Presentación sobre herramientas financieras (FBT) para el estudio de Cancer de Mama en México
|
|
- Hugo Hart
- 6 years ago
- Views:
Transcription
1 Presentación sobre herramientas financieras (FBT) para el estudio de Cancer de Mama en México Seminario Taller Sobre Costo Efectividad De Cancer de Mama en México México DF, 2-4 Febrero 2011 Jeremy Lauer, OMS Ginebra
2 Objectives of this session The role of financial cost analysis in the planning process Overview of the Financial Budgeting Tool for Breast Cancer interventions Issues for consideration
3 Cost- Effectiveness Analysis The role of financial cost analysis in the planning and budgeting process I- Strategic plan II- Operational plan and budget proposal III- Budget negotiation IV- Budget consolidation and approval V- Financial tracking and audit Timeline Strategic areas Policies Targets Assess Resource Needs and affordability Activity plan Input requirements Input costs Preliminary budget Costs and budget for activity plan Internal revision Negotiation with Ministry of Finance and other financial sources Advocacy with funders Budget approval by Ministry of Finance Distribution of the budget by line items Monitoring of financial disbursements by budgetary line items Financial costing
4 The role of financial cost analysis in the planning and budgeting process: the need for continuous updates and revisions I- Strategic plan Timeline Strategic areas Policies Targets II- Operational plan and budget proposal Activity plan Input requirements Input costs Preliminary budget III- Budget negotiation Internal revision Negotiation with Ministry of Finance and other financial sources
5 Why do we have a separate tool and analysis for financial costs? The cost-effectiveness analysis (CEA): looks at total costs incurred from the societal perspective, over a standardised time-frame, regardless of whether those resources are already in place and financed, or not. Allows for comparison between a wide range of interventions. The financial cost-analysis (FBT) looks at the financial cash flows by year. This means that resources already in place and funded are not costed (e.g., equipment and human resources already in place). Capital costs are not annualised. Focuses on a selected set of activities and interventions. The FBT allows for context-specific planning in the medium-term and alignment with other national strategic planning documents.
6 Needs-based costing A historical incremental budgeting approach looks at what was spent last year and increases the budget by e.g., 5-10 % Does not allow for shifting between priorities. A needs-based cost assessment looks at population needs and is determined by the set policies and planned coverage targets Provides a powerful tool for making adjustments to the budget allocation Historical (example) Coverage-based (example)
7 Herramienta financiera (Financial Budgeting Tool - FBT) to accompany cost-effectiveness analysis The purpose is to facilitate an assessment of the financial resources (cash flows) that would be required to implement the scenarios for Breast cancer interventions. Costs are estimated at national level, from the health provider perspective. Costs are estimated for the entire planned Breast Cancer programme regardless of who would hold the budget for the various items.
8 Costs included - definitions Specific costs to Breast Cancer programme Costes de pacientes (procedimientos de tratamiento, medicamentos, instalaciones, diagnosticos, etc.) Costes de programes (los medios de comunicación de administración, aplicación de la ley en los diferentes niveles; equipment needed in health centres and hospitals; monitoring and evaluation surveys; mass media awareness raising and outreach in the community). incluye los costes de formación Shared system resources Inpatient and outpatient services, health worker salaries, community-based health workers, infrastructure and building maintenance.
9 Objectives and process of application of the tool in México Build on lessons learnt from the CEA analysis in terms of most costeffective interventions and estimate the financial cost of these. Estimate the costs of scaling up BrCa services and activities over 5-15 year time frame Incorporate as much shared input data as possible from the CEA analysis. Defining an action plan for the next 5-10 years to outline a proposed scale-up scenario Compare costs of a current scenario, with the costs of a "scale-up scenario".
10 What we present here is just an example Limited information inputted on local data regarding Coverage, Definition of the Interventions and their costs, and programme activities. Costs Millions LCU Estadio III Estadio I PCE + IV + Tzmab Estadio IV PC extendida + IV PC Basico + IV Estadio II I - IV + conciencia Presente 60% I - IV combinación Presente 100% I - IV + media I - III + media + PCB I - IV + MS(40-69) I - IV + MS(50-69) I - III + MS(40-70) + PCE I - IV + CBE (40-69) I - III + CBE + PCB I - III + MS (40-70) + PCB + Tzmab I - III + MS(40-70) + PCB Efectos en DALYs perdido A more thorough assessment would be led by a country team of experts and based on: - the findings from the costeffectiveness analysis, and - other criteria (equity, political feasibility, health systems considerations, etc) i.e. the discussions in this workshop
11 Comparing two scenarios: 1. current delivery, and 2. proposed scale-up The proposed scale-up scenario can refer to increased population coverage of current services Increased quality of care provided of current services Adjustments to the screening process (frequency, inputs) Adjustments to the treatment and care provided (frequency, inputs) Intensified programmatic investments (mass media, training, etc) Change in strategy for more effective delivery Shifting patient load from Hospital level to Health Centre level to save costs. in our example we have focused on coverage increases. More country-specific information would be needed to undertake a more context-specific assessment.
12 A look at the tool and assumptions used for the example cost analysis for México
13 Interventions in current vs. scale-up scenario Interventions Select which interventions packages are included in the programs Interventions in Current Breast Cancer Program Interventions in Proposed Breast Cancer Program Awareness Basic Awareness Reach Out Program Biennial Screening None Diagnosis & Treatment Stage I to IV treatment combined Palliative Care Stage IV Palliative Care Extended Awareness Basic Awareness Reach Out Program Bi Annual Screening Clinical Breast Examination (40 69 years) Diagnosis & Treatment Stage I to IV treatment combined Palliative Care Stage IV Palliative Care Extended Trastuzumab Stage IV Trastuzumab Trastuzumab Stage IV 1 Trastuzumab
14 Coverage trajectory Awareness current Basic Awareness Reach Out Program Basic Awareness Reach Out Program 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% target Basic Awareness Reach Out Program 60% 64% 68% 72% 76% 80% 84% 88% 92% 96% 100% Biennial Screening Clinical Breast Examination (40 69 years) current None 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% target Clinical Breast Examination (40 69 years) 60% 62% 64% 66% 68% 70% 72% 74% 76% 78% 80% Diagnosis & Treatment Stage I to IV treatment combined current Stage I to IV treatment combined 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% target Target coverage 60% 62% 64% 66% 68% 70% 72% 74% 76% 78% 80% % Palliative Care Stage IV Palliative Care Extended current Current coverage 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% target Target coverage 60% 62% 64% 66% 68% 70% 72% 74% 76% 78% 80% % Trastuzumab Trastuzumab current Current coverage 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% 60% target Target coverage 60% 62% 64% 66% 68% 70% 72% 74% 76% 78% 80%
15 Detailed inputs and activities are defined by year (#1: equipment) Number of new equipment to purchase in each year: 2009 Minimum additional equipment needed Bone density: CT scanning system Radiotherapy: linear accelerator Radiotherapy: radiographic quality assurance Mammograph: Radio quality Mammograph: Radio machine Mammograph: digital machine quality X-ray machine other <please specify>: 0 other <please specify>: 0 other <please specify>: 0
16 Detailed inputs and activities are defined by year (#2: training) Second course: Specialist training for surgeons or radiologists Participant Costs Number of Classes per year Size of Class: Per Diem Rate (Students): Average Travel Costs: Cost of Training Packet (per student): Trainer costs: Total Student Costs: Number of Trainers per class: Per Diem Rate (Trainers): Hotel/travel costs (total for the course per trainer): Other Costs: Total Trainer Costs: Cost for lecture room rental Other Costs (per class): Total Other Costs: Total Costs for Training:
17 Results #1: assessment of resource needs for clinical services, based on our example Cost per woman >40 years, per year Number of women aged , , , ,640 Cost per woman >40 years (current scenario) 1,557 1,826 2,091 2,351 Cost per woman >40 years (proposed scenario) 2,671 3,055 3,505 4, , , , , , ,220 2,605 2,808 3,003 3,190 3,370 3,544 4,575 5,109 5,665 6,241 6,835 7,444
18 Results #2: assessment of resource needs for clinical services, based on our example 14,000 12,000 10,000 8,000 6,000 4,000 2,000-18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 - Costs for medical services in current scenario, million colones Current scenario Scale-up scenario ,, Trastuzumab Palliative Care Relapse diagnosis and treatment Trastuzumab Follow -up (all stages) Treatment stage IV Treatment stage III Palliative Care Treatment stage II Treatment stage I Diagnosis stage IV Relapse diagnosis and treatment Follow-up (all stages) Diagnosis stage III Diagnosis stage II Diagnosis stage I Screening Treatment stage IV Treatment stage III Treatment stage II Treatment stage I Diagnosis stage IV Diagnosis stage III Diagnosis stage II Diagnosis stage I Screening
19 Current scenario - Costes (milliones colones) Program costs Medical Devices Disposable Drugs Running costs for overhead Results # Home based visit community Nurse / volunteer Additional Human Resources Health Centre Outpatient Visit Hospital Outpatient Visit Hospital Inpatient services Breakdown of costs by input sheds light on the budget categories, and who will bear the costs Proposed scale-up scenario - Costes (milliones colones) Program costs Medical Devices Disposable Drugs Running costs for overhead Home based visit community Nurse / volunteer Additional Human Resources Health Centre Outpatient Visit Hospital Outpatient Visit Hospital Inpatient services
20 Issues for consideration
21 Application of the FBT Will demonstrate future resource needs associated with a plan Could be used to illustrate cost savings: Treating women in late stages, vs. Comprehensive preventive screening programmes and treating women in earlier stages Incorporates demographic changes over time change in population size of various age cohorts can model an increase or decrease in incidence over time, based on the local context and expected change in risk factors. Waiting times not explicitly addressed but could be taken into account by estimating costs for the activities required to reduce waiting times
22 Issues for consideration The financial cost analysis should be based on an analysis of the current health systems constraints, and how to overcome them (access to care, quality of care), and link to the broader health sector plans. If estimated costs are deemed as not affordable, potential strategies include: Plan for a less ambitious strategy (lower coverage) Explore innovative ways to save costs (greater integration of services, shift service delivery to lower level facilities, use generic drugs, etc) Explore different options for financing the plan Link the implementation plan for Breast Cancer programme to the broader national health strategic plan
23 Tres dimensiones de financiamento Reduce la participación de los gastos ye las cuotas Ampliar la cobertura
24 Issues for consideration (contd.) Equity e.g., variation in access and quality of care by geography The role of public / private providers Coverage targets/ scale-up phasing aligned with national health investment plans National vs. Decentralised level planning Inflation and price changes over time not yet accounted for
25 Proposed next steps Strategic: Define the overall strategic plan and implementation plan Link these to broader national plans for the health sector Programmatic: Refine inputs and assumptions for the programmatic investments, including treatment protocols, and price data. Define the format of results that are useful in the Mexican context (cost categories, budget categories) Assess financing policy Assess financing options Develop financing strategy (how to ensure moving towards universal financial access with long-term predictability of funding)
26 Muchas gracias por su atención
Methods of Financial Costing Analysis. Jeremy Lauer, WHO (Geneva)
Methods of Financial Costing Analysis Jeremy Lauer, WHO (Geneva) Objectives of this session The role of financial cost analysis in the planning process Overview of the Financial Costing Tool for Breast
More informationMethodology to assess the cost impact of PMB benefit definitions
Methodology to assess the cost impact of PMB benefit definitions Version 1.0.0 07 March 2012 Contents 1 Background... 1 2 Aim... 1 3 Objectives... 1 4 Methods... 2 5 Variables for data collection, data
More informationBooklet C.2: Estimating future financial resource needs
Booklet C.2: Estimating future financial resource needs This booklet describes how managers can use cost information to estimate future financial resource needs. Often health sector budgets are based on
More informationG4S Secure Solutions (USA), Inc.: PanaBridge Advantage Coverage Period: 11/01/ /31/2017
G4S Secure Solutions (USA), Inc.: PanaBridge Advantage Coverage Period: 11/01/2016 10/31/2017 The attached Summary of Benefits and Coverage (SBC) is required under the new Affordable Care Act (ACA). Under
More informationUnitedHealthcare Choice Plus. United HealthCare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus United HealthCare Insurance Company Certificate of Coverage For the Definity Health Savings Account (HSA) Plan 7PC of East Central College Enrolling Group Number: 711369 Effective
More informationUnitedHealthcare Choice Plus. UnitedHealthcare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus UnitedHealthcare Insurance Company Certificate of Coverage For the Plan 21D of Big Walnut Local School District Enrolling Group Number: 753271 Effective Date: January 1, 2016
More informationFAQS ON ACA ISSUES AND MENTAL HEALTH PARITY IMPLEMENTATION
Issue One Hundred Thirteen November 2015 November 18, 2015 FAQS ON ACA ISSUES AND MENTAL HEALTH PARITY IMPLEMENTATION The Departments of Labor (DOL), Health and Human Services (DHHS) and the Treasury (collectively
More informationCovered 100%; deductible waived 30%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $500 Individual $500 Individual $1,000 Family $1,000 Family All covered expenses accumulate separately toward the preferred or non-preferred
More informationBH Media Group, Inc. Coverage Period: 01/01/ /31/2016
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: HDHP What is the overall deductible? This is only a summary. If you want more detail about
More informationInside this Benefits Summary: Medical
BENEFITS SUMMARY Aetna Affordable Health Choices insurance plan Plan design and benefits provided by Aetna Life Insurance Company (Aetna) and administered by Strategic Resource Company (SRC). Unless otherwise
More informationKENYA DYNAMIC HEALTH SERVICE COSTING MODEL
KENYA DYNAMIC HEALTH SERVICE COSTING MODEL USER MANUAL G I Z Contents INTRODUCTION TO THE COSTING MODEL... 1 GETTING STARTED... 1 MODEL ASSUMPTIONS... 6 RESOURCE REQUIREMENTS FOR KEPH CONDITIONS... 14
More informationQualified High Deductible Health Plan PLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $6,600 Individual $20,000 Individual $13,200 Family $40,000 Family All covered expenses accumulate simultaneously toward both the
More informationCovered 100%; deductible waived 50%; after deductible
HEALTH SAVINGS ACCOUNT Employer HSA Contribution BARNES GROUP INC. HSA Value Plan Employee Only $250 Individual Not Applicable Family The amount reflected is on a per calendar year basis. The amount received
More informationCovered 100%; deductible waived 30%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $2,000 Individual $20,000 Individual $4,000 Family $40,000 Family All covered expenses accumulate simultaneously toward both the preferred
More informationBuilding Actuarial Cost Models from Health Care Claims Data for Strategic Decision-Making. Introduction. William Bednar, FSA, FCA, MAAA
Building Actuarial Cost Models from Health Care Claims Data for Strategic Decision-Making William Bednar, FSA, FCA, MAAA Introduction Health care spending across the country generates billions of claim
More informationRemoving private practice from public hospitals: Submission of the Health Insurance Authority to the de Buitleir Independent Review Group
Removing private practice from public hospitals: Submission of the Health Insurance Authority to the de Buitleir Independent Review Group February 2018 The Health Insurance Authority welcomes the invitation
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
Proprietary PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $750 Individual $20,000 Individual $2,000 Family $40,000 Family All covered expenses accumulate simultaneously toward
More informationHollard Cigna Health benefits overview
Hollard Cigna Health benefits overview Area(s) of cover Emergency out of area cover Annual maximum benefit per 1. Africa 2. Africa+ (including India, Pakistan, Sri Lanka, Bangladesh and Lebanon) 3. Europe
More information2015 Nursing Conference College of Nursing, Hong Kong
2015 Nursing Conference College of Nursing, Hong Kong Voluntary Health Insurance Scheme (VHIS) Food and Health Bureau 8 February 2015 Dr KO Wing Man, BBS, JP Secretary for Food & Health Hong Kong SAR Government
More informationHEALTH PLANS COMPARISON TABLE LATIN AMERICA & THE CARIBBEAN (EXCLUDING BRAZIL & MEXICO)
MAXIMUM COVERAGE US$ 5,000,000 US$ 2,000,000 (US$ 1,500,000 OPTIONAL) (US$ 1,500,000 OPTIONAL) COVERAGE & THE CARIBBEAN ELIGIBILITY UP TO 70 S OF AGE UP TO 70 S OF AGE UP TO 50 S OF AGE UP TO 70 S OF AGE
More informationStep by step guide to economic evaluation in cancer trials
What is CREST? The Centre for Health Economics Research and Evaluation (CHERE) at UTS has been contracted by Cancer Australia to establish a dedicated Cancer Research Economics Support Team (CREST) to
More informationGuidelines for cost analyses of new medicines and indications in the hospital sector
Guidelines for cost analyses of new medicines and indications in the hospital sector 1 Table of contents 1. Introduction... 3 2. Guidelines for cost analyses of new medicines and new indications in the
More informationPLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $1,000 Individual $2,000 Individual $2,000 Family $4,000 Family All covered expenses, accumulate separately toward the preferred or
More informationCT Silver PPO /50 HSA PY
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.healthreformplansbc.com or by calling 1-888-802-3862.
More informationUnitedHealthcare Choice Plus. UnitedHealthcare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus UnitedHealthcare Insurance Company Certificate of Coverage For the Health Savings Account (HSA) Plan 7PA of Educators Benefit Services, Inc. Enrolling Group Number: 717578
More informationSUMMARY OF BENEFITS Availability of services at SHC locations vary, please verify location when making appointments.
SUMMARY OF BENEFITS Availability of services at SHC locations vary, please verify location when making appointments. Policy Year Maximum Out-of-Pocket Limit OUTPATIENT BENEFITS Doctor s Visits Lab and
More information$8,300 $24,900 Maximum Lifetime Benefit
PPO Schedule of Health Plus 2 C & A Industries, Inc. Plan Effective Date: January 1, 2019 In-Network Out-of-Network** Benefit Year means a calendar year, which is the period of twelve (12) consecutive
More informationMemorial Hermann Advantage (HMO)
Memorial Hermann Advantage (HMO) INTRODUCTION TO SUMMARY OF BENEFITS January 1, 2015 December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn t list every service
More informationTRINET GROUP, INC : Traditional Choice - Indemnity
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationCovered 100%; deductible waived 30%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $500 Individual $500 Individual $1,000 Family $1,000 Family All covered expenses accumulate separately toward the preferred or non-preferred
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA HEALTH INSURANCE COMPANY - SELF-FUNDED
PLAN FEATURES Deductible (per plan year) None Individual None Family Member Coinsurance Covered 100% Applies to all expenses unless otherwise stated. Out-of-pocket limit (per plan year) $6,350 Individual
More informationCovered 100%; deductible waived 35%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible $300 Individual $1,000 Individual $600 Family $2,000 Family All covered expenses accumulate simultaneously toward both the preferred and non-preferred
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $3000 Individual $6,000 Individual $6000 Family $12,000 Family All covered expenses accumulate separately toward the preferred or
More informationCovered 100%; deductible waived 40%; after deductible
HEALTH SAVINGS ACCOUNT Employer HSA Contribution Barnes Group Inc. $500 Individual $1,000 Family The amount reflected is on a per calendar year basis. The amount received may be prorated based on your
More information$4,800 $9,600 Maximum Lifetime Benefit
PPO Schedule of PPO Medical C & A Industries, Inc. Plan Effective Date: January 1, 2019 In-Network Out-of-Network** Benefit Year means a calendar year, which is the period of twelve (12) consecutive months
More informationPLAN DESIGN & BENEFITS MEDICAL PLAN PROVIDED BY AETNA LIFE INSURANCE COMPANY
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $500 Individual $1,000 Individual $1,000 Family $2,000 Family All covered expenses accumulate separately toward the preferred or non-preferred
More information2017 Medical Benefits Highlights - City of Seattle/SHA Retirees Under Age 65
2017 Medical Benefits Highlights - City of Seattle/SHA Retirees Under Age 65 The purpose of this document is to help you make decisions. It is not a contract. Details are provided in your medical plan
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) None Individual $500 Individual None Family $1,000 Family Unless otherwise indicated, the deductible must be met prior to benefits
More informationDrug Coverage Programs for Patients with Cancer
Drug Coverage Programs for Patients with Cancer Information for patients and families Read this guide to learn about: different drug coverage programs which program to use and how to use it who to contact
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) None Individual $250 Individual None Family $500 Family All out-of-network covered expenses accumulate separately toward the non-preferred
More informationCovered 100%; deductible waived 40%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $2,500 Individual $4,500 Individual $5,000 Family $9,000 Family All covered expenses accumulate simultaneously toward both the preferred
More informationSUPRO: 2018 SCHEDULE OF BENEFITS - EMPLOYEE COST SHARING
SU Pro (In- and Out-of-) In - Out -of- Cost Sharing Definitions Annual Deductible 1 Coinsurance Annual Out-of-Pocket Maximum 2 $200 per individual with a maximum of $400 for a family 5% of allowable amount
More informationCovered 100%; deductible waived 50%; after deductible
HEALTH SAVINGS ACCOUNT Employer HSA Contribution Barnes Group Inc. HSA Value Plan Employee Only $250 Individual Not Applicable Family The amount reflected is on a per calendar year basis. The amount received
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK ( OUT-OF-NETWORK (Non- Deductible (per plan year) $350 Individual $800 Individual $1,050 Family $2,400 Family All covered expenses accumulate separately toward the preferred or
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA HEALTH INSURANCE COMPANY - SELF-FUNDED
PLAN FEATURES Deductible (per calendar year) $100 Individual $200 Family Unless otherwise indicated, the deductible must be met prior to benefits being payable. Member cost sharing for certain services,
More informationPRIDESTAFF, INC. : Open Choice - MedSure K
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationSuccessful disease management
Financial and Risk Considerations for Successful Disease Management Programs BY ARTHUR L. BALDWIN III, FSA, MAAA Milliman & Robertson, Seattle, Wash. ABSTRACT: Results for disease management [DM] programs
More informationCovered 100%; deductible waived 50%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per plan year) $1,500 Individual $3,000 Individual $3,000 Family $6,000 Family All covered expenses accumulate separately toward the in-network or out-of-network
More informationQualified High Deductible Health Plan PLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $2,000 Individual $2,000 Individual $6000 Family $6,000 Family All covered expenses accumulate simultaneously toward both the preferred
More informationThis chart summaries the coverage under the Standard Health Savings Account (HSA) Option using the Open Access Plus (OAP) network.
STANDARD HSA OPTION 2017 OPTIONS AT A GLANCE (DEDUCTIBLE 3000/6000) USING THE OPEN ACCESS PLUS (OAP) NETWORK This chart summaries the coverage under the Standard Health Savings Account (HSA) Option using
More informationMIAMI DADE COLLEGE : Open Choice - FL
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.healthreformplansbc.com or by calling 1-800-370-4526.
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) None Individual $600 Individual None Family $1,200 Family All out of network covered expenses accumulate towards the non-preferred
More informationCOSTING INTERVENTIONS
ASAP Regional Training on Epidemiological and Economic Tools for HIV/AIDS Strategic Planning COSTING INTERVENTIONS Julian Naidoo (Ph.D) Durban, November 2007 STRATEGY RESULTS CYCLE Formulate/Revise HIV/AIDS
More informationCovered 100%; deductible waived 50%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per plan year) $2,250 Individual $6,850 Individual $4,500 Family $13,700 Family All covered expenses accumulate separately toward the preferred or non-preferred
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $500 Individual $2,000 Individual $1,500 Family $6,000 Family All covered expenses accumulate separately toward the preferred or non-preferred
More informationNEW CASTLE COUNTY COMPARISON OF PRE-65 RETIREES/PENSIONERS BENEFITS PLAN YEAR 2019
Deductible Per Calendar Year (Individual/Family) $200 Individual $400 Family (DME, Prosthetics and Hearing Aids only) $200 per Individual $400 per Family $200 per Individual $400 per Family $200 per Individual
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) None Individual $500 None Family $1,500 All covered expenses accumulate separately toward the non-preferred Deductible. Unless otherwise
More informationOverview and Best Practices in Understanding and Interpreting Cost Data
Overview and Best Practices in Understanding and Interpreting Cost Data Carol Levin, PhD 7 November 2018 HEIST Workshop: Introduction to Economic Evaluation in Global Health Recognition This presentation
More informationCHILDREN'S HOME SOCIETY OF FLORIDA : Aetna Open Access Managed Choice - FL Plan 8
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationBlue Shield 65 Plus (HMO) summary of benefits
Blue Shield 65 Plus (HMO) summary of benefits Kern (partial) County January 1, 2016 to December 31, 2016 This booklet gives you a summary of what we cover and what you pay. It doesn t list every service
More informationCASA, INC. : Health Network Option SM - Low Plan (ACO)
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationCASA, INC. : Health Network Only SM - HDHP (ACO Plan)
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationCovered 100%; deductible waived 40%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $300 Individual $300 Individual $900 Family $900 Family All covered expenses accumulate separately toward the preferred or non-preferred
More informationSUMMARY OF BENEFITS. Cigna Health and Life Insurance Co. RADCO Health Savings Account Open Access Plus
SUMMARY OF BENEFITS Cigna Health and Life Insurance Co. RADCO Health Savings Account Open Access Plus General Services In-Network Out-of-Network Physician office visit Primary Care Physician (PCP) Physician
More informationWhat to Know About Your Health Plan
What to Know About Your Health Plan 1 Given the ever changing nature of health care, it s no surprise many people have a diffcult time understanding their health benefts. However, learning the basics of
More informationTRINET GROUP, INC. : Aetna Open Access Elect Choice - NY Tri-State EPO 20
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationTRINET GROUP, INC. : Health Network Only SM - IL HMO 20
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationTRINET GROUP, INC. : Aetna Open Access Managed Choice - NY Tri-State Portfolio POS 15
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.healthreformplansbc.com or by calling 1-888-982-3862.
More informationVA Aetna Whole Health Silver $10 Copay NA CSR $0
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.healthreformplansbc.com or by calling 1-855-586-6960.
More informationMemorial Hermann Advantage (PPO)
Memorial Hermann Advantage (PPO) INTRODUCTION TO SUMMARY OF BENEFITS January 1, 2015 December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn t list every service
More informationThis is an ERISA plan, and you have certain rights under this plan. Please contact your Employer for additional information.
Schedule of Benefits Employer: MSA Contract Number Control Number:: Barnes Group Inc. 397393 842881 Issue Date: February 15, 2017 Effective Date: January 1, 2017 Schedule: 3A Booklet Base: 3 For: Indemnity
More informationSUMMARY OF BENEFITS. Montgomery College Open Access Plus Coinsurance Plan. Connecticut General Life Insurance Co. Notice of Grandfathered Plan Status
SUMMARY OF BENEFITS Connecticut General Life Insurance Co. Notice of Grandfathered Plan Status This plan is being treated as a grandfathered health plan under the Patient Protection and Affordable Care
More informationSUBLUE AND SUORANGE: 2018 SCHEDULE OF BENEFITS -EMPLOYEE COST SHARING
Cost Sharing Definitions Annual Deductible 1 (amounts are not cumulative across levels) $100 per individual with a maximum of $250 for a family $300 per individual with a maximum of $1,000 for a family
More informationOECD Health Committee Survey on Health Systems Characteristics 2016 ROUND
OECD Health Committee Survey on Health Systems Characteristics 2016 ROUND PART I. HEALTH CARE FINANCING Section 1: Characteristics of basic health care coverage Section 2: Regulation of health insurance
More informationPLAN DESIGN & BENEFITS HDHP Standard ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per year) $1,750 Individual $3,500 Individual $3,500 Family $7,000 Family All covered expenses accumulate separately toward the preferred or non-preferred
More information: POS HD 3000 Silver Coverage Period: 2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Family Plan Type: POS
Standard Silver Point-of-Service 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.connecticare.com or
More informationPacificSource: PSN Silver 2500 Coverage Period: Beginning on or after 01/01/2017
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 PacificSource.com/oregon/small-group-plan-details-2017Jan
More informationPacificSource: PSN Balance Gold 250+0_20 S4 Coverage Period: 08/16/ /15/2017
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 PacificSource.com/GeorgeFox or by calling 1-888-977-9299
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $1,000 Individual $2,000 Individual $3,000 Family $6,000 Family All covered expenses accumulate separately toward the preferred or
More informationVA Aetna Whole Health Catastrophic 100%
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.healthreformplansbc.com or by calling 1-855-586-6960.
More informationUsing the OneHealth tool for planning and costing a national disease control programme
HIV TB Malaria Immunization WASH Reproductive Health Nutrition Child Health NCDs Using the OneHealth tool for planning and costing a national disease control programme Inter Agency Working Group on Costing
More informationPART A: TYPE OF COVERAGE 1. TYPE OF PLAN
$2,000 Deductible Plan with HSA Option (80%) and $2,000 Deductible Plan with HSA Option (100%) PART A: TYPE OF COVERAGE 1. TYPE OF PLAN Health Maintenance Organization (HMO) 2. OUT-OF-NETWORK CARE COVERED?
More informationHMSA: Catastrophic Plan
HMSA: Catastrophic Plan Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016-12/31/2016 Coverage for: Individual Plan Type: PPO This is only a summary. If
More informationCovered 100%; deductible waived 50%; after deductible. Covered 100%; deductible waived 50%; after deductible
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $1,500 Individual $4,500 Individual $3,000 Family $9,000 Family All covered expenses accumulate simultaneously toward both the preferred
More informationVA Aetna Coastal VA HP Silver $10 Copay
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthreformplansbc.com or by calling 1-855-586-6960.
More informationBlueCross 0.50, a Multi-State Plan STD
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at https://www.capbluecross.com/sbcsia or by calling 1-800-730-7219.
More information: Coverage Period: 01/01/ /31/2016
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.innovation-health.com/summary-benefits-and-coverage or
More informationTable of Benefits All monetary figures shown are in US Dollars ($). INDIVIDUAL POLICIES
Allianz Care International Healthcare Plans for Egypt Valid from 1st July 2018 INDIVIDUAL POLICIES Table of Benefits All monetary figures shown are in US Dollars ($). REASONS TO CHOOSE US Flexible modular
More informationWhat is the overall deductible? Are there other deductibles for specific services?
Standard Gold Point-of-Service (POS) : POS HD 1000 Gold Coverage Period: 2014 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $4,000 Individual $12,000 Individual $8,000 Family $24,000 Family All covered expenses accumulate separately toward the preferred
More informationPLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
AN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible $300 Individual $800 Individual $900 Family $2,400 Family All covered expenses accumulate toward the preferred or non-preferred Deductible. Unless otherwise
More informationGENERALI WORLDCHOICE DEDUCTIBLE OPTIONS
GENERALI WORLDCHOICE DEDUCTIBLE OPTIONS Group Health Plan Benefit Summary Comprehensive Major Medical Benefit Pre-Authorization through Generali Worldwide is required for certain Medical Services (1) otherwise
More information$ 600 individual / $ 1,200 family Does not apply to prescription drugs or exercise facility reimbursements. $ 4,000 individual / $ 8,000 family
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.metroplus.org or by calling 1-855-809-4073. Important
More informationChoice Plus Plan 14K / 0QG Coverage Period: 07/01/ /30/2015
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 welcometouhc.com or by calling 1-866-633-2446. Important
More informationAetna Leap Catastrophic Carolinas HealthCare System
: Aetna Leap Catastrophic Carolinas HealthCare System Coverage Period: 01/01/2016-12/31/2016 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms
More informationBENEFITS SCHEDULE. MyHEALTH. Please print only if necessary
BENEFITS SCHEDULE MyHEALTH www.april-international.com Please print only if necessary MyHEALTH BENEFITS SCHEDULE This s schedule provides a summary of the cover we provide per period of insurance unless
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
FUND FEATURES HealthFund Amount $500 Employee $1,000 Employee + 1 $1,500 Employee + 2 $2,000 Employee + 3 or more Amount contributed to the Fund by the employer Fund amount reflected is on a per calendar
More informationCancer. About this Benefit AMERICAN PUBLIC LIFE YOUR BENEFITS DID YOU KNOW?
AMERICAN PUBLIC LIFE Cancer YOUR BENEFITS About this Benefit Cancer insurance offers you and your family supplemental insurance protection in the event you or a covered family member is diagnosed with
More informationPLAN DESIGN & BENEFITS ADMINISTERED BY AETNA LIFE INSURANCE COMPANY - SELF FUNDED
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $2,500 Individual $5,000 Individual $5,000 Family $10,000 Family All covered expenses accumulate separately toward the preferred or
More informationAetna Leap Basic. Coverage Period: 01/01/ /31/2016. Summary of Benefits and Coverage: What this Plan Covers & What it Costs
: Aetna Leap Basic Coverage Period: 01/01/2016-12/31/2016 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
More information