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Insurance Benefits (insurance + benefit)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Interview with a Quality Leader,Karen Davis, Executive Director of The Commonwealth Fund

JOURNAL FOR HEALTHCARE QUALITY, Issue 2 2009
Lecia A. Albright
Dr. Davis is a nationally recognized economist, with a distinguished career in public policy and research. Before joining the Fund, she served as chairman of the Department of Health Policy and Management at The Johns Hopkins School of Public Health, where she also held an appointment as professor of economics. She served as deputy assistant secretary for health policy in the Department of Health and Human Services from 1977 to 1980, and was the first woman to head a U.S. Public Health Service agency. Before her government career, Ms. Davis was a senior fellow at the Brookings Institution in Washington, DC; a visiting lecturer at Harvard University; and an assistant professor of economics at Rice University. A native of Oklahoma, she received her PhD in economics from Rice University, which recognized her achievements with a Distinguished Alumna Award in 1991. Ms. Davis is the recipient of the 2000 Baxter-Allegiance Foundation Prize for Health Services Research. In the spring of 2001, Ms. Davis received an honorary doctorate in human letters from John Hopkins University. In 2006, she was selected for the Academy Health Distinguished Investigator Award for significant and lasting contributions to the field of health services research in addition to the Picker Award for Excellence in the Advancement of Patient Centered Care. Ms. Davis has published a number of significant books, monographs, and articles on health and social policy issues, including the landmark books HealthCare Cost Containment, Medicare Policy, National Health Insurance: Benefits, Costs, and Consequences, and Health and the War on Poverty. She serves on the Board of Visitors of Columbia University, School of Nursing, and is on the Board of Directors of the Geisinger Health System. She was elected to the Institute of Medicine (IOM) in 1975; has served two terms on the IOM governing Council (1986,90 and 1997,2000); was a member of the IOM Committee on Redesigning Health Insurance Benefits, Payment and Performance Improvement Programs; and was awarded the Adam Yarmolinsky medal in 2007 for her contributions to the mission of the Institute of Medicine. She is a past president of the Academy Health (formerly AHSRHP) and an Academy Health distinguished fellow, a member of the Kaiser Commission on Medicaid and the Uninsured, and a former member of the Agency for Healthcare Quality and Research National Advisory Committee. She also serves on the Panel of Health Advisors for the Congressional Budget Office. [source]

Evaluating Medical Effectiveness for the California Health Benefits Review Program

HEALTH SERVICES RESEARCH, Issue 3p2 2006
Harold S. Luft
An important aspect of the mandate assessments requested by the California legislature is a review of the scientific and medical literature on the medical effectiveness of the proposed health insurance benefit mandate. Although such a review bears many similarities to effectiveness reviews that might be undertaken for publication as research studies, several important differences arise from the requirements of the California legislation. Our reviews are intended to assist the legislators in deciding whether to support a specific mandate to modify health insurance benefits in a particular way. Thus, our assessments focus on how the scientific literature bears on the proposed mandate, which may involve a complicated chain of potential effects leading from altered coverage to ultimate impact on health. Evidence may be available for only some of the links in the chain. Furthermore, not all the evidence may be directly applicable to the diverse population of California or the subpopulation affected by the mandate. The mandate reviews, including the medical effectiveness analyses, may be used in a potentially contentious decision making setting. The legislative calendar requires that they need to be timely, yet they must be as valid, credible, and based on the best information available as possible. The focus on applicability also implies the need for informed, technical decisions concerning the relevance of the articles for the report, and these decisions need to be made as transparent as possible. These goals and constraints yield an approach that differs somewhat from an investigator-initiated review of the literature. [source]

Language preference and non-traumatic low back disorders in washington state workers' compensation

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010
David K. Bonauto MD
Abstract Background Workers in the United States with limited English proficiency likely perform more hazardous work, experience higher rates of work-related injury and illness, and have worse disability outcomes. Methods We conducted a descriptive study of employment characteristics, timeliness and utilization of workers' compensation (WC) insurance benefits, cost and occupational health outcomes for Washington State WC state fund, non-traumatic low back disorders (LBD) claimants by language preference. Results A greater proportion of Spanish language preferring (SLP) LBD claims filed were accepted and resulted in lost work time than English language preferring (ELP) LBD claims. There were significant differences in the demographic, employment, and occupational characteristics between the SLP and ELP compensable claimant populations. The SLP LBD compensable claimants had greater time loss duration, greater medical and total claim costs, more use of physical therapy and vocational services than the ELP LBD compensable claimants. With the exception of the timeliness for providing the first time loss payment, the time periods for provision of insurance benefits did not differ between the SLP and ELP populations. SLP compensable claimants received less back surgery and had comparable permanent partial disability payments to the ELP population. Employers were more likely to protest the acceptance of a SLP compensable than one in an ELP LBD compensable claim. Conclusion For those injured workers accessing the Washington State WC system, we observed differences based on language preference for pre-injury, and workers compensation outcomes. Further research is needed to explain the observed differences. Am. J. Ind. Med. 53:204,215 2010. © 2009 Wiley-Liss, Inc. [source]

Detecting malingering of Ganser-like symptoms with tests: A case study

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2006
HARALD MERCKELBACH phd
Abstract, A middle-aged man presented with Ganser symptoms. He had been involved in a car crash and was seeking disability insurance benefits. Extensive testing with malinger instruments revealed that he performed below chance on simple memory tests and endorsed a variety of nonexistent symptoms. With this in mind, the authors collected collateral information which showed that the patient was involved in high level sports activities that were difficult to reconcile with the severe cognitive dysfunctions that he claimed to suffer from. The case demonstrates that Ganser-like symptoms deserve close scrutiny, preferably with malinger tests. [source]