In the present article, Budget Impact Analysis as an effective, practical financial tool has been introduced to the policy makers for improving drug formulary and reimbursement decision making. In Iran, Ministry of Health (MOH), health insurance organizations, and health care providers such as hospitals could take the most advantage of the BIAs reports.

Business intelligence is one of the tools of IT in business and Information systems for management have been just developed theoretically, and have never fulfilled the demands of organizations, practically. The establishment and marketing of electronic insurance demands the readiness of tools and the foundation of IT. Business intelligence provides the managers with a collection of tools, techn...

PURPOSE The medical cost of diabetes in the United States in 1997 was at least $98 billion. This study illustrates the behavioral change and medical-care utilization impact that occurs in a community-based setting of a diabetes disease-management program that is applied to program participants in a health insurance plan's health maintenance organization and preferred provider organization. DE...

This article focuses on injuries committed by members of organizations, such as corporations, and examines distinct issues raised by apology in the organizational setting, in particular: the process of learning to prevent future errors, the divergent interests stemming from principal-agent tensions in employment, risk preferences and sources of insurance, the non-pecuniary benefits to corporate...

This Issue Brief discusses the evolution of the health care delivery and financing systems and its effects on health care cost management and describes the changes in the health care delivery system as they pertain to managed care. It presents empirical evidence on the effectiveness of managed care and concludes with an analysis of the potential of future health care reform to influence the evo...

In carrying out its statutory mandate to make studies concerning the advancement of economic security through social insurance, the Social Security Administration has followed closely the progress of voluntary health insurance. Important developments in this field have occurred during the 3 years that have passed since the Administration's Bureau of Research and Statistics published the results...

STUDIES OVER THE PAST 4 DECADES have shown that physicians die by suicide more frequently than nonphysicians. Because of this striking finding, experts with knowledge and experience in areas including medicine, health insurance, and physician licensing recently convened to address factors in the profession that can discourage physicians experiencing depression and other psychiatric conditions f...

A primary goal of the Patient Protection and Affordable Care Act (PPACA) is to reduce the number of uninsured by making health insurance more affordable for small businesses and individuals. Toward that end, the PPACA encourages the creation of nonprofit, member-owned health insurance cooperatives to operate inside each state exchange. Co-ops face significant challenges in entering mature insur...

UNLABELLED Using current treatment approaches, many patients with type 2 diabetes do not achieve glycemic goals--and do experience macrovascular complications that contribute to morbidity and mortality. It's time to consider other options. IMPLICATIONS Aggressive therapeutic interventions aimed at insulin resistance and cell dysfunction may alter outcomes. Managed care organizations may need ...