Government Individual Public Sector Agency Change in outcomes?
15 Ensuring sustainable change is difficult when it s not the core focus of a government Government Individual Change in outcomes?
16 Providers Public Sector Agencies Government Insurer/ Reinsurer Individual Agent/Broker Employer
17 Examples of Medical Procedure Cost Comparison [1] Medical Tourism, friend or foe?
18 All Stakeholders have an interest in Medical Tourism Procedure US Cost India Cost Thailand Cost Heart Bypass $130,000 $10,000 $11,000 Hip Replacement $43,000 $9,000 $12,000 Source:
19 All Stakeholders have an interest in Medical Tourism Medical Tourism, friend or foe? 2005, the Bumrungrad Hospital in Thailand served more than 50,000 American patients, up 30% from the previous year. Seventy five percent of the patients flew in directly from the U.S. and 83% of them had non-cosmetic surgery. As most of the procedures performed are high intensity, they are important revenue sources.
20 All Stakeholders have an interest in Medical Tourism Medical Tourism, friend or foe? Turkey and India, provider supply concerns, brain drain concerns. Medical Tourism can help? Medical Tourism can drive a wedge into the society and access for all? Either extreme won t work (ensure all stakeholders fairly reflected in regulation decisions).
21 All Stakeholders have an interest in Medical Tourism Medical Tourism, friend or foe? Quality, JCAHO, Australian Accreditation, Evidence Based Medicine..
22 Health Systems in Developing Countries Facets of health systems Stakeholder Behavior Malaria, Medical Tourism Moving forward
23 Developing markets are dealing with the same things Access to care Efficiency/cost of care Quality of care Changing market dynamics, needs, trends (SARS, polio, etc.)
24 Challenge is to ensure effective influence of the different stakeholders Access to care: Ensure effective incentives to practice medicine, to run clinics, to address rural areas Efficiency/cost of care: Standardize coding and data capture (both public and private sector), fair UCR, reduced demand to cost-shift Quality of care: Evidence based medicine, Continuing Medical Education, local accreditation standards Changing market dynamics, needs, trends (SARS, polio, etc.): Change is the only constant
25
MAKING HEALTH INSURANCE MARKETS WORK FOR THE POOR IN SOUTH AFRICA
MAKING HEALTH INSURANCE MARKETS WORK FOR THE POOR IN SOUTH AFRICA Jeremy Leach Roseanne da Silva IAAHS 2007 IAA Health Section Colloquium 13 th 16 th May 2007 CTICC www.iaahs2007.com FinMark Trust Independent
Background Paper: International Comparisons of Bulgaria s Health System Performance
ADVISORY SERVICES AGREEMENT between MINISTRY OF HEALTH OF THE REPUBLIC OF BULGARIA and the INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT Background Paper: International Comparisons of Bulgaria
Multinational Comparisons of Health Systems Data, Roosa Tikkanen The Commonwealth Fund
Multinational Comparisons of Health Systems Data, 217 Roosa Tikkanen The Commonwealth Fund Health Care Spending HEALTH CARE SPENDING Health Care Spending per Capita, 2 216 Adjusted for Differences in Cost
Bright Health Plan. Confirmed Complaints: N/A. Quality Overview. How Often Do Members Complain About This Company? Accreditation Exchange Product
Quality Overview Plan Accreditation Exchange Product Accrediting Organization: Accreditation Status: URAC Health Plan Accreditation (Marketplace ) Pending Full: Organization demonstrates full compliance
Thriving through shared-value
Thriving through shared-value Andrew Rayner Discovery Limited This presentation has been prepared for the Actuaries Institute 2018 Financial Services Forum. The Institute Council wishes it to be understood
Employee Benefit Plan: Missoula County Public Schools Coverage Period: 01/01/ /31/2014 Summary of Benefits and Coverage:
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type: HDHP This is only a summary. If you want more detail about your coverage and costs, you can get
Some of the services this plan doesn t cover are listed on page 5. See your policy Yes plan doesn t cover?
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type: Network This is only a summary. If you want more detail about your coverage and costs, you can
MN DEPARTMENT OF HEALTH PROVIDER PEER GROUPING (PPG) ADVISORY GROUP DEFINING PARAMETERS ANN ROBINOW
MN DEPARTMENT OF HEALTH PROVIDER PEER GROUPING (PPG) ADVISORY GROUP DEFINING PARAMETERS ANN ROBINOW MEETING 2: JUNE 26, 2009 Introduction Comments and changes to meeting summary? Review of questions or
Standard for informed financial consent
Standard for informed financial consent Developed between Cancer Council, Breast Cancer Network Australia, CanTeen and Prostate Cancer Foundation of Australia Contents Executive summary... 2 Explanation...
July 2014 Kagiso Asset Management Quarterly
July 2014 Kagiso Asset Management Quarterly Global brewers: working harder for growth pg 1 Volkswagen s ambitious vision pg 5 The coal conundrum pg 13 www.kagisoam.com Hospital groups face tougher times
Important Questions Answers Why this Matters:
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan Type: PPO This is only a summary. If you want more detail about your coverage and costs, you
HEALTH CARE IN THE U.S.
HEALTH CARE IN THE U.S. Health Care in America! The U.S. government does not pay any part of the medical expenses for international students studying here.! The average cost of a visit to an urgent care
Optional Group Critical Illness. Financial support at a critical time
Optional Group Critical Illness Financial support at a critical time Medical advances have greatly increased the ability of Canadians to survive a critical illness. However, few of us are prepared for
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type: Prev. Plus Plan This is only a summary. If you want more detail about your coverage and costs,
Coverage when it counts
CRITICAL ILLNESS INSURANCE Coverage when it counts Helping you recover from a critical illness with a plan You have a bright future ahead and big plans for what you want to achieve, but unexpected events
This is only a summary. Important Questions $500 $1,000 $500 $1,000. Why this Matters: $50 $4,850 $9,700 $2,000 $4, of 10
This is only a summary. Important Questions Answers $500 $1,000 $500 $1,000 Why this Matters: $50 $4,850 $9,700 $2,000 $4,000 1 of 10 Common Medical Event Services You May Need In-network Out-of-network
Prepared by cde Khwezi Mabasa ( FES Socio-economic Transformation Programme Manager) JANUARY 2016
Prepared by cde Khwezi Mabasa ( FES Socio-economic Transformation Programme Manager) JANUARY 2016 Political Context: Social Democratic Values Social policy and the access to basic public goods are the
Kansas City Regional Health Assessment
Kansas City Regional Health Assessment REACH Healthcare Foundation Prepared by Mid-America Regional Council 2013 The Regional Health Story How socio-economic factors, health access factors, health insurance
The Global Economy and Health
The Global Economy and Health Marty Makinen, PhD Results for Development Institute September 7, 2016 Presented by Sigma Theta Tau International Organization of the session The economic point of view on
HEALTH CARE ORGANIZATION AND FINANCING
HEALTH CARE ORGANIZATION AND FINANCING Fee for Service Care Independent physician Patient pays for care No middleman Little paperwork Fee for Service Challenges Running a business Employee relations Collections/
An Insight on Health Care Expenditure
An Insight on Health Care Expenditure Vishakha Khanolkar MBA Student The University of Findlay Simeen A. Khan MBA Student The University of Findlay Maria Gamba Associate Professor of Business The University
Thailand s UHC development. National Health Security Office 23 June 2014
Welcome to NHSO Thailand s UHC development National Health Security Office 23 June 2014 Thailand: country profiles Population - 64 million GNI 2012 US$5,090 per capita UHC achieved in 2001 under 3 scheme
You don t have to meet deductibles for specific services, but see the chart starting on page 3 for other costs for services this plan covers.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.nipponlifebenefits.com or by calling 1-800-374-1835.
9FG jg\e[`e^ fe _\Xck_ ?fn cxi^\ `j k_\ dxib\k6
Rural East Africa illustrates both the challenges BOP households face in obtaining health care and the potential health market they represent. Access to public health care is often very limited. Even finding
of-pocket Expenses, Financial Protection, and Catastrophic Health Expenditures The Case of INDIA
2nd International Conference Health Financing in Developing Countries Health Insurance, Out-of of-pocket Expenses, Financial Protection, and Catastrophic Health Expenditures The Case of INDIA Vijay Kalavakonda
Delivering Value-Based Care:
Discussion Summary Delivering Value-Based Care: Episodes of Care Analytics for Health Care Providers, Payers and ACOs July 2015 Interview Featuring: J. Peter Chingos, Senior Industry Consultant, Health
Summary of Benefits and Coverage (SBC) & Uniform Glossary A Supplement to the Insurance & Benefits Information Guide
2017-2018 Summary of Benefits and Coverage (SBC) & Uniform Glossary A Supplement to the 2017-2018 Insurance & Benefits Information Guide Nassau County School Board 1201 Atlantic Avenue Fernandina Beach,
Elevate by Denver Health Medical Plan
Quality Overview Elevate by Denver Health Medical Plan Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating
Will India Embrace UHC?
Will India Embrace UHC? Prof. K. Srinath Reddy President, Public Health Foundation of India Bernard Lown Professor of Cardiovascular Health, Harvard School of Public Health The Global Path to Universal
Rocky Mountain Health Plans PPO
Quality Overview Rocky Health Plans PPO Accreditation Exchange Product Accrediting Organization: NCQA PPO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange
UpDate I. SPECIAL REPORT. How Many Persons Are Uninsured?
UpDate I. SPECIAL REPORT A Profile Of The Uninsured In America by Diane Rowland, Barbara Lyons, Alina Salganicoff, and Peter Long As the nation debates health care reform and Congress considers the president's
Financial Planning. Patient Education. For a liver transplant
Patient Education Financial Planning For a liver transplant Liver transplants are expensive. Planning your finances, both your income and insurance, will be a key part of planning for transplant. The planning
*This document is searchable.
CCHP Prior Authorization List and Toll Free Phone Number 877-227-1142 Fax Number 414-266-4726 www. Childrenschp.com(childrenscommunityhealthplan.org) Utilization Provider Portal: provider.childrenscommunityhealthplan.org
OECD Reviews of Health Systems: Switzerland
OECD Reviews of Health Systems: Switzerland 2011 OECD World Health m/& Orqanization ^- u g a Table of Contents Introduction 9 Assessment and Recommendations 11 Chapter 1. Key Features of the Swiss Health
Elevate by Denver Health Medical Plan
Quality Overview by Denver Health Medical Plan Accreditation Exchange Product Accrediting Organization: Accreditation Status: NCQA Health Plan Accreditation (Marketplace HMO) Accredited* Excellent: Organization
Paying providers to increase Value for Money: Is Pay for Performance the Answer? Review of OECD experience
Paying providers to increase Value for Money: Is Pay for Performance the Answer? Review of OECD experience Michael Borowitz OECD Health Division SBO Network on Health Expenditures 1 Productivity Challenge:
Make Medicaid Better, Don t Cut It! What You Need to Know About Centennial Care 2.0
Make Medicaid Better, Don t Cut It! What You Need to Know About Centennial Care 2.0 The Human Services Department (HSD) recently released its draft plan to renew the state s Medicaid waiver (aka Centennial
Important Questions Answers Why this Matters:
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Plan Type: Premium Plan This is only a summary. If you want more detail about your coverage and costs, you
ADDRESSING PUBLIC PRIVATE SECTOR INEQUALITIES PROFESSOR EMERITUS YOSUF VERIAVA
ADDRESSING PUBLIC PRIVATE SECTOR INEQUALITIES PROFESSOR EMERITUS YOSUF VERIAVA HEALTH INEQUALITY AND INEQUITY Disparity: Is there a difference in the health status rates between population groups? Inequality:
Fiscal Implications of Chronic Diseases. Peter S. Heller SAIS, Johns Hopkins University November 23, 2009
Fiscal Implications of Chronic Diseases Peter S. Heller SAIS, Johns Hopkins University November 23, 2009 Defining Chronic Diseases of Concern Cancers Diabetes Cardiovascular diseases Mental Dementia (Alzheimers
Universal Health Coverage Assessment. Republic of the Fiji Islands. Wayne Irava. Global Network for Health Equity (GNHE)
Universal Health Coverage Assessment Republic of the Fiji Islands Wayne Irava Global Network for Health Equity (GNHE) July 2015 1 Universal Health Coverage Assessment: Republic of the Fiji Islands Prepared
Sri Lanka s Health Sector
Sri Lanka s Health Sector Issues, Challenges and Future Dr Ravi P. Rannan-Eliya Director Institute for Health Policy www.ihp.lk Ceylon Chamber of Commerce Colombo 26 September 2005 Outline A performance
Physician Services Analysis
Physician Services Analysis The following slides were prepared by KPMG on behalf of Alberta Health. All inter-provincial comparisons are based on data published by the Canadian Institute for Health Information
Co-payments, Choices and Coverage: Meeting the Challenge of Health Financing for Consumers
Co-payments, Choices and Coverage: Meeting the Challenge of Health Financing for Consumers Dr Sharon Willcox, Health Policy Solutions Catholic Health Australia National Conference 27 August 2013 OUTLINE
MACRO-ECONOMICS REGULATORY INFRASTRUCTURE PHARMA INDUSTRY
MACRO-ECONOMICS Economic growth are potentially good GDP per capita above $ 3.000 Government health budget increases to 5% Middle class category is projected into 150 Mn in 2014, average life expectancy
Corporate and financial sector dynamics
Financial Sector Indicators Note: 2 Part of a series illustrating how the (FSDI) project enhances the assessment of financial sectors by expanding the measurement dimensions beyond size to cover access,
TALKING POINTS ISSUES RELATING TO STATUS, FINANCIAL PERFORMANCE AND OTHER CORPORATE ISSUES
TALKING POINTS ISSUES RELATING TO STATUS, FINANCIAL PERFORMANCE AND OTHER CORPORATE ISSUES BCBSF's Status BCBSF's Status Blue Cross and Blue Shield of Florida (BCBSF) is a tax-paying mutual insurance company,
An integrated wellness and insurance model. Dr Dawn Richards, Medical Affairs Director, VitalityHealth
An integrated wellness and insurance model Dr Dawn Richards, Medical Affairs Director, VitalityHealth The genesis of Vitality, and the need to make people healthier: Overview of the South African healthcare
Note: Accredited is the highest rating an exchange product can have for 2015.
Quality Overview Permanente Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange product can
Mongolia The SCD-CPF Engagement meeting with development partners September 1 and 22, 2017
Mongolia The SCD-CPF Engagement meeting with development partners September 1 and, 17 This is a brief, informal summary of the issues raised during the meeting. If you were present and wish to make a correction
Personal Finance, 6e (Madura) Chapter 12 Health and Disability Insurance Background on Health Insurance
Personal Finance, 6e (Madura) Chapter 12 Health and Disability Insurance 12.1 Background on Health Insurance 1) Health insurance protects net worth by minimizing the chance that you will have to reduce
CRITICAL ILLNESS INSURANCE. Oasis. Critical coverage at critical times
CRITICAL ILLNESS INSURANCE Oasis Critical coverage at critical times Suffering a critical illness or condition may be more likely than you think. There are an estimated 70,000 heart attacks in Canada each
Blue Cross Blue Shield of Louisiana: BlueConnect POS Plan 2 Summary of Benefits and Coverage: What this Plan Covers & What it Costs
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bcbsla.com or by calling 1-800-599-2583. Important Questions
Medical expenses incurred in the event of sudden illness or accident. Covers 30 days prior and 60 days post hospitalization expenses.
************************************************* Parents Health and Medical Insurance NRI Rishtey Policy Wordings ************************************************* Policy Coverage Rishtey Parents' Health
Chronicle of deaths foretold George Nikolaidis 1, Director of Department of Mental Health and Social Welfare, Institute of Child Health, Athens
Chronicle of deaths foretold George Nikolaidis 1, Director of Department of Mental Health and Social Welfare, Institute of Child Health, Athens Introduction In Nov 2015 George Nikolaidis 2, Director of
Behavioral Logic in the ReThink Health Dynamics Model*
Behavioral Logic in the ReThink Health Dynamics Model* The ReThink Health model is a realistic but simplified portrait of a local health system. It rests upon a variety of explicit and testable hypotheses,
Blue Cross Blue Shield of Louisiana: Blue Max 2500 Maternity Summary of Benefits and Coverage: What this Plan Covers & What it Costs
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bcbsla.com or by calling 1-800-599-2583. Important Questions
OFFICE OF GROUP BENEFITS PELICAN HRA
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bcbsla.com/ogb by calling 1-800-392-4089. Important Questions
What You should Know about Medical Travel and the Potential Impact on the Cost of Your Healthcare Benefits!
What You should Know about Medical Travel and the Potential Impact on the Cost of Your Healthcare Benefits! PRESENTED BY Terry W. White March 12, 2009 Presentation Overview Problem: US Healthcare system
Administrative Classification
GLOSSARY OF TERMS A Administrative Classification Adult Lifetime Risk of Maternal Death Antenatal (or Prenatal) Surveys Antiretroviral Therapy (ART) Appropriation Auditor-General (Supreme Audit Institution)
Overview. Procure.shtml
Statewide Medicaid Managed Care (SMMC) Cost Proposal Magellan Complete Care (Florida MHS Inc., dba Magellan Complete Care) Actuarial Memorandum and Certification Overview The purpose of this memorandum
Cigna. Confirmed complaints: 5. Quality Overview. How Often Do Members Complain About This Company? Accreditation Exchange Product
Quality Overview Accreditation Exchange Product Accrediting Organization: NCQA Health Plan Accreditation (Exchange) Accreditation Status: Pending (214) Accreditation Commercial Product Accreditation Organization:
Medical Road to Korea
Company LOGO Korean Healthcare System Present & Future Medical Road to Korea Med Platform 1 Asia Contents 1. 1. Overview -- Overview of of Korea s Healthcare system 2. 2. Korean Healthcare Services --
Healthcare Cost Increases: Can They Be Managed Effectively?
Healthcare Cost Increases: Can They Be Managed Effectively? Actuarial Society of Hong Kong Evening Talk February 24, 2006 Howard J. Bolnick, FSA, MAAA, HonFIA Chairman, IAA Health Section Adjunct Professor
ACOs/Shared Savings Demonstration Project: What Does It All Mean?
ACOs/Shared Savings Demonstration Project: What Does It All Mean? None Conflicts of Interest Sean P. Roddy, MD Albany, NY Accountable Care Organizations Term introduced in 2006 by Fisher et al. the hospital
CalPERS: Sharp Performance Plus HMO Summary of Benefits and Coverage: What this Plan Covers & What it Costs
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.sharphealthplan.com/calpers or by calling 1-855-995-5004.
Mexico Health Plan: County of Imperial Coverage Period: 01/01/ /31/2017
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.pinnacletpa.com or by calling 1-800-649-9121. Important
Comprehensive benefit plan including high benefit limits and a worldwide open provider network.
2018 Comprehensive benefit plan including high benefit limits and a worldwide open provider network. Global Freedom Plus is tailored exclusively for individuals and families residing in Latin America and
Going Out of Network: Why It Happens, What It Costs, and What Can Be Done
Going Out of Network: Why It Happens, What It Costs, and What Can Be Done Kelly Kyanko, MD, MHS Assistant Professor of Population Health and Medicine, NYU School of Medicine Assistant Attending Physician,
Long-term Care Primer. Your Guide to LTC Insurance and the State Partnership Program
Long-term Care Primer Your Guide to LTC Insurance and the State Partnership Program People age 65 face at least a 40% chance of entering a nursing home during their lifetime. - America s Health Insurance
Affordable Care Act Survival Kit
Affordable Care Act Survival Kit The Affordable Care Act (ACA) stands poised to usher in sweeping changes for many businesses. Multiple regulations and shifting timetables, however, make it difficult to
Roger Williams University-Facilities BlueChip Health Reimbursement Arrangement Coverage Period: 07/01/ /30/2019
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bcbsri.com or by calling 1-800-639-2227 or (401) 459-5000.
Initiative Options for Simulation Scenarios
Initiative Options for Simulation Scenarios The following options are in version 2h of the ReThink Health simulation model. Enable healthier behaviors Promote healthy behavior and help people to stop behaviors
(Applies to IP, Emergency when the deductible starts over (usually, but not always, January 1st). See the deductible?
Molina Healthcare of California: Silver 94 HMO Coverage Period: 01/01/2016-12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family I Plan Type:
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.centralpateamsters.com or by calling 1-800-422-8330 (PA)
STATE MUTUAL INSURANCE COMPANY OUTLINE OF COVERAGE SPECIFIED DISEASE INSURANCE
STATE MUTUAL INSURANCE COMPANY Rome, Georgia 30161 OUTLINE OF COVERAGE SPECIFIED DISEASE INSURANCE HEART ATTACK AND STROKE LUMP SUM BENEFIT INSURANCE POLICY P o l i c y F o r m SMHS2015MN BENEFITS PROVIDED
Summary of Benefits and Coverage Distribution Instructions
Summary of Benefits and Coverage Distribution Instructions Federal law requires you, as an employer, to provide your employees with a Summary of Benefits and Coverage (SBC) at certain times. You can read
This report summarizes the major arguments put forward by Richard Lane & Kara Hanson, Faculty of Public Health, London School of Hygiene and Tropical
This report summarizes the major arguments put forward by Richard Lane & Kara Hanson, Faculty of Public Health, London School of Hygiene and Tropical Medicine. In this podcast produced by the Lancet, they
Health Insurance Part 2. Health Policy Eric Jacobson
Health Insurance Part 2 Health Policy Eric Jacobson The Uninsured 44 million individuals in the U.S. are without any insurance coverage at all. They tend to have below-average incomes. Nearly two-thirds
INFORMATION ABOUT YOUR OXFORD COVERAGE
OXFORD HEALTH PLANS (CT), INC. INFORMATION ABOUT YOUR OXFORD COVERAGE PART I. REIMBURSEMENT Overview of Provider Reimbursement Methodologies Generally, Oxford pays Network Providers on a fee-for-service
Talking Points in Support of Medicaid Expansion December 29, 2013
Talking Points in Support of Medicaid Expansion December 29, 2013 This document contains key talking points in favor of Medicaid expansion. The talking points are sorted by the important themes we wish
Translating Health Data into Community Change
Translating Health Data into Community Change Ricky C. Brathwaite, PhD Director, Health Economics 11th Caribbean Conference on Health Financing Bonaire, 2016 Topics The Need for Claims Analysis Select
Eliminating the Catastrophic Economic Burden of TB:
Eliminating the Catastrophic Economic Burden of TB: Universal Health Coverage and Social Protection Opportunities A consultation to inform a post-2015 TB Elimination Strategy Hosted and co-organized by
Multinational Comparisons of Health Systems Data, 2010
1 Multinational Comparisons of Health Systems Data, 21 Gerard F. Anderson and Patricia Markovich Johns Hopkins University November 21 Support for this research was provided by The Commonwealth Fund. 2
Where does the typical health insurance dollar go?
Where does the typical health insurance dollar go? 87 13 Inpatient Services = 20 Outpatient Services = 15 Hospital Costs = 35 Based on a PricewaterhouseCoopers analysis. Factors Fueling Rising Healthcare
Value-Based Pricing Working Party #1: Briefing for DH presentation
Value-Based Pricing Working Party #1: Briefing for DH presentation This document provides background material for the DH presentation to the first Working Party on the implementation of value assessment
Admitting Privileges: The right granted to a doctor to admit patients to a particular hospital.
Glossary of Health Care Terms Adapted from the Health Insurance Resource Center Admitting Privileges: The right granted to a doctor to admit patients to a particular hospital. Benefit: Amount payable by
ECONOMIC PRINCIPLES IMPACTING MANAGED CARE PHARMACY. Adrian Washington PharmD., MBA Vice President of Client Management United Healthcare OptumRx
ECONOMIC PRINCIPLES IMPACTING MANAGED CARE PHARMACY Adrian Washington PharmD., MBA Vice President of Client Management United Healthcare OptumRx As vice president, Adrian is responsible for strategic planning
Consumers' Choice Silver 10 Coverage Period: 01/01/ /31/2015
Coverage Period: 01/01/2015-12/31/2015 If you qualified for a Cost Sharing Reduction Plan on Healthcare.gov, please click on the appropriate link below to receive your Summary of Benefits and Coverage
A CONSUMER S GUIDE TO CANCER INSURANCE
A CONSUMER S GUIDE TO CANCER INSURANCE WHAT IS CANCER INSURANCE? Cancer insurance provides benefits only if you are diagnosed with cancer, as defined by the terms of the policy contract. These policies
Healthcare System Innovation for Aging Society -Issues and Direction-
Healthcare System Innovation for Aging Society -Issues and Direction- APEC Life Sciences Innovation Forum Health Financing Mechanisms & Options Sep. 19, 2010 Prof. Akira Morita University of Tokyo 2010
Terms of Reference. Challenges and opportunities for health finance in South Africa: a supply and regulation perspective
Terms of Reference Challenges and opportunities for health finance in South Africa: a supply and regulation perspective 28 October 2015 Page 2 1. Introduction Health risks are experienced by most households
$0 See the chart starting on page 2 for your costs for services this plan covers.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the plan document, a copy of which can be requested by emailing fsa@nhlgc.org or by calling
Aetna Senior Supplemental Insurance
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Senior Supplemental Insurance Includes all products underwritten by: American Continental Insurance Company
BERMUDA HEALTH INSURANCE DEPARTMENT ANNUAL REPORT
BERMUDA HEALTH INSURANCE DEPARTMENT ANNUAL REPORT YOUR HEALTH MATTERS Welcome to the Health Insurance Department s first annual report for policyholders of FutureCare and the Health Insurance Plan ( HIP
Healthcare Financial Management Association Certification Program. Module I: The Business of Health Care Learner s Guide
Healthcare Financial Management Association Certification Program Module I: The Business of Health Care Learner s Guide For examination period beginning June 2015 1 Course 1 - The Big Picture Learning
By Bharathi Ghanashyam
By Bharathi Ghanashyam Three years after a community health insurance scheme was implemented by the government of Karnataka and Karuna Trust, around 200,000 poor people have benefited, paying annual premiums
Rocky Mountain Health Plans
Quality Overview Rocky Health Plans Accreditation Exchange Product Accrediting Organization: Accreditation Status: NCQA Health Plan Accreditation (Marketplace ) Accredited Accreditation Commercial Product
Coverage Expansion [Sections 310, 323, 324, 341, 342, 343, 344, and 1701]
![Coverage Expansion [Sections 310, 323, 324, 341, 342, 343, 344, and 1701]](/thumbs/87/96500790.jpg "Coverage Expansion [Sections 310, 323, 324, 341, 342, 343, 344, and 1701]")
Summary of the U.S. House of Representatives Health Reform Bill October 2009 The following summarizes the major hospital and health system provisions included in the U.S. House of Representatives health
2015 MERCER BENEFITS ANALYSIS REVIEW
2015 MERCER BENEFITS ANALYSIS REVIEW Definitions Top Management (Top Mgt) Management (Mgt) Professionals (Prof) Staff (Staff) Employees with roles such as Head of rganization, Function Heads. Typical Career