Are health-based payments a feasible tool for addressing risk segmentation?

Article Abstract:

Health-based payments and risk-adjusted payments are practical tools that can help solve the problem on risk segmentation for majority of the populations receiving acute care. However, problems on technical limitations, political issues and several research gaps still remain. The relations between health-based payments and differing insurance market rating requirements should however be understood. Since health-based payments are becoming widely implemented by state Medicaid programs, research should focus more on developing risk assessment tools to enable implementation of health-based payments for chronic conditions.

HEALTH SERVICES, Asset & Risk Management, Health Planning, Management, Risk assessment

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Health risk and access to employer-provided health insurance

Article Abstract:

Employers are often apprehensive to offer comprehensive health insurance coverage to workers with high health risk. This can be explained by the negative effects of poor health on company earnings and productivity. Studies also indicate that prior to the passage of the American with Disabilities Act, many companies screen out high-risk workers by giving pre-employment medical examinations and interviews. These actions, which are still being practiced by some employers, will have serious repercussions on health care reform.

Accident & Health Insurance, Insurance Carriers, Employee Health & Safety, Occupational safety and health, Occupational health services

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Marital status, spousal coverage, and the gender gap in employer-sponsored health insurance

Article Abstract:

A study to determine the existence of a gender gap in employer-sponsored health insurance. The results revealed that the gender gap was due to relatively high rates of coverage for married men and low rates for married women which resulted in the conclusion that for married workers, especially in women, coverage rates and offer rates differ. Among single workers however, women were found to have slightly higher coverage rates than men, revealing a similarity in offer rates and coverage rates.

Direct Health and Medical Insurance Carriers, Hospital and medical service plans, Medical Care Insurance, Research, Demographic aspects, Sex discrimination, Insurance, Discrimination in insurance, Insurance discrimination, Employment discrimination

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