The purpose of this project was to evaluate practice type and geographical differences in methods of payment accepted for children's dental services. A survey was mailed to 2000 general dentists and 1000 pediatric dentists randomly selected to provide representation from the 50 United States. Dentists were asked to specify the type of practice and the state in which they primarily practice. The...

This paper provides a summary of the cost-effectiveness research for family therapy. Data were available from four different sources in the United States: (1) a health maintenance organization with 180,000 subscribers; (2) the Medicaid system of the State of Kansas; (3) CIGNA Behavioral Health, a division of a health insurance company with nine million subscribers; and (4) a family therapy trai...

Norton Healthcare, an integrated delivery system based in Louisville, Ky., is one of the provider groups taking part in the Brookings–Dartmouth ACO Pilot Program to form accountable care organizations, which assume responsibility for improving patient care and lowering total costs and, in turn, share in the savings achieved. This case study explores the characteristics of Norton and its partner...

    Background: Sukuk is a type of financial instrument backed by balance sheet and physical assets. This applied and descriptive study aimed at providing solutions to the problems faced by insurance companies in the health sector.    Methods: In this study, we achieved operational models by reviewing the release nature and mechanism of any of the securities and combin...

The claim that managed care plans are more efficient than fee-for-service plans has been made so often that it has reached the status of folklore, but the evidence is inconclusive. The claim is usually based on one or both of the following errors: (1) lower medical care costs mean lower total costs (medical plus administrative costs) and (2) lower HMO premiums mean HMOs are more efficient than ...

elivery of health care services to patients is facing extreme levels of change and challenge, ushered in not just by the Affordable Care Act, but also by demands from insurers, payers and employers for improved approaches. At Our Lady of the Lake Regional Medical Center in Baton Rouge, La., the goal of our quality improvement efforts is — as always — to improve patient care. But we also want to...

Accountable Care Organizations (ACOs) are networks of providers that assume risk for the quality and total cost of the care they deliver. Public policymakers and private insurers hope that ACOs will achieve the elusive "triple aim" of improving quality of care, improving population health, and reducing costs. The model is still evolving, but the premise is that ACOs will accomplish these aims b...

Recent healthcare reforms have sought to increase efficiency by introducing managed care (MC) while respecting consumer preferences by admitting choice between MC and conventional care. This article proposes an institutional change designed to let German consumers choose between the two settings through directing payments from the Federal Health Fund to social health insurers (SHIs) or to speci...

After the introduction of public long-term care insurance in 2000, for-profit facilities were allowed to enter the at-home care market in Japan, where nonprofits are dominant. However, according to a popular hypothesis called the “contract failure,” nonprofit centers are preferred over for-profit counterparts due to an asymmetry of information. If this is the case, a change in competition polic...

BACKGROUND The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offerin...