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Sample records for pilot insurance plan

  1. Understanding health insurance plans

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000879.htm Understanding health insurance plans To use the sharing features on this ... plan for you and your family. Types of Health Insurance Plans Depending on how you get your health ...

  2. Self-insured health plans

    PubMed Central

    McDonnell, Patricia; Guttenberg, Abbie; Greenberg, Leonard; Arnett, Ross H.

    1986-01-01

    Nationwide, 8 percent of all employment-related health plans were self-insured in 1984, which translates into more than 175,000 self-insured plans according to our latest study of independent health plans. The propensity of an organization to self-insure differs primarily by its size, with large establishments more likely to self-insure. In the overwhelming majority of cases, the self-insured benefit was hospital and/or medical. Among employers who self-insure, 23 percent self-administer, and the remaining 77 percent hire a commercial insurance company, Blue Cross/Blue Shield plan, or an independent third-party administrator to administer the health plan. PMID:10312008

  3. Prescriptions and Insurance Plans

    MedlinePlus

    ... ContentCancer: End-of-Life Issues for the CaregiverRead Article >>Cancer: End-of-Life Issues for the CaregiverJuly 2017June 2002Healthcare Managementfamilydoctor.org editorial staffHealth Insurance: ... Insurance: Understanding What It CoversJanuary 2015April 2004Insurance & ...

  4. ADS pilot program Plan

    NASA Technical Reports Server (NTRS)

    Clauson, J.; Heuser, J.

    1981-01-01

    The Applications Data Service (ADS) is a system based on an electronic data communications network which will permit scientists to share the data stored in data bases at universities and at government and private installations. It is designed to allow users to readily locate and access high quality, timely data from multiple sources. The ADS Pilot program objectives and the current plans for accomplishing those objectives are described.

  5. 48 CFR 428.307-1 - Group insurance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Group insurance plans. 428... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 428.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  6. 48 CFR 2828.307-1 - Group insurance plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Group insurance plans... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 2828.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  7. 48 CFR 2828.307-1 - Group insurance plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Group insurance plans... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 2828.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  8. 48 CFR 428.307-1 - Group insurance plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Group insurance plans. 428... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 428.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  9. 48 CFR 2828.307-1 - Group insurance plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Group insurance plans... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 2828.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  10. 48 CFR 2828.307-1 - Group insurance plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Group insurance plans... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 2828.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  11. 48 CFR 2828.307-1 - Group insurance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Group insurance plans. 2828... Contracting Requirements BONDS AND INSURANCE Insurance 2828.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  12. 48 CFR 428.307-1 - Group insurance plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Group insurance plans. 428... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 428.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  13. 48 CFR 428.307-1 - Group insurance plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Group insurance plans. 428... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 428.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  14. 48 CFR 428.307-1 - Group insurance plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Group insurance plans. 428... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 428.307-1 Group insurance plans. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor shall submit...

  15. Insurance planning for dentists and dental practices.

    PubMed

    Thomalla, Kenneth C; Wherry, Jeffrey

    2008-07-01

    There are a myriad of insurance products available for the dentist and his dental practice. Care must be taken to ensure that all risks have been reviewed and the appropriate risks covered with an insurance plan. Taking the time to solidify your base helps to ensure a strong financial plan for years to come.

  16. 48 CFR 28.307-1 - Group insurance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 28.307-1 Group insurance plans. (a) Prior approval requirement. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the contractor must submit the plan for approval, in accordance with agency regulations. Any change in benefits...

  17. 48 CFR 228.307-1 - Group insurance plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Group insurance plans. 228..., DEPARTMENT OF DEFENSE GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 228.307-1 Group insurance plans. The Defense Department Group Term Insurance Plan is available for contractor use under...

  18. 48 CFR 228.307-1 - Group insurance plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Group insurance plans. 228..., DEPARTMENT OF DEFENSE GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 228.307-1 Group insurance plans. The Defense Department Group Term Insurance Plan is available for contractor use under...

  19. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical...

  20. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Health insurance, life insurance and other benefit plans. 60-300.25 Section 60-300.25 Public Contracts and Property Management... Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital,...

  1. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical...

  2. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical...

  3. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 1 2014-07-01 2014-07-01 false Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... § 60-741.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital,...

  4. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical...

  5. Evaluating Long-Term Disability Insurance Plans.

    ERIC Educational Resources Information Center

    Powell, Jan

    1992-01-01

    This report analyzes the factors involved in reviewing benefits and services of employer-sponsored group long-term disability plans for higher education institutions. Opening sections describe the evolution of disability insurance and its shape today. Further sections looks at the complex nature of "value" within a plan, relationship…

  6. 48 CFR 3028.307-1 - Group insurance plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Group insurance plans..., HOMELAND SECURITY ACQUISITION REGULATION (HSAR) SOCIOECONOMIC PROGRAMS BONDS AND INSURANCE Insurance 3028.307-1 Group insurance plans. Plans shall be submitted to the contracting officer, who must obtain...

  7. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  8. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  9. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  10. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  11. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  12. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  13. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  14. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company,...

  15. State of emergency preparedness for US health insurance plans.

    PubMed

    Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

    2015-01-01

    Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

  16. Framework for planning and conducting pilot studies.

    PubMed

    Smith, Lisa Janette; Harrison, Margaret B

    2009-12-01

    Researchers working with partners in home care to plan a pragmatic multicenter community-based, randomized, controlled trial for leg ulcer compression treatment realized a smaller pilot study would be necessary. Because no framework for conducting pilot studies could be found, the authors developed a framework for pilot study methodology to inform the planning of such research. To this end, an integrative literature review was conducted, guided by an explicit search strategy, retrieval procedures, and appraisal process, to identify recognized pilot study aims, processes, and methodologies used in previously reported community pilot studies. Factors influencing study inclusion were recognized pilot study aims and purposes and a concise working definition of pilot study. Methodologies used in previously conducted community pilot studies were reviewed. Although relevant published research was limited, 11 pilot studies met the inclusion criteria for this review and contained suggestions to further develop or improve plans for larger definitive trials to enable a better fit of protocols within the delivery systems and scopes of practice. Pilot research processes could be divided into two stages: early planning and pilot trial. Direction for procedures and methods was gained relative to planning for an effective pilot study regarding eligibility, recruitment and data collection, management, and analysis. The results were used to develop an organizing framework for the authors' pilot study and named the Pilot Research Process (PReP) Framework. The process was instrumental in working with the authors' research team and clinical partners in the planning of their leg ulcer treatment pilot study. This framework may provide a foundation for others to analyze or develop a pilot study methodology in planning a large-scale study.

  17. Correlating Ratings of Health Insurance Plans to Their Providers' Attributes

    PubMed Central

    Shetty, Prajna; Hristidis, Vagelis

    2016-01-01

    Background There is a push towards quality measures in health care. As a consequence, the National Committee for Quality Assurance (NCQA) has been publishing insurance plan quality measures. Objective The objective of this study was to examine the relationship between insurance plan quality measures and the participating providers (doctors). Methods We collected and analyzed provider and insurance plan data from several online sources, including provider directories, provider referrals and awards, patient reviewing sites, and hospital rankings. The relationships between the provider attributes and the insurance plan quality measures were examined. Results Our analysis yielded several findings: (1) there is a moderate Pearson correlation (r=.376) between consumer satisfaction insurance plan scores and review ratings of the member providers, (2) referral frequency and provider awards are negligibly correlated to consumer satisfaction plan scores (correlations of r=.031 and r=.183, respectively), (3) there is weak positive correlation (r=.266) between the cost charged for the same procedures and consumer satisfaction plan scores, and (4) there is no significant correlation between member specialists’ review ratings and specialty-specific insurance plan treatment scores for most specialties, except a surprising weak negative correlation for diabetes treatment (r=-.259). Conclusions Our findings may be used by consumers to make informed choices about their insurance plans or by insurances to understand the relationship between patients’ satisfaction and their network of providers. PMID:27777217

  18. 48 CFR 1228.307-1 - Group insurance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Group insurance plans. 1228.307-1 Section 1228.307-1 Federal Acquisition Regulations System DEPARTMENT OF TRANSPORTATION... basis on proposed purchases of group insurance plans. Legal advice should be sought where necessary on...

  19. Health Insurance: Understanding Your Health Plan's Rules

    MedlinePlus

    ... ContentCancer: End-of-Life Issues for the CaregiverRead Article >>Cancer: End-of-Life Issues for the CaregiverJuly 2017June 2002Healthcare Managementfamilydoctor.org editorial staffHealth Insurance: ... Insurance: Understanding What It CoversJanuary 2015April 2004Insurance & ...

  20. 77 FR 72721 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-06

    ... Internal Revenue Service 26 CFR Parts 40, 46, and 602 RIN 1545-BK59 Fees on Health Insurance Policies and... issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to...-3970 (regarding health insurance policies). SUPPLEMENTARY INFORMATION: Paperwork Reduction Act...

  1. 45 CFR 149.340 - Rule for insured plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Rule for insured plans. 149.340 Section 149.340 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.340 Rule for insured...

  2. Employee demand for health insurance and employer health plan choices.

    PubMed

    Bundorf, M Kate

    2002-01-01

    Although most private health insurance in US is employment-based, little is known about how employers choose health plans for their employees. In this paper, I examine the relationship between employee preferences for health insurance and the health plans offered by employers. I find evidence that employee characteristics affect the generosity of the health plans offered by employers and the likelihood that employers offer a choice of plans. Although the results suggest that employers do respond to employee preferences in choosing health benefits, the effects of worker characteristics on plan offerings are quantitatively small.

  3. 24. Site plan, 1924 Photocopied from Sanborn Map Company, Insurance ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. Site plan, 1924 Photocopied from Sanborn Map Company, Insurance Maps of New Haven, v. 5, map no. 540, 1924 - Eli Whitney Armory, West of Whitney Avenue, Armory Street Vicinity, Hamden, New Haven County, CT

  4. 23. Site plan, 1931 Photocopied from Sanborn Map Company, Insurance ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. Site plan, 1931 Photocopied from Sanborn Map Company, Insurance Maps of New Haven, v. 5, map no. 540, 1924 updated to 1931. - Eli Whitney Armory, West of Whitney Avenue, Armory Street Vicinity, Hamden, New Haven County, CT

  5. 48 CFR 3028.307-1 - Group insurance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Group insurance plans. 3028.307-1 Section 3028.307-1 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY... advice of legal counsel. ...

  6. 77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-09

    ... Internal Revenue Service 26 CFR Parts 40 and 46 RIN 1545-BK59 Fees on Health Insurance Policies and Self... Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust...

  7. 77 FR 52614 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-30

    ... HUMAN SERVICES 45 CFR Part 152 RIN 0938-AQ70 Pre-Existing Condition Insurance Plan Program AGENCY... regarding program eligibility to the interim final regulation implementing the Pre- Existing Condition Plan... provide immediate access to coverage for eligible uninsured Americans with pre-existing...

  8. 7 CFR 457.139 - Fresh market tomato (dollar plan) crop insurance provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Fresh market tomato (dollar plan) crop insurance...) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.139 Fresh market tomato (dollar plan) crop insurance provisions. The fresh market tomato (dollar plan) crop...

  9. 76 FR 7098 - Dealer Floor Plan Pilot Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-09

    ... ADMINISTRATION 13 CFR Parts 120 and 121 Dealer Floor Plan Pilot Program AGENCY: U.S. Small Business... Dealer Floor Plan Pilot Program to make available 7(a) loan guaranties for lines of credit that provide floor plan financing. This new Dealer Floor Plan Pilot Program was created in the Small Business...

  10. Plan choice, health insurance cost and premium sharing.

    PubMed

    Kosteas, Vasilios D; Renna, Francesco

    2014-05-01

    We develop a model of premium sharing for firms that offer multiple insurance plans. We assume that firms offer one low quality plan and one high quality plan. Under the assumption of wage rigidities we found that the employee's contribution to each plan is an increasing function of that plan's premium. The effect of the other plan's premium is ambiguous. We test our hypothesis using data from the Employer Health Benefit Survey. Restricting the analysis to firms that offer both HMO and PPO plans, we measure the amount of the premium passed on to employees in response to a change in both premiums. We find evidence of large and positive effects of the increase in the plan's premium on the amount of the premium passed on to employees. The effect of the alternative plan's premium is negative but statistically significant only for the PPO plans. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Alternative Compensation Plans for Improving Retention of Air Force Pilots

    DTIC Science & Technology

    1989-08-01

    paid to most pilots. These plans do tend, however, to provide equal pay for pilots with equal YOS. o Plans that avoid indexing flight pay to annual... equal YOS receive different amounts of pay . Despite precedents for such differences in the military pay system, the Air Force argues that pilots with... equal YOS should receive equal pay in order to maintain pilot morale. o Plans that emphasize across-the-board pay increases for pilots of all types

  12. 20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance....

  13. 20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

  14. 29 CFR 452.39 - Participation in insurance plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Participation in insurance plan. 452.39 Section 452.39 Labor Regulations Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR LABOR... AND DISCLOSURE ACT OF 1959 Candidacy for Office; Reasonable Qualifications § 452.39 Participation...

  15. 48 CFR 1028.307-1 - Group insurance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Group insurance plans. 1028.307-1 Section 1028.307-1 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL... submitted to the CO, who must obtain the advice of legal counsel. ...

  16. 78 FR 30218 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ... HUMAN SERVICES 45 CFR Part 152 RIN 0938-AQ70 Pre-Existing Condition Insurance Plan Program AGENCY... payment rates for covered services furnished to individuals enrolled in the Pre-Existing Condition... to eligible uninsured individuals with pre- existing conditions. A number of states elected...

  17. 75 FR 70061 - Dealer Floor Plan Pilot Program Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... ADMINISTRATION Dealer Floor Plan Pilot Program Meeting AGENCY: U.S. Small Business Administration (SBA). ACTION... agenda for a meeting regarding the Dealer Floor Plan Pilot Program established in the Small Business Jobs Act of 2010. The meeting will be open to the public. DATES: The Dealer Floor Plan Pilot Program...

  18. Waste Isolation Pilot Plant, Land Management Plan

    SciTech Connect

    Not Available

    1993-12-01

    To reflect the requirement of section 4 of the Wastes Isolation Pilot Plant Land Withdrawal Act (the Act) (Public Law 102-579), this land management plan has been written for the withdrawal area consistent with the Federal Land Policy and Management Act of 1976. The objective of this document, per the Act, is to describe the plan for the use of the withdrawn land until the end of the decommissioning phase. The plan identifies resource values within the withdrawal area and promotes the concept of multiple-use management. The plan also provides opportunity for participation in the land use planning process by the public and local, State, and Federal agencies. Chapter 1, Introduction, provides the reader with the purpose of this land management plan as well as an overview of the Waste Isolation Pilot Plant. Chapter 2, Affected Environment, is a brief description of the existing resources within the withdrawal area. Chapter 3, Management Objectives and Planned Actions, describes the land management objectives and actions taken to accomplish these objectives.

  19. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

  20. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

  1. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

  2. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

  3. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

  4. 26 CFR 1.72-16 - Life insurance contracts purchased under qualified employee plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... in Gross Income § 1.72-16 Life insurance contracts purchased under qualified employee plans. (a... pension, annuity, or profit-sharing plans for the purchase of life insurance contracts and rules for the... under such plans. For purposes of this section, the term “life insurance contract” means a retirement...

  5. Do employers voluntarily include patient protections in self-insured managed care plans?

    PubMed

    Lawlor, Janice S; Hall, Mark A

    2005-01-01

    Managed care patient protection laws passed by states do not apply to health plans sponsored by self-insured employers, although 54% of workers who receive health insurance coverage through their employer are in self-insured plans. In-depth interviews conducted in five states with employers offering self-insured health benefits and with other knowledgeable market informants provide evidence that self-insured managed care plans nonetheless include important features that strengthen subscribers' access to medical providers. Less common in these plans were features providing for independent external appeal of coverage denials and for protecting network providers from undue influence by plan administrators.

  6. Managed-care plans. Their future under national health insurance.

    PubMed Central

    Weil, T. P.

    1991-01-01

    The nation's health maintenance organizations, preferred-provider organizations, independent practice associations, and similar managed-care efforts are not well positioned to take a leadership role in a nationwide universal access or national health insurance plan. They--with the possible exception of some large staff and group health maintenance organizations--have been unable to show uniformly that they can contain costs, provide better access or higher quality of care, and achieve greater patient satisfaction than fee-for-service endeavors. As the United States pursues universal access as a step toward national health insurance, the managed-care plans will continue to increase their numbers of subscribers. They will not, however, be able to enroll large numbers of the young, low-income employees and their dependents who account for most of the 63 million people uninsured sometime during each year. Under national health insurance, there might be an option for some health maintenance organizations to negotiate capitated payments. The vast majority of the nation's physicians, however, will reluctantly embrace a centrally managed fee-for-service approach rather than a salary or capitated reimbursement method, leaving only a trace of the competitive managed-care plan theme in a future, primarily monolithic, national health care system. PMID:1815407

  7. Medicare program; right of appeal for Medicare secondary payer determinations relating to liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws and plans. Final rule.

    PubMed

    2015-02-27

    This final rule implements provisions of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act) which require us to provide a right of appeal and an appeal process for liability insurance (including self-insurance), no-fault insurance, and workers' compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from the liability insurance (including self-insurance), no-fault insurance, or workers' compensation law or plan.

  8. 26 CFR 46.4376-1 - Fee on sponsors of self-insured health plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Fee on sponsors of self-insured health plans..., except that for the 2014 plan year Employer B determines the number of lives covered that are not covered... this section)). (ii) On January 10, 2014, Employer B Self-Insured Health Plan provides self-only...

  9. 7 CFR 457.128 - Guaranteed production plan of fresh market tomato crop insurance provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Guaranteed production plan of fresh market tomato crop... § 457.128 Guaranteed production plan of fresh market tomato crop insurance provisions. The Guaranteed Production Plan of Fresh Market Tomato Crop Insurance FCIC Policies Department of Agriculture Federal Crop...

  10. 7 CFR 457.128 - Guaranteed production plan of fresh market tomato crop insurance provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Guaranteed production plan of fresh market tomato crop... § 457.128 Guaranteed production plan of fresh market tomato crop insurance provisions. The Guaranteed Production Plan of Fresh Market Tomato Crop Insurance FCIC Policies Department of Agriculture Federal Crop...

  11. 75 FR 66293 - Adoption of Federal Deposit Insurance Corporation Restoration Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-27

    ... From the Federal Register Online via the Government Publishing Office #0;#0;Federal Register / Vol. 75, No. 207 / Wednesday, October 27, 2010 / Notices#0;#0; ] FEDERAL DEPOSIT INSURANCE CORPORATION Adoption of Federal Deposit Insurance Corporation Restoration Plan AGENCY: Federal Deposit Insurance...

  12. 26 CFR 1.72-16 - Life insurance contracts purchased under qualified employee plans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... plan. Such death benefits are not in the nature of life insurance and are not excludable from gross... annuity contract, or the portion of the death proceeds under a life insurance contract which is equal to... respect to the taxability of proceeds of a life insurance contract paid by reason of the death of an...

  13. 26 CFR 1.72-16 - Life insurance contracts purchased under qualified employee plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... plan. Such death benefits are not in the nature of life insurance and are not excludable from gross... annuity contract, or the portion of the death proceeds under a life insurance contract which is equal to... respect to the taxability of proceeds of a life insurance contract paid by reason of the death of an...

  14. Empirically-Based Crop Insurance for China: A Pilot Study in the Down-middle Yangtze River Area of China

    NASA Astrophysics Data System (ADS)

    Wang, Erda; Yu, Yang; Little, Bertis B.; Chen, Zhongxin; Ren, Jianqiang

    Factors that caused slow growth in crop insurance participation and its ultimate failure in China were multi-faceted including high agricultural production risk, low participation rate, inadequate public awareness, high loss ratio, insufficient and interrupted government financial support. Thus, a clear and present need for data driven analyses and empirically-based risk management exists in China. In the present investigation, agricultural production data for two crops (corn, rice) in five counties in Jiangxi Province and Hunan province for design of a pilot crop insurance program in China. A crop insurance program was designed which (1) provides 75% coverage, (2) a 55% premium rate reduction for the farmer compared to catastrophic coverage most recently offered, and uses the currently approved governmental premium subsidy level. Thus a safety net for Chinese farmers that help maintain agricultural production at a level of self-sufficiency that costs less than half the current plans requires one change to the program: ≥80% of producers must participate in an area.

  15. Vermont lakes and ponds: a pilot recreation planning process

    Treesearch

    Daniel T. Malone; John J. Lindsay

    1992-01-01

    This report analyzes a pilot planning study conducted on two Vermont ponds by University of Vermont outdoor recreation planning students. It discusses the planning process used for these ponds and offers ways in which a statewide lake and pond planning process could be implemented.

  16. Waste Isolation Pilot Plant Environmental Monitoring Plan

    SciTech Connect

    Washington Regulatory and Environmental Services; Washington TRU Solutions LLC

    2004-02-19

    U.S. Department of Energy (DOE) Order 450.1, Environmental Protection Program, requires each DOE site to conduct environmental monitoring. Environmental monitoring at the Waste Isolation Pilot Plant (WIPP) is conducted in order to: (a) Verify and support compliance with applicable federal, state, and local environmental laws, regulations, permits, and orders; (b) Establish baselines and characterize trends in the physical, chemical, and biological condition of effluent and environmental media; (c) Identify potential environmental problems and evaluate the need for remedial actions or measures to mitigate the problem; (d) Detect, characterize, and report unplanned releases; (e) Evaluate the effectiveness of effluent treatment and control, and pollution abatement programs; and (f) Determine compliance with commitments made in environmental impact statements, environmental assessments, safety analysis reports, or other official DOE documents. This Environmental Monitoring Plan (EMP) has been written to contain the rationale and design criteria for the monitoring program, extent and frequency of monitoring and measurements, procedures for laboratory analyses, quality assurance (QA) requirements, program implementation procedures, and direction for the preparation and disposition of reports. Changes to the environmental monitoring program may be necessary to allow the use of advanced technology and new data collection techniques. This EMP will document any proposed changes in the environmental monitoring program. Guidance for preparation of Environmental Monitoring Plans is contained in DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance. The plan will be effective when it is approved by the appropriate Head of Field Organization or their designee. The plan discusses major environmental monitoring and hydrology activities at the WIPP and describes the programs established to ensure that WIPP operations do not

  17. 75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage Rules... respect to group health plans and health insurance coverage offered in connection with a group health plan... temporary regulations provide guidance to employers, group health plans, and health insurance...

  18. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Employer-sponsored insurance health plans. 440.350 Section 440.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may...

  19. 76 FR 46677 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Coverage of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirements for Group Health Plans and Health... Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human Services... with respect to group health plans and health insurance coverage offered in connection with a group...

  20. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Employer-sponsored insurance health plans. 440.350 Section 440.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may...

  1. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Employer-sponsored insurance health plans. 440.350 Section 440.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may...

  2. Waste Isolation Pilot Plant Environmental Monitoring Plan

    SciTech Connect

    None, None

    2008-03-12

    U.S. Department of Energy (DOE) Order 450.1, Environmental Protection Program, requires each DOE site to conduct environmental monitoring. Environmental monitoring at the Waste Isolation Pilot Plant (WIPP) is conducted in order to: (a) Verify and support compliance with applicable federal, state, and local environmental laws, regulations, permits, and orders; (b) Establish baselines and characterize trends in the physical, chemical, and biological condition of effluent and environmental media; (c) Identify potential environmental problems and evaluate the need for remedial actions or measures to mitigate the problems; (d) Detect, characterize, and report unplanned releases; (e) Evaluate the effectiveness of effluent treatment and control, and pollution abatement programs; and (f) Determine compliance with commitments made in environmental impact statements, environmental assessments, safety analysis reports, or other official DOE documents. This Environmental Monitoring Plan (EMP) explains the rationale and design criteria for the environmental monitoring program, extent and frequency of monitoring and measurements, procedures for laboratory analyses, quality assurance (QA) requirements, program implementation procedures, and direction for the preparation and disposition of reports. Changes to the environmental monitoring program may be necessary to allow the use of advanced technology and new data collection techniques. This EMP will document changes in the environmental monitoring program. Guidance for preparation of EMPs is contained in DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance.

  3. 75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan Under... and Insurance Oversight, Department of Health and Human Services. ACTION: Amendment to interim final... regulations implementing the rules for group health plans and health insurance coverage in the group...

  4. 76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ...-AQ66 Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... amendment to the interim final rules (76 FR 37208) entitled, ``Group Health Plans and Health Insurance... rule with request for comments entitled, ``Group Health Plans and Health Insurance Issuers:...

  5. Intelligent Pilot Aids for Flight Re-Planning in Emergencies

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy R.; Ockerman, Jennifer

    2005-01-01

    Effective and safe control of an aircraft may be difficult or nearly impossible for a pilot following an unexpected system failure. Without prior training, the pilot must ascertain on the fly those changes in both manual control technique and procedures that will lead to a safe landing of the aircraft. Sophisticated techniques for determining the required control techniques are now available. Likewise, a body of literature on pilot decision making provides formalisms for examining how pilots approach discrete decisions framed as the selection between options. However, other aspects of behavior, such as the task of route planning and guidance, are not as well studied. Not only is the pilot faced with possible performance changes to the aircraft dynamics, but he or she is also tasked to create a plan of actions that will effectively take the aircraft down to a safe landing. In this plan, the many actions that the pilot can perform are closely intertwined with the trajectory of the aircraft, making it difficult to accurately predict the final outcome. Coupled with the vast number of potential actions to be taken, this problem may seem intractable. This is reflected in the lack of a pre-specified procedure capable of giving pilots the ability to find a resolution for this task. This report summarizes a multi-year effort to examine methods to aid pilots in planning an approach and arrival to an airport following an aircraft systems failure. Ultimately, we hypothesize that automatic assistance to pilots can be provided in real-time in the form of improving pilot control of a damaged aircraft and providing pilots with procedural directives suitable for critical flight conditions; such systems may also benefit pilot training and procedure design. To achieve this result, a systematic, comprehensive research program was followed, building on prior research. This approach included a pencil-and-paper study with airline pilots examining methods of representing a flight route in

  6. 26 CFR 1.105-11 - Self-insured medical reimbursement plan.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... ancillary, services. For purposes of the preceding sentence, physical proximity between a medical facility.... However, a plan is not considered self-insured merely because one factor the insurer uses in determining... disability, or treatment or testing for a physical injury, complaint or specific symptom of a bodily...

  7. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured 10...

  8. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured 10...

  9. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured 10...

  10. 7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Insured 10-Year Home Warranty Plan Requirements L Exhibit L to Subpart A of Part 1924 Agriculture Regulations of the Department of Agriculture (Continued... Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured 10...

  11. 38 CFR 8.26 - Renewal of National Service Life Insurance on the 5-year level premium term plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...: Provided, That on or after September 1, 1984, National Service Life Insurance “V” 5-year level premium term... Service Life Insurance on the 5-year level premium term plan. 8.26 Section 8.26 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Renewal of Term Insurance...

  12. 38 CFR 8.26 - Renewal of National Service Life Insurance on the 5-year level premium term plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...: Provided, That on or after September 1, 1984, National Service Life Insurance “V” 5-year level premium term... Service Life Insurance on the 5-year level premium term plan. 8.26 Section 8.26 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Renewal of Term Insurance...

  13. 38 CFR 8.26 - Renewal of National Service Life Insurance on the 5-year level premium term plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...: Provided, That on or after September 1, 1984, National Service Life Insurance “V” 5-year level premium term... Service Life Insurance on the 5-year level premium term plan. 8.26 Section 8.26 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Renewal of Term Insurance...

  14. 38 CFR 8.26 - Renewal of National Service Life Insurance on the 5-year level premium term plan.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...: Provided, That on or after September 1, 1984, National Service Life Insurance “V” 5-year level premium term... Service Life Insurance on the 5-year level premium term plan. 8.26 Section 8.26 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Renewal of Term Insurance...

  15. Region and Insurance Plan Type Influence Discharge Disposition After Hip and Knee Arthroplasty: Evidence From the Privately Insured US Population.

    PubMed

    Soley-Bori, Marina; Soria-Saucedo, Rene; Youn, Bora; Haynes, Alex B; Macht, Ryan; Ryan, Colleen M; Schneider, Jeffrey C; Kazis, Lewis E

    2017-06-13

    Little is known about regional variation in the use of postacute care services after elective procedures, such as total hip or knee arthroplasty (THA/TKA), and how insurance type may influence it. The goal of this study is to assess the influence of region and insurance arrangements on discharge disposition. A representative sample of the privately insured US population with THA or TKA in 2009 or 2010 was obtained from the MarketScan database applying individual-level weights from the Medical Expenditure Panel Survey. Multivariate logistic regression was used to predict the odds of being discharged to an extended care facility (ECF) compared with being discharged home. The model adjusted for region, insurance plan type, sociodemographic characteristics, comorbidities, and length of stay. Large variability was observed in ECF use across the US. Patients in the Northeast were 2.5 times more likely to receive care at an ECF compared with patients in the South (odds ratio [OR] = 2.51, 95% confidence interval [CI]: 1.97-3.19). Enrollees in noncapitated plans such as fee-for-service plans or exclusive provider organizations were less likely to be discharged to an ECF compared with health maintenance organizations/preferred provider organizations with capitation enrollees (OR = 0.74, 95% CI: 0.57-0.94; OR = 0.49, 95% CI: 0.34-0.74, respectively). Region and private insurance plan arrangements are related to extended care use among THA and TKA patients. Understanding regional variation in discharge disposition provides policy makers with important information as to where to focus new tests of hip and knee procedures such as same day arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. 75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... implementing the rules for group health plans and health insurance coverage in the group and individual markets... issuers in the group and individual markets. The term ``group health plan'' includes both insured and self... market provisions over group and individual health insurance issuers. HHS enforces these provisions with...

  17. 75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ50 Group Health Plans and Health Insurance Coverage... provide guidance to employers, group health plans, and health insurance issuers providing group health... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially...

  18. Remotely Piloted Aircraft: An Integrated Domestic Disaster Relief Plan

    DTIC Science & Technology

    2014-12-01

    Remotely Piloted Aircraft An Integrated Domestic Disaster Relief Plan Lindsay Totten Major, USAF Air Command and Staff College Wright Flyer... Domestic Disaster Relief Plan 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK...into incident management plans in support of domestic disaster relief efforts. Some DOD agencies have developed concepts of operations and employment

  19. Razing a Tower of Babel: a taxonomy for managed care and health insurance plans.

    PubMed

    Weiner, J P; de Lissovoy, G

    1993-01-01

    To many, the U.S. health care system has become an unintelligible alphabet soup of three-letter health plans. There is little agreement about which characteristics distinguish one type of plan from another. In this article we chip away at what has become a Tower of Babel of managed care and health insurance terminology. We review past and current trends in the market for nontraditional health benefit plans and propose a taxonomy, or system of classification, that will aid in understanding how managed care plans differ from conventional health insurance and from one another. Also included is a comprehensive glossary of terms.

  20. Fees on health insurance policies and self-insured plans for the patient-centered outcomes research trust fund. Final regulations.

    PubMed

    2012-12-06

    This document contains final regulations that implement and provide guidance on the fees imposed by the Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund. These final regulations affect the issuers and plan sponsors that are directed to pay those fees.

  1. When Catastrophe Strikes: Have Adequate Insurance and a Detailed Disaster Plan.

    ERIC Educational Resources Information Center

    Balbresky, Paul

    1992-01-01

    Disaster response planning should be a high and ongoing priority in college administration. To ensure safety well before disaster strikes, administrators must select appropriate and adequate insurance coverage and prepare a written catastrophe plan, developed cooperatively with students, parents, and community members and reviewed by staff…

  2. ARCHITECTURAL ROOF PLAN AND WESTSOUTHEAST ELEVATIONS OF HOT PILOT PLANT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    ARCHITECTURAL ROOF PLAN AND WEST-SOUTHEAST ELEVATIONS OF HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111680. ALTERNATE ID NUMBER 8952-CPP-640-A-3. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

  3. ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111679. ALTERNATE ID NUMBER 8952-CPP-640-A-2. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

  4. Family Planning and the Young Minority Male: A Pilot Project.

    ERIC Educational Resources Information Center

    Johnson, Leanor Boulin; Staples, Robert E.

    1989-01-01

    Describes the Young Inner-City Males Project, a pilot project to provide culturally relevant family life planning services to young minority males in Los Angeles. The project offered goal-directed support to promote sexual responsibility and reduce unwanted pregnancies. (FMW)

  5. Family Planning for Inner-City Adolescent Males: Pilot Study.

    ERIC Educational Resources Information Center

    Reis, Janet; And Others

    1987-01-01

    Describes a pilot family planning program in an inner-city pediatric practice. Male adolescents were more likely to accept contraceptives if the provider first raised the topic of birth control to them. Identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives. Emphasizes…

  6. Necessary health care and basic needs: health insurance plans and essential benefits.

    PubMed

    Ward, Andrew; Johnson, Pamela Jo

    2013-12-01

    According to HealthCare.gov, by improving access to quality health for all Americans, the Affordable Care Act (ACA) will reduce disparities in health insurance coverage. One way this will happen under the provisions of the ACA is by creating a new health insurance marketplace (a health insurance exchange) by 2014 in which "all people will have a choice for quality, affordable health insurance even if a job loss, job switch, move or illness occurs". This does not mean that everyone will have whatever insurance coverage he or she wants. The provisions of the ACA require that each of the four benefit categories of plans (known as bronze, silver, gold and platinum) provides no less than the benefits available in an "essential health benefits package". However, without a clear understanding of what criteria must be satisfied for health care to be essential, the ACA's requirement is much too vague and open to multiple, potentially conflicting interpretations. Indeed, without such understanding, in the rush to provide health insurance coverage to as many people as is economically feasible, we may replace one kind of disparity (lack of health insurance) with another kind of disparity (lack of adequate health insurance). Thus, this paper explores the concept of "essential benefits", arguing that the "essential health benefits package" in the ACA should be one that optimally satisfies the basic needs of the people covered.

  7. Paying for individual health insurance through tax-sheltered cafeteria plans.

    PubMed

    Hall, Mark A; Monahan, Amy B

    2010-01-01

    When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

  8. 26 CFR 31.3401(a)(19)-1 - Reimbursements under a self-insured medical reimbursement plan.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Reimbursements under a self-insured medical... Reimbursements under a self-insured medical reimbursement plan. Amounts reimbursed to or on behalf of an employee after December 31, 1979, as a medical care reimbursement under a self-insured medical reimbursement...

  9. 26 CFR 31.3401(a)(19)-1 - Reimbursements under a self-insured medical reimbursement plan.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 15 2011-04-01 2011-04-01 false Reimbursements under a self-insured medical... Reimbursements under a self-insured medical reimbursement plan. Amounts reimbursed to or on behalf of an employee after December 31, 1979, as a medical care reimbursement under a self-insured medical reimbursement...

  10. 26 CFR 31.3401(a)(19)-1 - Reimbursements under a self-insured medical reimbursement plan.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 15 2013-04-01 2013-04-01 false Reimbursements under a self-insured medical... Reimbursements under a self-insured medical reimbursement plan. Amounts reimbursed to or on behalf of an employee after December 31, 1979, as a medical care reimbursement under a self-insured medical reimbursement...

  11. 78 FR 25909 - Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-03

    ... Other Rules Regarding the Health Insurance Premium Tax Credit AGENCY: Internal Revenue Service (IRS... relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care... coverage under a qualified health plan through an Affordable Insurance Exchange may receive a premium...

  12. Insuring That Families Plan and Save for College.

    ERIC Educational Resources Information Center

    Belvin, James

    1995-01-01

    Because so many Americans can afford to save for children's college costs but do not, it is proposed that employers take a more active role in promoting college financial planning. Possible solutions include company-sponsored contributory accounts, educational savings plans; payroll deduction plans, educational annuity programs, subsidized or…

  13. Statistical analysis plan of the head position in acute ischemic stroke trial pilot (HEADPOST pilot).

    PubMed

    Olavarría, Verónica V; Arima, Hisatomi; Anderson, Craig S; Brunser, Alejandro; Muñoz-Venturelli, Paula; Billot, Laurent; Lavados, Pablo M

    2017-02-01

    Background The HEADPOST Pilot is a proof-of-concept, open, prospective, multicenter, international, cluster randomized, phase IIb controlled trial, with masked outcome assessment. The trial will test if lying flat head position initiated in patients within 12 h of onset of acute ischemic stroke involving the anterior circulation increases cerebral blood flow in the middle cerebral arteries, as measured by transcranial Doppler. The study will also assess the safety and feasibility of patients lying flat for ≥24 h. The trial was conducted in centers in three countries, with ability to perform early transcranial Doppler. A feature of this trial was that patients were randomized to a certain position according to the month of admission to hospital. Objective To outline in detail the predetermined statistical analysis plan for HEADPOST Pilot study. Methods All data collected by participating researchers will be reviewed and formally assessed. Information pertaining to the baseline characteristics of patients, their process of care, and the delivery of treatments will be classified, and for each item, appropriate descriptive statistical analyses are planned with comparisons made between randomized groups. For the outcomes, statistical comparisons to be made between groups are planned and described. Results This statistical analysis plan was developed for the analysis of the results of the HEADPOST Pilot study to be transparent, available, verifiable, and predetermined before data lock. Conclusions We have developed a statistical analysis plan for the HEADPOST Pilot study which is to be followed to avoid analysis bias arising from prior knowledge of the study findings. Trial registration The study is registered under HEADPOST-Pilot, ClinicalTrials.gov Identifier NCT01706094.

  14. How a new 'public plan' could affect hospitals' finances and private insurance premiums.

    PubMed

    Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

    2009-01-01

    Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

  15. A modeling framework for optimal long-term care insurance purchase decisions in retirement planning.

    PubMed

    Gupta, Aparna; Li, Lepeng

    2004-05-01

    The level of need and costs of obtaining long-term care (LTC) during retired life require that planning for it is an integral part of retirement planning. In this paper, we divide retirement planning into two phases, pre-retirement and post-retirement. On the basis of four interrelated models for health evolution, wealth evolution, LTC insurance premium and coverage, and LTC cost structure, a framework for optimal LTC insurance purchase decisions in the pre-retirement phase is developed. Optimal decisions are obtained by developing a trade-off between post-retirement LTC costs and LTC insurance premiums and coverage. Two-way branching models are used to model stochastic health events and asset returns. The resulting optimization problem is formulated as a dynamic programming problem. We compare the optimal decision under two insurance purchase scenarios: one assumes that insurance is purchased for good and other assumes it may be purchased, relinquished and re-purchased. Sensitivity analysis is performed for the retirement age.

  16. Receipt of Preventive Services Among Privately Insured Minorities in Managed Care versus Fee-for-service Insurance Plans

    PubMed Central

    DeLaet, David E; Shea, Steven; Carrasquillo, Olveen

    2002-01-01

    OBJECTIVE We compare preventive services utilization among privately insured African Americans and Hispanics in managed care organizations (MCOs) versus fee-for-service (FFS) plans. We also examine racial/ethnic disparities in the receipt of preventive services among enrollees in FFS or MCO plans. DESIGN Analysis of the nationally representative 1996 Medical Expenditure Panel Survey. PARTICIPANTS Participants included 1,120 Hispanic, 929 African-American, and 6,383 non-Hispanic white (NHW) adults age 18 to 64 years with private health insurance. MEASUREMENTS AND MAIN RESULTS We examined self-reported receipt of physical examination, blood pressure measurement, cholesterol assessment, Papanicolau testing, screening mammography, and breast and prostate examinations. Multivariate modeling was used to adjust for age, gender, education, household income, and health status. Hispanics in MCOs were more likely than their FFS counterparts to report having preventive services, with adjusted differences ranging from 5 to 19 percentage points (P < .05 for physical examination, blood pressure measurement, breast examination and Pap smear). Among African Americans, such patterns were of a smaller magnitude. In both MCOs and FFS plans the proportion of African Americans reporting preventive services was equal to or greater than NHWs. In contrast, among Hispanic women in FFS, a non–statistically significant trend of fewer cancer screening tests than NHW's was observed (Pap smears 75% vs 80%; mammograms 66% vs 74%, respectively). In both MCO and FFS plans, Hispanics were less likely than NHWs to report having blood pressure and cholesterol measurement (P < .05). CONCLUSIONS With the demise of traditional MCOs, reform efforts should incorporate those aspects of MCOs that were associated with greater preventive service utilization, particularly among Hispanics. Existing ethnic disparities warrant further attention. PMID:12133160

  17. Adverse selection with a multiple choice among health insurance plans: a simulation analysis.

    PubMed

    Marquis, M S

    1992-08-01

    This study uses simulation methods to quantify the effects of adverse selection. The data used to develop the model provide information about whether families can accurately forecast their risk and whether this forecast affects the purchase of insurance coverage--key conditions for adverse selection to matter. The results suggest that adverse selection is sufficient to eliminate high-option benefit plans in multiple choice markets if insurers charge a single, experience-rated premium. Adverse selection is substantially reduced if premiums are varied according to demographic factors. Adverse selection is also restricted in supplementary insurance markets. In this market, supplementary policies are underpriced because a part of the additional benefits that purchasers can expect is a cost to the base plan and is not reflected in the supplementary premium. As a result, full supplementary coverage is attractive to both low and high risks.

  18. 20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... lost, because their inherent nature is to supplement benefit payments under the Railroad Unemployment... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Definition of nongovernmental plan for unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD...

  19. 20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... lost, because their inherent nature is to supplement benefit payments under the Railroad Unemployment... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Definition of nongovernmental plan for unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD...

  20. 20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... lost, because their inherent nature is to supplement benefit payments under the Railroad Unemployment... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Definition of nongovernmental plan for unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD...

  1. 42 CFR 440.350 - Employer-sponsored insurance health plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Employer-sponsored insurance health plans. 440.350 Section 440.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Benchmark Benefit and Benchmark-Equivalent Coverage § 440.350...

  2. Structuring group medical practices: liability insurance, retirement plan considerations, and ownership transition.

    PubMed

    Gassman, A S; Popson, J; Waggoner, S E

    1993-01-01

    This article is the fourth in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, important considerations relating to liability insurance and pension plans, and both the phasing in and phasing out of shareholders are discussed.

  3. Waste Isolation Pilot Plant Environmental Monitoring Plan

    SciTech Connect

    Westinghouse Electric Company Waste Isolation Division

    1999-09-29

    DOE Order 5400.1, General Environmental Protection Program Requirements (DOE, 1990a), requires each DOE facility to prepare an EMP. This document is prepared for WIPP in accordance with the guidance contained in DOE Order 5400.1; DOE Order 5400.5, Radiation Protection of the Public and Environment (DOE, 1990b); Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance (DOE/EH-0173T; DOE, 1991); and the Title 10 Code of Federal Regulations (CFR) 834, Radiation Protection of the Public and Environment (Draft). Many sections of DOE Order 5400.1 have been replaced by DOE Order 231.1 (DOE, 1995), which is the driver for the Annual Site Environmental Report (ASER) and the guidance source for preparing many environmental program documents. The WIPP project is operated by Westinghouse Electric Company, Waste Isolation Division (WID), for the DOE. This plan defines the extent and scope of the WIPP's effluent and environmental monitoring programs during the facility's operational life and also discusses the WIPP's quality assurance/quality control (QA/QC) program as it relates to environmental monitoring. In addition, this plan provides a comprehensive description of environmental activities at WIPP including: A summary of environmental programs, including the status of environmental monitoring activities A description of the WIPP project and its mission A description of the local environment, including demographics An overview of the methodology used to assess radiological consequences to the public, including brief discussions of potential exposure pathways, routine and accidental releases, and their consequences Responses to the requirements described in the Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance (DOE, 1991). This document references DOE orders and other federal and state regulations affecting environmental monitoring programs at the site. WIPP procedures, which implement

  4. Mental health and substance abuse insurance parity for federal employees: how did health plans respond?

    PubMed

    Barry, Colleen L; Ridgely, M Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity.

  5. School-Sponsored Health Insurance: Planning for a New Reality

    ERIC Educational Resources Information Center

    Liang, Bryan A.

    2010-01-01

    Health care reform efforts in both the Clinton and Obama administrations have attempted to address college and university health. Yet, although the world of health care delivery has almost universally evolved to managed care, school health programs have not. In general, school-sponsored health plans do little to improve access and have adopted…

  6. School-Sponsored Health Insurance: Planning for a New Reality

    ERIC Educational Resources Information Center

    Liang, Bryan A.

    2010-01-01

    Health care reform efforts in both the Clinton and Obama administrations have attempted to address college and university health. Yet, although the world of health care delivery has almost universally evolved to managed care, school health programs have not. In general, school-sponsored health plans do little to improve access and have adopted…

  7. The Role of Publicly Funded Family Planning Sites In Health Insurance Enrollment.

    PubMed

    Yarger, Jennifer; Daniel, Sara; Antonia Biggs, M; Malvin, Jan; Brindis, Claire D

    2017-06-01

    Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance. Weighted univariate and bivariate analyses were conducted to examine enrollment activities and perceived barriers to facilitating enrollment by site characteristics. Most family planning program sites provided eligibility screening (68%), enrollment education (77%), on-site enrollment assistance (55%) and referrals for off-site enrollment support (91%). The proportion of sites offering each type of assistance was highest among community clinics (83-96%), primary care and multispecialty sites (65-95%), Title X-funded sites (72-98%), sites with contracts to provide primary care services (64-93%) and sites using only electronic health records (66-94%). Commonly identified barriers to providing assistance were lack of staff time (reported by 52% of sites), lack of funding (47%), lack of physical space (34%) and lack of staff knowledge (33%); only 20% of sites received funding to support enrollment activities. Although there were significant variations among them, publicly funded family planning providers in California are actively engaged in health insurance enrollment. Supporting their vital role in enrollment could help in the achievement of universal health insurance coverage. Copyright © 2017 by the Guttmacher Institute.

  8. Health insurance reform and the development of health insurance plans: the case of the Emirate of Abu Dhabi, UAE.

    PubMed

    Hamidi, Samer; Shaban, Sami; Mahate, Ashraf A; Younis, Mustafa Z

    2014-01-01

    The Emirate of Abu Dhabi has taken concrete steps to reform health insurance by improving the access to health providers as well as freedom of choice. The growing cost of health care and the impact of the global financial crisis have meant that countries are no longer able to solely bear the cost. As a result many countries have sought to overhaul their health care system so as to share the burden of provision with the private sector whether it is health care plan providers or employers. This article explores and discusses how the policy issues inherent in private health care schemes have been dealt with by the Emirate of Abu Dhabi. Data was collected in early 2013 on health care plans in Abu Dhabi from government sources. The Abu Dhabi model has private sector involvement but the government sets prices and benefits. The Abu Dhabi model adequately deals with the problem of adverse selection through making insurance coverage a mandatory requirement. There are issues with moral hazards, which are a combination of individual and medical practitioner behavior that might affect the efficiency of the system. Over time there is a general increase in the usage of medical services, which may be reflective of greater awareness of the policy and its benefits as well as lifestyle change. Although the current health care system level of usage is adequate for the current population, as the level of usage increases, the government may face a financial burden. Therefore, the government needs to place safeguards in order to limit its exposure. The market for medical treatment needs to be made more competitive to reduce monopolistic behavior. The government needs to make individuals aware of a healthier lifestyle and encourage precautionary actions.

  9. High-deductible health plans and the new risks of consumer-driven health insurance products.

    PubMed

    Johnson, Anthony D; Wegner, Steven E

    2007-03-01

    Consumer-driven health care is the most noteworthy development in health insurance since the widespread adoption of health maintenance organizations and preferred provider organizations in the 1980s. The most common consumer-driven health plan is the high-deductible health plan, which is essentially a catastrophic health insurance plan, often linked with tax-advantaged spending accounts, with very high deductibles, fewer benefits, and higher cost-sharing than conventional health maintenance organization or preferred provider organization plans. The financial risks are significant under high-deductible health plans, especially for low- to moderate-income families and for families whose children have special health care needs. Of concern for pediatricians are the potential quality risks that are predictable in high-deductible health plans, in which families are likely to delay or avoid seeking care, especially preventive care (if it is not exempted from the deductible), when they are faced with paying for care before the deductible is met. This policy statement provides background information on the most common consumer-driven health plan model, discusses the implications for pediatricians and families, and offers recommendations pertaining to health plan product design, education, practice administration, and research.

  10. [Informatics system at the Croatian Institute of Health Insurance today and plans for future].

    PubMed

    Jezidzić, Hrvoje

    2005-01-01

    Basic information is provided on the informatics system at the Croatian Institute of Health Insurance (CIHI). The focus is on the newwork infrastructure, which connects 130 locations 24 hours on line and installed hardware and software equipment at CIHI. A modern network infrastructure makes technical basis of modern informatics system. Technical data on the safe and reliable communication system with FR telecommunication capacity are presented. UNIX servers at the headquaters and branch offices, INFORMIX database and the own application ZOROH provide a basis for core business. Active Directory, web pages www.hzzo-net.hr, Intranet and CIHI IT portal are the main parts of the modern CIHI office info subsystem. Basic information is given about the system for production and.distribution of health insurance cards--plastic cards with magnetic strip for basic and additional health insurance. Informatics Department of CIHI has issued more than 13,000,000 basic health insurance cards and over 1,500,000 additional health insurance cards. Data storage and reporting system as part of the CIHI informatics system is essential for analyzing and planning health insurance business. CIHI IT has created a modern reporting system with: (a) superior performance and power of analytical and reporting possibilities; (b) scalable and flexible platform; (c) proactive reporting (Web, SMS, WAP, e-mail, fax, voice); (d) web interface for users. The presentation is concluded with basic information on the current projects such as introduction of digital signature in CIHI and plans for the introduction of smart cards instead of plastic cards with magnetic strip. Today, CIHI IT plays the major role in the process of health system computerization in Croatia. CIHI is technically and personnel equipped for computerization of the entire health system. The informatics system of CIHI can serve as a backbone for the informatics health system in the future.

  11. Health Insurance Basics

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Health Insurance Basics KidsHealth > For Teens > Health Insurance Basics A ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

  12. Health Insurance Basics

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Health Insurance Basics KidsHealth > For Teens > Health Insurance Basics Print ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

  13. Experimental program plan for the Waste Isolation Pilot Plant

    SciTech Connect

    Not Available

    1994-01-01

    The US Department of Energy has prepared this Experimental Program Plan for the Waste Isolation Pilot Plant (EPP) to provide a summary of the DOE experimental efforts needed for the performance assessment process for the WIPP, and of the linkages of this process to the appropriate regulations. The Plan encompasses a program of analyses of the performance of the planned repository based on scientific studies, including tests with transuranic waste at laboratory sites, directed at evaluating compliance with the principal regulations governing the WIPP. The Plan begins with background information on the WIPP project, the requirements of the LWA (Land Withdrawal Act), and its objective and scope. It then presents an overview of the regulatory requirements and the compliance approach. Next are comprehensive discussions of plans for compliance with disposal regulations, followed by the SWDA (Solid Waste Disposal Act) and descriptions of activity programs designed to provide information needed for determining compliance. Descriptions and justifications of all currently planned studies designed to support regulatory compliance activities are also included.

  14. The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs.

    PubMed

    Manns, Braden; McKenzie, Susan Q; Au, Flora; Gignac, Pamela M; Geller, Lawrence Ian

    2017-01-01

    Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs. This study used an analytical model combining Canadian data from various sources. This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m(2) and those on dialysis. We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD. We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years. This study does not estimate how CKD prevention or increasing the rate of kidney

  15. The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs

    PubMed Central

    Manns, Braden; McKenzie, Susan Q.; Au, Flora; Gignac, Pamela M.; Geller, Lawrence Ian

    2017-01-01

    Background: Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. Objective: The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs. Design: This study used an analytical model combining Canadian data from various sources. Setting and Patients: This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m2 and those on dialysis. Measurements: We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD. Results: We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years. Limitations

  16. 76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ62 Requirements for Group Health Plans and Health..., Health care, Health insurance, Pensions, Reporting and recordkeeping requirements. Proposed Amendments to... the Center for Consumer Information & Insurance Oversight of the U.S. Department of Health and Human...

  17. 75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-28

    ... Revenue Service 26 CFR Part 54 RIN 1545-BJ57 Requirements for Group Health Plans and Health Insurance..., Health care, Health insurance, Pensions, Reporting and recordkeeping requirements. Proposed Amendments to... U.S. Department of Health and Human Services are issuing substantially similar interim final...

  18. 75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ62 Requirements for Group Health Plans and Health... taxes, Health care, Health insurance, Pensions, Reporting and recordkeeping requirements. Proposed... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar...

  19. 76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ...-AQ07 Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under... the Patient Protection and Affordable Care Act regarding preventive health services. DATES: Effective... insurance coverage except to the extent that such standard or requirement prevents the application of...

  20. 38 CFR 8.26 - Renewal of National Service Life Insurance on the 5-year level premium term plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Effective June 25, 1970, a 5-year level premium term policy which lapsed for nonpayment of the premium due... Service Life Insurance on the 5-year level premium term plan. 8.26 Section 8.26 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Renewal of Term...

  1. Intelligent Pilot Aids for Flight Re-Planning in Emergencies

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy R.

    2002-01-01

    Experimental studies were conducted with pilots to investigate the attributes of automation that would be appropriate for aiding pilots in emergencies. The specific focus of this year was on methods of mitigating automation brittleness. Brittleness occurs when the automatic system is used in circumstances it was not designed for, causing it to choose an incorrect action or make an inaccurate decision for the situation. Brittleness is impossible to avoid since it is impossible to predict every potential situation the automatic system will be exposed to over its life. However, operators are always ultimately responsible for the actions and decisions of the automation they are monitoring or using, which means they must evaluate the automation's decisions and actions for accuracy. As has been pointed out, this is a difficult thing for human operators to do. There have been various suggestions as to how to aid operators with this evaluation. In the study described in this report we studied how presentation of contextual information about an automatic system's decision might impact the ability of the human operators to evaluate that decision. This study focused on the planning of emergency descents. Fortunately, emergencies (e.g., mechanical or electrical malfunction, on-board fire, and medical emergency) happen quite rarely. However, they can be catastrophic when they do. For all predictable or conceivable emergencies, pilots have emergency procedures that they are trained on, but those procedures often end with 'determine suitable airport and land as quickly as possible.' Planning an emergency descent to an unplanned airport is a difficult task, particularly under the time pressures of an emergency. Automatic decision aids could be very efficient at the task of determining an appropriate airport and calculating an optimal trajectory to that airport. This information could be conveyed to the pilot through an emergency descent procedure listing all of the actions

  2. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    SciTech Connect

    Washington TRU Solutions

    2002-09-24

    U.S. Department of Energy (DOE) Order 5400.1, General Environmental Protection Program, requires each DOE site to prepare a Groundwater Protection Management Program Plan. This document fulfills the requirement for the Waste Isolation Pilot Plant (WIPP). This document was prepared by the Hydrology Section of the Westinghouse TRU Solutions LLC (WTS) Environmental Compliance Department, and it is the responsibility of this group to review the plan annually and update it every three years. This document is not, nor is it intended to be, an implementing document that sets forth specific details on carrying out field projects or operational policy. Rather, it is intended to give the reader insight to the groundwater protection philosophy at WIPP.

  3. Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study.

    PubMed

    Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika

    2014-01-01

    Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

  4. Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015.

    PubMed

    Gabel, Jon; Whitmore, Heidi; Green, Matthew; Stromberg, Sam; Oran, Rebecca

    2015-12-01

    Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. We examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance. We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs.

  5. Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Final regulations.

    PubMed

    2015-12-18

    This document contains final regulations on the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act, 2011. These final regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges, sometimes called Marketplaces) and claim the health insurance premium tax credit, and Exchanges that make qualified health plans available to individuals and employers.

  6. The Fermilab ISDN Pilot Project: Experiences and future plans

    SciTech Connect

    Martin, D.E.; Lego, A.J.; Clifford, A.E.

    1995-12-31

    Fully operational in June of 1994, the Fermilab ISDN Pilot Project was started to gain insight into the costs and benefits of providing ISDN service to the homes of Fermilab researchers. Fourteen users were chosen from throughout Fermilab, but the number of Fermilab-employed spouses pushed the total user count to 20. Each home was equipped with a basic rate ISDN (BRI) line, a BRI Ethernet half-bridge, and an NT-1. An inter-departmental team coordinated the project. Usage at each home was tracked and frequent surveys were attempted. Lessons learned include: working with Ameritech can be difficult; careful monitoring is essential; and configuration of home computing equipment is very time consuming. Plans include moving entirely to primary rate ISDN hubs, support for different home ISDN equipment and better usage and performance tracking.

  7. The early experience of a voluntary small group insurance program utilizing managed care plans.

    PubMed

    Christianson, J B; Liu, C F; Schroeder, C; Read, W; Murphy, J

    1997-01-01

    HealthCare Group of Arizona (HCGA), a state-sponsored, voluntary health insurance purchasing program offering prepaid health plans to small businesses, became operational in 1988. This article summarizes the results from a wide-ranging evaluation of that program and discusses their implications. In general, enrollees were satisfied with their experience in their plans. HCGA did not appear to attract an adverse mix of health risks, and service utilization rates were consistent with HMO industry averages. However, these findings varied across health plans and the marketing approaches they adopted. Enrollment growth in HCGA has been steady, but premium subsidies may be necessary if HCGA is to substantially increase its enrollment of low-wage, uninsured workers.

  8. A study of decision-making behavior of aircraft pilots deviating from a planned flight.

    PubMed

    Flathers, G W; Giffin, W C; Rockwell, T H

    1982-10-01

    This paper outlines an investigation into the worth structures of pilots facing a deviation from a planned flight. A "paper and pencil" simulation was used to frame the situation into which pilots interjected their own decision-making skills in a simple ranking of candidate diversion airports with varying locational, navigational aid, radar, and weather attributes. Using the conjoint measurement technique, attribute worth functions of 30 pilots were constructed. Systematic differences in the worth functions of the pilots were not found as a result of dividing the pilot sample according to any measure of flight hours' experience. However, differences were found when the pilot sample was grouped according to grade of pilot certificate, type of pilot training, and type of flying most commonly done.

  9. A study of decision-making behavior of aircraft pilots deviating from a planned flight

    NASA Technical Reports Server (NTRS)

    Flather, G. W., II; Giffin, W. C.; Rockwell, T. H.

    1981-01-01

    This paper outlines an investigation into the worth structures of pilots facing a deviation from a planned flight. A 'paper and pencil' simulation was used to frame the situation into which pilots interjected their own decision making skills in a simple ranking of candidate diversion airports with varying locational, navigational aid, radar and weather attributes. Using the conjoint measurement technique, attribute worth functions of 30 pilots were constructed. It was discovered that systematic differences in the worth functions of the pilots did not occur as a result of dividing the pilot sample according to any measure of flight hour experience. However, differences were found when the pilot sample was grouped according to grade of pilot certificate, type of pilot training, and type of flying most commonly done.

  10. Marketing and Utilization of the Active Duty Dependent’s Dental Insurance Plan

    DTIC Science & Technology

    1993-11-01

    lot ,•ducsnq this buroen, to Wsahnqton A D ,,O. , 15 01etr., oxq D ,s qhqi v . Suite t tQ4. A,’nqjton. VA 22202A407. and’O theOtfeol Manaqotc e ,ni A...Dependent’s In the spring and fail of every year. the Army Personnel Dental Insurance Plan (ADDDIP). we found that soldiers turned Snrte spring a l v r Army...outside the 50 U.S. states reduced our sample vey of the ADDDIP in the spring of 1990. Marketing research to 2,733 officers and 7,938 enlisted personnel

  11. Reaction of Army Families with Grade School Children to the Active Duty Dependents Dental Insurance Plan

    DTIC Science & Technology

    1992-06-01

    Dupendent s Dental Insu rance, P lan 6. A L; 1 n R (S) Chisick, M.C.; Guerin, R.D.; and Williams, T.R. P01`0 QfU1I7.G JrAGANIZATION NAMr:S) A JU ACIMP1...8217LS) . U.S. Army Institute of Dental Research Washington, D.C. 20307-5300 ,PONýGiýIN𔃿i MONITORING AGENCY NAMIE(S) AND ADDRESS(ES) U.S. Army...on enrollment of 1,445 Army families with grade school children in the Active Duty Dependents Dental Insurance Plan at two Army posts. We also

  12. 29 CFR 2520.104a-6 - Annual reporting for plans which are part of a group insurance arrangement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Annual reporting for plans which are part of a group... Requirements § 2520.104a-6 Annual reporting for plans which are part of a group insurance arrangement. (a...) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR REPORTING AND DISCLOSURE UNDER THE...

  13. Experiences With Insurance Plans and Providers Among Persons With Mental Illness.

    PubMed

    Rowan, Kathleen; Shippee, Nathan D

    2016-03-01

    This study used nationally representative household survey data to examine the association between mental illness and experiences with usual care providers and health plans among persons with public or private insurance (N=25,176). Data were from the 2004-2012 Medical Expenditure Panel Surveys. Mental illness was assessed with symptom scales of serious psychological distress and depression at two time points, and persons were categorized by whether mental illness was episodic or persistent over time. Questions about experiences with providers (four questions) and plans (five questions) were based on the Consumer Assessment of Healthcare Providers and Systems survey. Rates of problems with plans and providers were reported for each category of mental illness, and multivariate regression was used to examine the association of problems with mental illness. Rates of problems with health plans were high, specifically for treatment approvals, finding information, and customer service, and were higher among persons with mental illness. Rates of problems with providers were lower than problems with plans, but persons with mental illness were more likely to report problems, specifically that doctors do not explain treatment options, respect treatment choices, or seek participation in decisions. Persons with mental illness reported experiencing more clinical and administrative problems at their usual source of care, although the reasons were not clear. Efforts by plans to improve health care before and after the clinical encounter and by providers to design treatments in line with patient preferences may improve experiences for all patients and particularly for those with mental illness.

  14. The Cost of Unintended Pregnancies for Employer-Sponsored Health Insurance Plans

    PubMed Central

    Dieguez, Gabriela; Pyenson, Bruce S.; Law, Amy W.; Lynen, Richard; Trussell, James

    2015-01-01

    Background Pregnancy is associated with a significant cost for employers providing health insurance benefits to their employees. The latest study on the topic was published in 2002, estimating the unintended pregnancy rate for women covered by employer-sponsored insurance benefits to be approximately 29%. Objectives The primary objective of this study was to update the cost of unintended pregnancy to employer-sponsored health insurance plans with current data. The secondary objective was to develop a regression model to identify the factors and associated magnitude that contribute to unintended pregnancies in the employee benefits population. Methods We developed stepwise multinomial logistic regression models using data from a national survey on maternal attitudes about pregnancy before and shortly after giving birth. The survey was conducted by the Centers for Disease Control and Prevention through mail and via telephone interviews between 2009 and 2011 of women who had had a live birth. The regression models were then applied to a large commercial health claims database from the Truven Health MarketScan to retrospectively assign the probability of pregnancy intention to each delivery. Results Based on the MarketScan database, we estimate that among employer-sponsored health insurance plans, 28.8% of pregnancies are unintended, which is consistent with national findings of 29% in a survey by the Centers for Disease Control and Prevention. These unintended pregnancies account for 27.4% of the annual delivery costs to employers in the United States, or approximately 1% of the typical employer's health benefits spending for 1 year. Using these findings, we present a regression model that employers could apply to their claims data to identify the risk for unintended pregnancies in their health insurance population. Conclusion The availability of coverage for contraception without employee cost-sharing, as was required by the Affordable Care Act in 2012, combined with

  15. The Effects of a Proposed No-Fault Plan on the Costs of Auto Insurance in California: An Updated Analysis.

    DTIC Science & Technology

    1996-01-01

    20 40 Fraction injured in single- car accidents 0 10 20 1. We used all the cases in our sample to make nominal (midpoint) estimates of the...uninsured drivers who will purchase insurance under the proposed plan, and percentage of people injured in single- car accidents . Taking all possible...proposal. We included all accident victims—insured and uninsured drivers, passengers, pedestrians, bicyclists, people injured in single- car accidents , etc

  16. Studies of planning behavior of aircraft pilots in normal, abnormal and emergency situations

    NASA Technical Reports Server (NTRS)

    Johannsen, G.; Rouse, W. B.; Hillmann, K.

    1981-01-01

    A methodology for the study of planning is presented and the results of applying the methodology within two experimental investigations of planning behavior of aircraft pilots in normal, abnormal, and emergency situations are discussed. Beyond showing that the methodology yields consistent results, these experiments also lead to concepts in terms of a dichotomy between event driven and time driven planning, subtle effects of automation on planning, and the relationship of planning to workload and flight performance.

  17. [Quality Assurance in Sociomedical Evaluation by Peer Review: A Pilot Project of the German Statutory Pension Insurance].

    PubMed

    Strahl, A; Gerlich, C; Wolf, H-D; Gehrke, J; Müller-Garnn, A; Vogel, H

    2016-03-01

    The sociomedical evaluation by the German Pension Insurance serves the purpose of determining entitlement to disability pensions. A quality assurance concept for the sociomedical evaluation was developed, which is based on a peer Review process. Peer review is an established process of external quality assurance in health care. The review is based on a hierarchically constructed manual that was evaluated in this pilot project. The database consists of 260 medical reports for disability pension of 12 pension insurance agencies. 771 reviews from 19 peers were included in the evaluation of the inter-rater reliability. Kendall's coefficient of concordance W for more than 2 raters is used as primary measure of inter-rater reliability. Reliability appeared to be heterogeneous. Kendalls W varies for the particular criteria from 0.09 to 0.88 and reached for primary criterion reproducibility a value of 0.37. The reliability of the manual seemed acceptable in the context of existing research data and is in line with existing peer review research outcomes. Nevertheless, the concordance is limited and requires optimisation. Starting points for improvement can be seen in a systematic training and regular user meetings of the peers involved. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Group Health Insurance Plans for Public-School Personnel, 1964-65.

    ERIC Educational Resources Information Center

    National Education Association, Washington, DC.

    This report explains the major considerations in developing group health insurance coverage for public school personnel. A general overview is given of (1) group health insurance coverage, (2) patterns of group health insurance, (3) group health insurance organizations, (4) eligibility and enrollment practices, and (5) continuous health insurance…

  19. 77 FR 33498 - Joint Industry Plans; Order Approving, on a Pilot Basis, the National Market System Plan To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-06

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Joint Industry Plans; Order Approving, on a Pilot Basis, the National Market System Plan To Address Extraordinary Market Volatility by BATS Exchange, Inc., BATS Y-Exchange, Inc., Chicago Board Options Exchange, Incorporated, Chicago Stock...

  20. [The relationship between hospitals and health plans organizations in the scope of ANS Health Insurance Qualification Program].

    PubMed

    Escrivão Junior, Alvaro; Koyama, Marcos Fumio

    2007-01-01

    In Brazilian health insurance sector, the fee-for-service model still remains the major payment method for health services, and predominates in the relationship between hospitals and private health insurance companies. After the creation of Health Insurance Qualification Program (HIQP), which focuses on the quality of the assistance given to consumers, the health insurance companies will be evaluated by health care performance indicators, established by this program. The present study discusses the impact of this pattern on the relationship between health insurance companies and hospitals, by analyzing data from interviews carried through with 18 health insurance managers, regarding the use - in hospital management - of performance indicators compatible to those adopted by HIQP. According to the managers perception, only three hospitals use this sort of indicators, two of them which are hospitals managed by the health insurance companies. The alignment of interests between health plans organizations and health care providers, at the HIQP proposed template, will imply changes in payment models between these market players, towards the inclusion of performance and quality of assistance given to users by providers, as components of wage determination.

  1. The cost escalation of social health insurance plans in China: its implication for public policy.

    PubMed

    Liu, X; Hsiao, W C

    1995-10-01

    China has been alarmed by its rapid rise in health care expenditures of social health insurance schemes. The health care expenditure per person for the 155 million people covered by the Chinese social insurance plans has been rising at an accelerative rate. We analyze why health care cost in China has risen, and show how other nations may benefit from this experience. The annual rate of increase in health expenditure per capita was only 3.1% during 1952 to 1978, the average rate rose to 8.2% during 1978 to 1985 and then 24.4% during 1985 to 1989. We found general inflation explained one-half of the high rates of increase between 1985-1989. Although China introduced patients co-payments in 1985, the residual expenditure per capita (after adjusting for general inflation and aging of the beneficiaries) increased at 7.4% per year due to the adoption of new technology, uses of more expensive drugs and increased quality of services. While we found the expenditure increases in China were largely caused by uncontrollable factors such as general inflation and aging of the population, we also found the change in Chinese hospital financing and payment policy caused rapid adoption of high-tech medicine and abusive usage of more expensive drugs which largely explained the annual increases in expenditures of 7.4% between 1985-1989. Chinese experience also shows that demand strategy (co-payment by patients) had very little effect to contain cost escalation.

  2. Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act.

    PubMed

    Gruber, Jonathan

    2014-06-01

    Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.

  3. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    SciTech Connect

    Washington Regulatory and Environmental Services

    2005-07-01

    The DOE established the Groundwater Monitoring Program (GMP) (WP 02-1) to monitor groundwater resources at WIPP. In the past, the GMP was conducted to establish background data of existing conditions of groundwater quality and quantity in the WIPP vicinity, and to develop and maintain a water quality database as required by regulation. Today the GMP is conducted consistent with 204.1.500 NMAC (New MexicoAdministrative Code), "Adoption of 40 CFR [Code of Federal Regulations] Part 264,"specifically 40 CFR §264.90 through §264.101. These sections of 20.4.1 NMAC provide guidance for detection monitoring of groundwater that is, or could be, affected by waste management activities at WIPP. Detection monitoring at WIPP is designed to detect contaminants in the groundwater long before the general population is exposed. Early detection will allow cleanup efforts to be accomplished before any exposure to the general population can occur. Title 40 CFR Part 264, Subpart F, stipulates minimum requirements of Resource Conservation and Recovery Act of 1976 (42 United States Code [U.S.C.] §6901 et seq.) (RCRA) groundwater monitoring programs including the number and location of monitoring wells; sampling and reporting schedules; analytical methods and accuracy requirements; monitoring parameters; and statistical treatment of monitoring data. This document outlines how WIPP intends to protect and preserve groundwater within the WIPP Land Withdrawal Area (WLWA). Groundwater protection is just one aspect of the WIPP environmental protection effort. An overview of the entire environmental protection effort can be found in DOE/WIPP 99-2194, Waste Isolation Pilot Plant Environmental Monitoring Plan. The WIPP GMP is designed to statistically determine if any changes are occurring in groundwater characteristics within and surrounding the WIPP facility. If a change is noted, the cause will then be determined and the appropriate corrective action(s) initiated.

  4. Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

    PubMed

    Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

    2012-08-01

    In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.

  5. 29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... accounts. 2550.401c-1 Section 2550.401c-1 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS... an insurer issues one or more policies to or for the benefit of an employee benefit plan (and such... of guaranteed benefits or to the payment of benefits, and the terms on which such withdrawals...

  6. The influence of health insurance plans on the long term outcome of patients with acute myocardial infarction.

    PubMed

    Nicolau, José Carlos; Baracioli, Luciano Moreira; Serrano, Carlos Vicente; Giraldez, Roberto Rocha; Kalil Filho, Roberto; Lima, Felipe Galego; Franken, Marcelo; Ganem, Fernando; Lage, Rony Lopes; Truffa, Rodrigo

    2008-12-01

    Little is known, especially in our country, about the influence of health insurance plans on the long term outcome of patients after acute myocardial infarction (AMI). To assess the outcome of patients with AMI who are covered by the National Health System (SUS) or other health insurance plans. We analyzed 1,588 patients with AMI (mean age of 63.3 + 12.9 years, 71.7% male) who were included prospectively into a specific database and followed up for up to 7.55 years. Of this total, 1,003 were placed in the "SUS" group and 585 in the "other insurance plans" group. We applied chi-square, log-rank and Cox (stepwise) to the different statistical analyses. The long term multivariate model with mortality as a dependent variable included 18 independent variables. In-hospital mortality rates in the "other insurance plans" and "SUS" groups were 11.4% and 10.3%, respectively (p = 0.5); in the long term, survival chances in the groups were respectively, 70.4% + 2.9 and 56.4% + 4.0 (p = 0.001, hazard-ratio = 1.43, or a 43% higher chance of death in the "SUS" group). In the adjusted model, the 'SUS' group had a significantly higher chance of death (a 36% higher chance, p = 0.005). Surgical revascularization and angioplasty improved the prognosis of these patients, whereas age and previous history of infarction, diabetes or heart failure worsened the prognosis. Relative to patients with other insurance plans, SUS users present similar mortality rates during hospital stay, but their prognosis is worse in the long term, thus reinforcing the need for additional efforts to improve the care provided to these patients after hospital discharge.

  7. Five features of value-based insurance design plans were associated with higher rates of medication adherence.

    PubMed

    Choudhry, Niteesh K; Fischer, Michael A; Smith, Benjamin F; Brill, Gregory; Girdish, Charmaine; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

    2014-03-01

    Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline trends, VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points. These findings can provide guidance for the structure of future VBID plans.

  8. Nonprofit to for-profit conversions by hospitals, health insurers, and health plans.

    PubMed Central

    Needleman, J

    1999-01-01

    Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services. Images p109-a p110-a p115-a p116-a PMID:10199712

  9. Examining the Value of Subsidies of Health Plans and Cost-Sharing for Prescription Drugs in the Health Insurance Marketplace

    PubMed Central

    Ngorsuraches, Surachat; Mort, Jane R.

    2016-01-01

    Background The Affordable Care Act (ACA) initiated federally and state-run health insurance exchanges, or marketplaces, with health plans offering subsidies for plan members as well as coverage for essential health benefits, to help individuals, families, and small businesses find health plans that fit their specific needs. A recent study found that the value of these healthcare subsidies varied with the number of health plans in the different geographic rating areas, but that study only examined the premiums and the deductibles of those health plans. Objectives To examine the value of subsidies of health plans, including cost-sharing for prescription drugs in the health insurance marketplace. Methods We have used publicly available health plan data from HealthCare.gov and from county population data obtained from the US Census Bureau in June 2015. The average-weighted premium; medical deductible; medical maximum out-of-pocket spending; and cost-sharing for generic drugs, preferred and nonpreferred brand-name drugs, and specialty drugs were calculated for the second lowest-cost silver plan in each geographic rating area. These were then compared across geographic areas with different numbers of plans to determine the value of the subsidies. We also compared the difference between the cost of the average silver plan and the second lowest-cost silver plan for each area to determine the cost to enrollees if they selected the average silver plan. Results The monetary value of the subsidies provided by health plans was lower in areas with a larger number of plans, because the second lowest-cost silver plans in these areas tended to have lower premiums and higher deductibles. For the most common type of cost-sharing for generic and for preferred brand-name drugs, plan enrollees would likely have a lower or similar copayment if they selected the average-cost silver plan instead of the second lowest-cost silver plan. However, they may end up paying approximately $8 less in

  10. Examining the Value of Subsidies of Health Plans and Cost-Sharing for Prescription Drugs in the Health Insurance Marketplace.

    PubMed

    Ngorsuraches, Surachat; Mort, Jane R

    2016-10-01

    The Affordable Care Act (ACA) initiated federally and state-run health insurance exchanges, or marketplaces, with health plans offering subsidies for plan members as well as coverage for essential health benefits, to help individuals, families, and small businesses find health plans that fit their specific needs. A recent study found that the value of these healthcare subsidies varied with the number of health plans in the different geographic rating areas, but that study only examined the premiums and the deductibles of those health plans. To examine the value of subsidies of health plans, including cost-sharing for prescription drugs in the health insurance marketplace. We have used publicly available health plan data from HealthCare.gov and from county population data obtained from the US Census Bureau in June 2015. The average-weighted premium; medical deductible; medical maximum out-of-pocket spending; and cost-sharing for generic drugs, preferred and nonpreferred brand-name drugs, and specialty drugs were calculated for the second lowest-cost silver plan in each geographic rating area. These were then compared across geographic areas with different numbers of plans to determine the value of the subsidies. We also compared the difference between the cost of the average silver plan and the second lowest-cost silver plan for each area to determine the cost to enrollees if they selected the average silver plan. The monetary value of the subsidies provided by health plans was lower in areas with a larger number of plans, because the second lowest-cost silver plans in these areas tended to have lower premiums and higher deductibles. For the most common type of cost-sharing for generic and for preferred brand-name drugs, plan enrollees would likely have a lower or similar copayment if they selected the average-cost silver plan instead of the second lowest-cost silver plan. However, they may end up paying approximately $8 less in copayment for nonpreferred branded

  11. Disability Insurance

    PubMed Central

    Williamson, Elliot A.

    1985-01-01

    A disability insurance policy provides specified income benefits when the insured person becomes unable to work because of illness or accident. With an individual policy, the insured person is generally the policy holder. With a group plan, the employer is the policy holder. An individual policy can provide several optional benefits in addition to disability benefits, which are not available in a group plan. In assessing risk, the insurer uses the application, the agent's report, a physical examination, the attending physician's report, and sometimes a consumer investigation company's inspection report. Records from the Medical Information Bureau, an association of American and Canadian life insurance companies, may also be used. The process of claims adjudication is described, as are differences between short-term and long-term disability claims. Many group policies have a rehabilitation provision; payments may continue while the claimant undergoes rehabilitation or retraining. Imagesp1928-a PMID:21274206

  12. [Linkage Between Promotion of Employment and Promotion of Health in the Community Setting - Results of the Pilot Project of the Federal Employment Agency and the Statutory Health Insurance].

    PubMed

    Bellwinkel, Michael; Schreiner-Kürten, Karin; Melzer, Kathrin

    2017-04-03

    The Federal Employment Agency and the Statutory Health Insurance (GKV) have put the link between the promotion of employment and of health to the test by making a joint approach aiming to reach unemployed persons with preventive health services and to maintain or improve their employability. Specialist case workers (Integrationsfachkräfte) of the job centres conducted health consultations, motivating unemployed persons and raising their awareness of their own health as well as enabling them to access health promotion services of health insurance funds on a voluntary basis. Three different approaches were tested: consultations either being offered by specialist case workers of the job centres, by contracted educational institutions or by the federal employment agency's own special services (Fachdienste). The pilot project was implemented locally in the community setting. The steering groups set up in the 6 pilot locations, consisting of representatives of the job centres and the health insurance funds as well as of further local players, were the key element of this project. The offers implemented were a success: The unemployed persons welcomed the consultations offered by job centres; the preventive health services specifically directed at unemployed persons that were provided by health insurance funds have proven successful, especially in terms of reducing stress and maintaining employability. Inclusion of the key points of this approach into the basic recommendations at federal level (Bundesrahmenempfehlungen) of the National Conference on Prevention of 19 February 2016 has created a basis for further advances and dissemination.

  13. Value-Based Insurance Design Benefit Offsets Reductions In Medication Adherence Associated With Switch To Deductible Plan.

    PubMed

    Reed, Mary E; Warton, E Margaret; Kim, Eileen; Solomon, Matthew D; Karter, Andrew J

    2017-03-01

    Enrollment in high-deductible health plans is increasing out-of-pocket spending. But innovative plans that pair deductibles with value-based insurance designs can help preserve low-cost access to high-value treatments for patients by aligning coverage with clinical value. Among adults in high-deductible health plans who were prescribed medications for chronic conditions, we examined what impact a value-based pharmacy benefit that offered free chronic disease medications had on medication adherence. Overall, we found that the value-based plan offset reductions in medication adherence associated with switching to a deductible plan. The value-based plan appeared particularly beneficial for patients who started with low levels of medication adherence. Patients with additional clinical complexity or vulnerable populations living in neighborhoods with lower socioeconomic status, however, did not show adherence improvements and might not be taking advantage of value-based insurance design provisions. Additional efforts may be needed to educate patients about their nuanced benefit plans to help overcome initial confusion about these complex plans.

  14. Interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.

    PubMed

    2010-06-17

    This document contains interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan.

  15. Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.

    PubMed

    2010-11-17

    This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

  16. The Instructional Planning Team: An Organizational Arrangement To Accomplish Planning, Teaching, and Evaluation in a School. A Pilot Study.

    ERIC Educational Resources Information Center

    Carlisle, David H.; And Others

    The Instructional Planning Team is based on the Research and Instruction Unit of the Wisconsin R & D Center for Cognitive Learning. To determine if the IPT as an organizational arrangement would increase the ability of a group of classroom teachers to use research-based information to improve their instructional program, a pilot test was conducted…

  17. Assessment of levels of hospice care coverage offered to commercial managed care plan members in California: implications for the California Health Insurance Exchange.

    PubMed

    Chung, Kyusuk; Jahng, Joelle; Petrosyan, Syuzanna; Kim, Soo In; Yim, Victoria

    2015-06-01

    The implementation of the Affordable Care Act that provides for the expansion of affordable insurance to uninsured individuals and small businesses, coupled with the provision of mandated hospice coverage, is expected to increase the enrollment of the terminally ill younger population in hospice care. We surveyed health insurance companies that offer managed care plans in the 2014 California health insurance exchange and large hospice agencies that provided hospice care to privately insured patients in 2011. Compared with Medicare and Medicaid hospice benefits, hospice benefits for privately insured patients, particularly those enrolled in managed care plans, varied widely. Mandating hospice care alone may not be sufficient to ensure that individuals enrolled in different managed care plans receive the same level of coverage.

  18. 77 FR 22691 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-17

    ... research. The statute provides that the Institute will not develop a dollars-per-quality-life-year estimate..., including whether the information will have practical utility; How the quality, utility, and clarity of the... issuers and plan sponsors of calculating the average number of lives covered for the applicable policy...

  19. Social Security in the USA: A Discussion Guide to Social Insurance with Lesson Plans.

    ERIC Educational Resources Information Center

    Kingson, Eric R.; And Others

    This publication is intended as a guide for teaching high school and adult education students about social insurance concepts. Goals of the project are that students: (1) understand the historical context from which social insurance programs emerged; (2) can participate fully as members of a democratic society in making informed decisions about…

  20. Mental Health and Substance Abuse Insurance Parity for Federal Employees: How Did Health Plans Respond?

    ERIC Educational Resources Information Center

    Barry, Colleen L.; Ridgely, M. Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than…

  1. Mental Health and Substance Abuse Insurance Parity for Federal Employees: How Did Health Plans Respond?

    ERIC Educational Resources Information Center

    Barry, Colleen L.; Ridgely, M. Susan

    2008-01-01

    A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than…

  2. Interim rules for health insurance portability for group health plans--HCFA. Interim rules with request for comments.

    PubMed

    1997-04-08

    This document contains interim rules governing access, portability and renewability requirements for group health plans and issuers of health insurance coverage offered in connection with a group health plan. The rules contained in this document implement changes made to certain provisions of the Internal Revenue Code of 1986 (Code), the Employee Retirement Income Security Act of 1974 (ERISA), and the Public Health Service Act (PHS Act) enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Interested persons are invited to submit comments on the interim rules for consideration by the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury (Departments) in developing final rules. The rules contained in this document are being adopted in an interim basis to accommodate statutorily established time frames intended to ensure that sponsors and administrators of group health plans, participants and beneficiaries, States, and issuers of group health insurance coverage have timely guidance concerning compliance with the recently enacted requirements of HIPAA.

  3. [The contradictions between the universal Unified Health System and the transfer of public funds to private health plans and insurances].

    PubMed

    Bahia, Ligia

    2008-01-01

    Trailing the whole group of trends and changes in the scenario of relations between the public and the private, this article analyses the effects of the rise in the rates of return of health plan operators and health insurance companies in 2007. Special attention is given to the segmentation of the system, the complaints about the naturalization of inequitable access to health services and to the depreciation of the original concepts of the Unified Health System. The study also gathers information regarding the production of knowledge about supplementary care with the intent to systemize the bases and methodological approaches adopted by a selected sub-group of scientific papers. Finally, the article develops conjectures and hypotheses with regard to possible associations between growth and stability of the health plan and insurance market and as refers to the nature of scientific production about this issue, taking into consideration the contradictions between the political and economical circuit in which the health plan and insurance companies are operating and the universality of the Brazilian Health System.

  4. Private Health Insurance Plans in 1977: Coverage, Enrollment, and Financial Experience

    PubMed Central

    Carroll, Marjorie Smith; Arnett, Ross H.

    1979-01-01

    The private health insurance industry collected $47.1 billion in premiums in 1977 and returned $41.6 billion in benefits to their subscribers. Premiums rose 16.3 percent as a direct consequence of rapid claims growth in 1976. After operating expenses were deducted, the industry showed a small, $.4 billion underwriting loss. About 78 percent of the population were insured for hospital care, and about 76 percent for surgical services. Smaller percentages had coverage for other types of care. An estimated 61.8 percent of the aged bought private hospital insurance, and 47.1 percent bought surgical insurance, mostly to supplement Medicare benefits. About 12 percent of persons under age 65 had no protection against the cost of hospital care either through private insurance or a public program such as Medicare or Medicaid. PMID:10309113

  5. Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

    PubMed

    Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

    2013-10-01

    The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

  6. Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.

    PubMed

    2011-08-03

    This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.

  7. Interim final rules prohibiting discrimination based on genetic information in health insurance coverage and group health plans. Interim final rules with request for comments.

    PubMed

    2009-10-07

    This document contains interim final rules implementing sections 101 through 103 of the Genetic Information Nondiscrimination Act of 2008. These provisions prohibit discrimination based on genetic information in health insurance coverage and group health plans.

  8. Plan Selection in the Non-Group Market in the First Year of the Health Insurance Marketplace.

    PubMed

    Gillen, Emily; Lich, Kristen Hassmiller; Trantham, Laurel; Silberman, Pam; Weinberger, Morris; Holmes, Mark

    2017-01-01

    BACKGROUND The Affordable Care Act (ACA)-created Marketplaces reduced barriers to entry in the non-group health insurance market. Although tax credits were available to individuals who enrolled in qualified health plans (QHPs) beginning in 2014, many individuals chose not to switch plans. We examined characteristics associated with switching from a non-ACA compliant plan to a QHP in 2014 and, conditional on switching, the characteristics associated with selection of a specific plan level.METHODS Using claims data from a large commercial insurer, we examined characteristics associated with switching to a QHP in 2014. For those who did switch, we used a multinomial logit model to estimate odds of selecting different metal levels-representing varying degrees of coverage-for a group of the highest and lowest risk individuals.RESULTS We found individuals most likely to benefit from the premium and benefit requirements on QHPs were more likely to switch to QHPs. Individuals at high-risk for high health care expenditures who had advance premium tax credits (APTCs) had lower odds of choosing a less generous plan compared to individuals without APTCs (odds of bronze plan over silver: 0.40, CI: 0.30 - 0.55), while individuals at low-risk of being high cost with APTCs were more likely to select a plan with a lower premium (odds bronze plan over silver: 1.35, CI: 1.09 - 1.66).LIMITATIONS This study was conducted with data from 1 health plan, limiting its national generalizability; however, this study is a good representation of activity within the state.CONCLUSIONS APTCs are important for ensuring that less healthy individuals are able to afford adequate levels of coverage. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  9. The impact of Gonoshasthaya Kendra's Micro Health Insurance plan on antenatal care among poor women in rural Bangladesh.

    PubMed

    Islam, Mohammad Touhidul; Igarashi, Isao; Kawabuchi, Koichi

    2012-08-01

    Low utilization of antenatal care (ANC) by pregnant women, particularly in rural areas, is an obstacle to ensuring safe motherhood in Bangladesh. Currently, Micro Health Insurance (MHI) is being considered in many developing countries as a potential method for assuring greater access to health care, especially for the poor. So far, there is only limited evidence evaluating MHI schemes. This study assesses the impact of MHI administered by Gonoshasthaya Kendra (GK) on ANC utilization by poor women in rural Bangladesh. We conducted a questionnaire survey and collected 321 valid responses from women enrolled in GK's MHI scheme and 271 from women not enrolled in any health insurance plan. We used a two-part model in which dependent variables were whether or not women utilized ANC and the number of times ANC was used. The model consisted of logistic regression analysis and ordinary least squares regression analysis. The main independent variables were dummies for socioeconomic classes according to GK, each of which represented the premiums and co-payments charged by class. The results showed that destitute, ultra-poor, and poor women enrolled in MHI used ANC significantly more than women not enrolled in health insurance. Women enrolled in MHI, except for those who were destitute or ultra-poor, utilized ANC significantly more times than women not enrolled in health insurance. We assume that GK's sliding premium and co-payment scales are key to ANC utilization by women. Expanding the MHI scheme may enhance ANC utilization among poor women in rural Bangladesh.

  10. ARCHITECTURAL FLOOR PLAN OF OPERATING AREA HOT PILOT PLANT (CPP640). ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    ARCHITECTURAL FLOOR PLAN OF OPERATING AREA HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111678. ALTERNATE ID NUMBER 8952-CPP-640-A-1. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

  11. Using Study Plans to Develop Self-Directed Learning Skills: Implications from a Pilot Project

    ERIC Educational Resources Information Center

    Du, Fengning

    2012-01-01

    Self-directed learning has been lauded as a powerful learner-centered approach to involve students in every aspect of their learning. This article depicts a pilot project utilizing study plan as a vehicle to promote self-directed learning in an intensive and teacher-dominant college language program. This article seeks to identify both the…

  12. Using Study Plans to Develop Self-Directed Learning Skills: Implications from a Pilot Project

    ERIC Educational Resources Information Center

    Du, Fengning

    2012-01-01

    Self-directed learning has been lauded as a powerful learner-centered approach to involve students in every aspect of their learning. This article depicts a pilot project utilizing study plan as a vehicle to promote self-directed learning in an intensive and teacher-dominant college language program. This article seeks to identify both the…

  13. Growth of consumer-directed health plans to one-half of all employer-sponsored insurance could save $57 billion annually.

    PubMed

    Haviland, Amelia M; Marquis, M Susan; McDevitt, Roland D; Sood, Neeraj

    2012-05-01

    Enrollment is increasing in consumer-directed health insurance plans, which feature high deductibles and a personal health care savings account. We project that an increase in market share of these plans--from the current level of 13 percent of employer-sponsored insurance to 50 percent--could reduce annual health care spending by about $57 billion. That decrease would be the equivalent of a 4 percent decline in total health care spending for the nonelderly. However, such growth in consumer-directed plan enrollment also has the potential to reduce the use of recommended health care services, as well as to increase premiums for traditional health insurance plans, as healthier individuals drop traditional coverage and enroll in consumer-directed plans. In this article we explore options that policy makers and employers facing these challenges should consider, including more refined plan designs and decision support systems to promote recommended services.

  14. AgRISTARS: Renewable resources inventory. Land information support system implementation plan and schedule. [San Juan National Forest pilot test

    NASA Technical Reports Server (NTRS)

    Yao, S. S. (Principal Investigator)

    1981-01-01

    The planning and scheduling of the use of remote sensing and computer technology to support the land management planning effort at the national forests level are outlined. The task planning and system capability development were reviewed. A user evaluation is presented along with technological transfer methodology. A land management planning pilot test of the San Juan National Forest is discussed.

  15. Tobacco Surcharges on 2015 Health Insurance Plans Sold in Federally Facilitated Marketplaces: Variations by Age and Geography and Implications for Health Equity

    PubMed Central

    Drope, Jeffrey M.; Graetz, Ilana; Waters, Teresa M.; Kaplan, Cameron M.

    2015-01-01

    In 2014, few health insurance plans sold in the Affordable Care Act’s Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance. PMID:26447913

  16. Addressing health care market reform through an insurance exchange: essential policy components, the public plan option, and other issues to consider.

    PubMed

    Fronstin, Paul; Ross, Murray N

    2009-06-01

    HEALTH INSURANCE EXCHANGE: This Issue Brief examines issues related to managed competition and the use of a health insurance exchange for the purpose of addressing cost, quality, and access to health care services. It discusses issues that must be addressed when designing an exchange in order to reform the health insurance market and also examines state efforts at health reform that use an exchange. RISK VS. PRICE COMPETITION: The basic component of managed competition is the creation an organized marketplace that brings together health insurers and consumers (either as individuals or through their employers). The sponsor of the exchange would set "rules of engagement" for participating insurers and offer consumers a menu of choices among different plans. Ultimately, the goal of a health insurance exchange is to shift the market from competition based on risk to competition based on price and quality. ADVERSE SELECTION AND AFFORDABILITY: Among the issues that need to be addressed if an exchange that uses managed competition has a realistic chance of reducing costs, improving quality, and expanding coverage: Everyone needs to be in the risk pool, with individuals required to purchase insurance or face significant financial consequences; effective risk adjustment is essential to eliminate risk selection as an insurance business model--forcing competition on costs and quality; the insurance benefit must be specific and clear--without standards governing cost sharing, covered services, and network coverage there is no way to assess whether a requirement to purchase or issue coverage has been met; and subsidies would be necessary for low-income individuals to purchase insurance. THE PUBLIC PLAN OPTION: The public plan option is shaping up to be one of the most contentious issues in the health reform debate. Proponents also believe of a public plan is necessary to drive private insurers toward true competition. Opponents view it as a step toward government-run health

  17. [Spending on private health insurance plans of Brazilian families: a descriptive study with data from the Family Budget Surveys 2002-2003 and 2008-2009].

    PubMed

    Garcia, Leila Posenato; Ocké-Reis, Carlos Octávio; de Magalhães, Luís Carlos Garcia; Sant'Anna, Ana Claudia; de Freitas, Lúcia Rolim Santana

    2015-05-01

    Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R$154.35 to R$183.97. The average spending on health insurance plans was greater with increasing household income, as well as portions of the family income and total expenditure committed to these expenses. Spending on health insurance is concentrated among higher-income families, for which it was the main component of total health expenditure.

  18. Quality assurance project plan: 1991 EMAP wetlands southeastern pilot study

    SciTech Connect

    Swenson, E.M.; Lee, J.M.; Turner, R.E.

    1992-12-01

    The goal of the Environmental Monitoring and Assessment Program - Wetlands (EMAP-Wetlands) Southeastern Pilot Study is to develop field indicators of salt marsh condition. These indicators are of four general types: (1) vegetation; (2) hydrology; (3) soil parameters; and (4) soil constituents. Field measurements and samples will be collected during late summer/early fall in 1991 and will be analyzed to identify which indicators and measurements best delineate salt marsh in good condition from that in impaired condition. Thus the project will involve field work, laboratory analysis, and data analysis. Results from this project will be used to establish criteria and parameters for long-term monitoring and assessment of salt marshes, particularly those parameters that may serve as indicators of healthy salt marsh and deteriorated salt marsh. Since EMAP-Wetlands-Southeastern is a pilot study, the measurement criteria will be evaluated as one of the project goals. Of concern will be how well the standardized sampling methods performed in actual field conditions, and which of these methods can be used to assess and characterize salt marshes.

  19. Including Internet insurance as part of a hospital computer network security plan.

    PubMed

    Riccardi, Ken

    2002-01-01

    Cyber attacks on a hospital's computer network is a new crime to be reckoned with. Should your hospital consider internet insurance? The author explains this new phenomenon and presents a risk assessment for determining network vulnerabilities.

  20. An early examination of access to select orphan drugs treating rare diseases in health insurance exchange plans.

    PubMed

    Robinson, Sandy W; Brantley, Kelly; Liow, Christine; Teagarden, J Russell

    2014-10-01

    Patients with rare diseases often face significant health care access challenges, particularly since the number of available treatment options for rare diseases is limited. The implementation of health insurance exchanges promises improved access to health care. However, when purchasing a plan, patients with rare diseases need to consider multiple factors, such as insurance premium, access to providers, coverage of a specific medication or treatment, tier placement of drug, and out-of-pocket costs.  To provide an early snapshot of the exchange plan landscape from the perspective of patients with select rare diseases by evaluating the degree of access to medications in a subset of exchange plans based on coverage, tier placement, associated cost sharing, and utilization management (UM) applied.  The selection of drugs for this analysis began by identifying rare diseases with FDA-approved treatment options using the National Institutes of Health Office of Rare Diseases' webpage and further identification of a subset of drugs based on select criteria to ensure a varied sample, including the characteristics and prevalence of the condition. The medications were categorized based on whether alternative therapies have FDA approval for the same indication and whether there are comparators based on class or therapeutic area. The list was narrowed to 11 medications across 7 diseases, and the analysis was based on how these drugs are listed in exchange plan outpatient pharmacy benefit formularies. This analysis focused on 84 plans in 15 states with the highest expected exchange enrollment and included a variety of plan types to ensure that variability in the marketplace was represented. To best approximate plans that will have the greatest enrollment, the analysis focused on silver and bronze plan formularies because consumers in this market are expected to be sensitive to premiums. Data on drug coverage, tier placement, cost, and UM were collected from these plans

  1. Patient Protection and Affordable Care Act; establishment of the multi-state plan program for the Affordable Insurance Exchanges.

    PubMed

    2013-03-11

    The U.S. Office of Personnel Management (OPM) is issuing a final regulation establishing the Multi-State Plan Program (MSPP) pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). One of the issuers must be non-profit. Under the law, an MSPP issuer may phase in the States in which it offers coverage over 4 years, but it must offer MSPs on Exchanges in all States and the District of Columbia by the fourth year in which the MSPP issuer participates in the MSPP. This rule aims to balance adhering to the statutory goals of MSPP while aligning its standards to those applying to qualified health plans to promote a level playing field across health plans.

  2. Interim final rules for group health plans and health insurance issuers relating to internal claims and appeals and external review processes under the Patient Protection and affordable Care Act. Interim final rules with request for comments.

    PubMed

    2010-07-23

    This document contains interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act. The regulations will generally affect health insurance issuers; group health plans; and participants, beneficiaries, and enrollees in health insurance coverage and in group health plans. The regulations provide plans and issuers with guidance necessary to comply with the law.

  3. The Pilot Land Data System: Report of the Program Planning Workshops

    NASA Technical Reports Server (NTRS)

    1984-01-01

    An advisory report to be used by NASA in developing a program plan for a Pilot Land Data System (PLDS) was developed. The purpose of the PLDS is to improve the ability of NASA and NASA sponsored researchers to conduct land-related research. The goal of the planning workshops was to provide and coordinate planning and concept development between the land related science and computer science disciplines, to discuss the architecture of the PLDs, requirements for information science technology, and system evaluation. The findings and recommendations of the Working Group are presented. The pilot program establishes a limited scale distributed information system to explore scientific, technical, and management approaches to satisfying the needs of the land science community. The PLDS paves the way for a land data system to improve data access, processing, transfer, and analysis, which land sciences information synthesis occurs on a scale not previously permitted because of limits to data assembly and access.

  4. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    SciTech Connect

    Not Available

    1993-12-31

    The DOE has mandated in DOE Order 5400.1 that its operations will be conducted in an environmentally safe manner. The Waste Isolation Pilot Plant (WIPP) will comply with DOE Order 5400.1 and will conduct its operations in a manner that ensures the safety of the environment and the public. This document outlines how the WIPP will protect and preserve groundwater within and surrounding the WIPP facility. Groundwater protection is just one aspect of the WIPP environmental protection effort. The WIPP groundwater surveillance program is designed to determine statistically if any changes are occurring in groundwater characteristics within and surrounding the WIPP facility. If a change is noted, the cause will be determined and appropriate corrective action initiated.

  5. Family Planning and the Young Minority Male: A Pilot Project.

    ERIC Educational Resources Information Center

    Johnson, Leanor Boulin; Staples, Robert E.

    1979-01-01

    Reports on a program aimed at young Black, Spanish-speaking, Asian, and American Indian males in relation to family life education, planning, and parental concerns. The project develops an approach to the promotion of sexual responsibility and reduction of unwanted pregnancy through support and assistance to potential unwed fathers. (Author)

  6. Advanced Simulation in Undergraduate Pilot Training (ASUPT) Facility Utilization Plan.

    ERIC Educational Resources Information Center

    Hagin, William V.; Smith, James F.

    The capabilities of a flight simulation research facility located at Williams AFB, Arizona are described. Research philosophy to be applied is discussed. Long range and short range objectives are identified. A time phased plan for long range research accomplishment is described. In addition, some examples of near term research efforts which will…

  7. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the “Borda” Method: a Pilot Study

    PubMed Central

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called “Borda” in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software “Math-lab”7, “SPSS” 17 and Excel 2007 were used in this study. “Borda” estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance

  8. Pilot-scale treatability test plan for the 200-UP-1 groundwater Operable Unit

    SciTech Connect

    Wittreich, C.D.

    1994-05-01

    This document presents the treatability test plan for pilot-scale pump and treat testing at the 200-UP-1 Operable Unit. This treatability test plan has been prepared in response to an agreement between the US Department of Energy, the US Environmental Protection Agency, and the Washington State Department of Ecology, as documented in Hanford Federal Facility Agreement and Consent Order (Ecology et al. 1989a) Change Control Form M-13-93-03 (Ecology et al. 1994). The agreement also requires that, following completion of the activities described in this test plan, a 200-UP-1 Operable Unit interim remedial measure (IRM) proposed plan be developed for use in preparing an interim action record of decision (ROD). The IRM Proposed Plan will be supported by the results of the testing described in this treatability test plan, as well as by other 200-UP-1 Operable Unit activities (e.g., limited field investigation, development of a qualitative risk assessment). Once issued, the interim action ROD will specify the interim action for groundwater contamination at the 200-UP-1 Operable Unit. The approach discussed in this treatability test plan is to conduct a pilot-scale pump and treat test for the contaminant plume associated with the 200-UP-1 Operable Unit. Primary contaminants of concern are uranium and technetium-99; the secondary contaminant of concern is nitrate. The pilot-scale treatability testing presented in this test plan has as its primary purpose to assess the performance of aboveground treatment systems with respect to the ability to remove the primary contaminants in groundwater withdrawn from the contaminant plume.

  9. Pilot-scale treatability test plan for the 100-HR-3 operable unit

    SciTech Connect

    Not Available

    1994-08-01

    This document presents the treatability test plan for pilot-scale pump-and-treat testing at the 100-HR-3 Operable Unit. The test will be conducted in fulfillment of interim Milestone M-15-06E to begin pilot-scale pump-and-treat operations by August 1994. The scope of the test was determined based on the results of lab/bench-scale tests (WHC 1993a) conducted in fulfillment of Milestone M-15-06B. These milestones were established per agreement between the U.S. Department of Energy (DOE), the Washington State Department of Ecology and the U.S. Environmental Protection Agency (EPA), and documented on Hanford Federal of Ecology Facility Agreement and Consent Order Change Control Form M-15-93-02. This test plan discusses a pilot-scale pump-and-treat test for the chromium plume associated with the D Reactor portion of the 100-HR-3 Operable Unit. Data will be collected during the pilot test to assess the effectiveness, operating parameters, and resource needs of the ion exchange (IX) pump-and-treat system. The test will provide information to assess the ability to remove contaminants by extracting groundwater from wells and treating extracted groundwater using IX. Bench-scale tests were conducted previously in which chromium VI was identified as the primary contaminant of concern in the 100-D reactor plume. The DOWEX 21K{trademark} resin was recommended for pilot-scale testing of an IX pump-and-treat system. The bench-scale test demonstrated that the system could remove chromium VI from groundwater to concentrations less than 50 ppb. The test also identified process parameters to monitor during pilot-scale testing. Water will be re-injected into the plume using wells outside the zone of influence and upgradient of the extraction well.

  10. Pilot test specific test plan for the removal of arsenic Socorro, New Mexico.

    SciTech Connect

    Collins, Sue S.; Aragon, Malynda Jo; Everett, Randy L.; Siegel, Malcolm Dean; Aragon, Alicia R.; Dwyer, Brian P.; Marbury, Justin Luke

    2006-03-01

    Sandia National Laboratories (SNL) is conducting pilot scale evaluations of the performance and cost of innovative drinking water treatment technologies designed to meet the new arsenic maximum contaminant level (MCL) of 10 {micro}g/L (effective January 2006). As currently envisioned, pilots tests may include multiple phases. Phase I tests will involve side-by-side comparisons of several commercial technologies primarily using design parameters suggested by the Vendors. Subsequent tests (Phase II) may involve repeating some of the original tests, testing the same commercial technologies under different conditions and testing experimental technologies or additional commercial technologies. This Pilot Test Specific Test Plan (PTSTP) was written for Phase I of the Socorro Springs Pilot. The objectives of Phase I include evaluation of the treatment performance of five adsorptive media under ambient pH conditions (approximately 8.0) and assessment of the effect of contact time on the performance of one of the media. Addenda to the PTSTP may be written to cover Phase II studies and supporting laboratory studies. The Phase I demonstration began in the winter of 2004 and will last approximately 9 months. The information from the test will help the City of Socorro choose the best arsenic treatment technology for the Socorro Springs well. The pilot demonstration is a project of the Arsenic Water Technology Partnership program, a partnership between the American Water Works Association (AWWA) Research Foundation, SNL, and WERC (A Consortium for Environmental Education and Technology Development).

  11. 100-OL-1 Operable Unit Field Portable X-Ray Fluorescence (XRF) Analyzer Pilot Study Plans

    SciTech Connect

    Bunn, Amoret L.; Fritz, Brad G.; Wellman, Dawn M.

    2014-07-01

    A pilot study is being conducted to support the approval of the Remedial Investigation/Feasibility Study (RI/FS) Work Plan to evaluate the 100-OL-1 Operable Unit (OU) pre-Hanford orchard lands. Based on comments received by the U.S. Environmental Protection Agency (EPA) and Washington State Department of Ecology, the pilot study will evaluate the use of field portable X-ray fluorescence (XRF) spectrometry measurements for evaluating lead and arsenic concentrations on the soil surface as an indicator of past use of lead arsenate pesticide residue in the OU. The work will be performed in the field during the summer of 2014, and assist in the planning for the characterization activities in the RI/FS.

  12. Direct Reimbursement of Nurse Practitioners in Health Insurance Plans of Research Universities.

    ERIC Educational Resources Information Center

    Scott, Cynthia Luna; Harrison, O. Anne

    1990-01-01

    Results of a survey of 77 public research universities indicated that, in spite of the presence of state legislation for third-party reimbursement of nursing services, legislation is not being implemented in many states by employers in their purchase of group health insurance policies. Nursing services covered by these policies include private…

  13. 77 FR 22467 - Common Crop Insurance Regulations; Fresh Market Tomato (Dollar Plan) Crop Provisions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-16

    ... administrative review process of good farming practices as applicable, must be exhausted before any action... for all producers regardless of the size of their farming operation. For instance, all producers are... have produced per acre assuming normal growing conditions and practices by the end of the insurance...

  14. 7 CFR 457.139 - Fresh market tomato (dollar plan) crop insurance provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... precipitation sufficient to directly damage the crop. Freeze—The formation of ice in the cells of the plant or... and not cut by a sharp knife in slicing; and (4) Shows no red color. Plant stand—The number of live plants per acre prior to the occurrence of an insurable cause of loss. Planted acreage—In addition to the...

  15. Direct Reimbursement of Nurse Practitioners in Health Insurance Plans of Research Universities.

    ERIC Educational Resources Information Center

    Scott, Cynthia Luna; Harrison, O. Anne

    1990-01-01

    Results of a survey of 77 public research universities indicated that, in spite of the presence of state legislation for third-party reimbursement of nursing services, legislation is not being implemented in many states by employers in their purchase of group health insurance policies. Nursing services covered by these policies include private…

  16. Direct reimbursement of nurse practitioners in health insurance plans of research universities.

    PubMed

    Scott, C L; Harrison, O A

    1990-01-01

    The purpose of this study was to explore the nature of health insurance coverage research universities offer their employees and the extent to which these employers offer options providing for reimbursement of services of independent nurse practitioners. A request for health insurance documents mailed to 77 public research universities resulted in a response rate of 83 per cent. A total of 75 per cent sent usable descriptions of insurance coverage for analysis. Among the respondents, 69 per cent (n = 40) reported offering insurance through Blue Cross/Blue Shield companies. Nursing services reimbursed generally included traditional nursing care such as private duty nursing and home health care. Coverage of nursing services that overlap with traditional medical practice, such as prenatal care and labor and delivery services of nurse midwives, anesthesia services of nurse anesthetists, psychiatric services of nurse specialists, and primary care nursing services of nurse practitioners, was less evident. Findings generally indicated that in spite of the presence of enabling or mandatory state legislation for third-party reimbursement of nursing services, legislation is not being implemented in many states by employers in their purchase of group policies.

  17. 7 CFR 457.128 - Guaranteed production plan of fresh market tomato crop insurance provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... Harvest—Picking of marketable tomatoes. Mature green tomato—A tomato that: (a) Has a heightened gloss due... be insured as either spring-or fall-planted tomatoes. Plant stand—The number of live plants per acre before any damage occurs. Potential production—The number of cartons per acre of mature green or...

  18. Pitching plans to the uninsured. Insurers increasingly see viable market in growing pool of middle-class workers who don't have health insurance.

    PubMed

    Benko, Laura B

    2003-02-24

    It's a bold new world in healthcare insurance. A few years ago, insurers would have been reluctant to use advertising dollars to reach the uninsured. But now, as the average income of the typical uninsured person is climbing and Congress is pondering initiatives to expand coverage, the market is gaining zealous suitors. "Things are really heating up," says Merrill Matthews Jr., left, director of the Council for Affordable Health Insurance.

  19. Fiscal year 1981 US corn and soybeans pilot preliminary experiment plan, phase 1

    NASA Technical Reports Server (NTRS)

    Livingston, G. P.; Nedelman, K. S.; Norwood, D. F.; Smith, J. H. (Principal Investigator)

    1981-01-01

    A draft of the preliminary experiment plan for the foreign commodity production forecasting project fiscal year 1981 is presented. This draft plan includes: definition of the phase 1 and 2 U.S. pilot objectives; the proposed experiment design to evaluate crop calendar, area estimation, and area aggregation components for corn and soybean technologies using 1978/1979 crop-year data; a description of individual sensitivity evaluations of the baseline corn and soybean segment classification procedure; and technology and data assessment in support of the corn and soybean estimation technology for use in the U.S. central corn belt.

  20. Farmers Insures Success

    ERIC Educational Resources Information Center

    Freifeld, Lorri

    2012-01-01

    Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

  1. Farmers Insures Success

    ERIC Educational Resources Information Center

    Freifeld, Lorri

    2012-01-01

    Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

  2. Distance to a Plastic Surgeon and Type of Insurance Plan Are Independently Predictive of Postmastectomy Breast Reconstruction

    PubMed Central

    Roughton, Michelle C.; DiEgidio, Paul; Zhou, Lei; Stitzenberg, Karyn; Meyer, Anne Marie

    2016-01-01

    Background The psychosocial benefits of postmastectomy breast reconstruction are well established; however, health care barriers persist. The authors evaluated statewide patient population to further identify obstacles to reconstruction. Methods A linked data set combining the North Carolina Central Cancer Registry with administrative claims from Medicare, Medicaid, and private insurance plans identified women diagnosed with breast cancer from 2003 to 2006. For inclusion in the study, women must have had a mastectomy within 6 months of diagnosis and had continuous insurance enrollment at least 2 years postoperatively (n = 5381). Multivariable logistic regression was used to model odds of reconstruction. Results Approximately 20 percent underwent reconstruction (n = 1130). Distance to a plastic surgeon—10 to 20 miles (OR, 0.78) and greater than 20 miles (OR, 0.73; p < 0.05)—was significantly predictive of no reconstruction, independent of other well-known disparities, including age, race, rural location, and lower household income. Women with government-funded health care, such as Medicare (OR, 0.58) and Medicaid (OR, 0.24; p < 0.001), were also significantly less likely to undergo reconstruction. Consistent with previous study, advanced cancer stage and receipt of radiation therapy decreased the likelihood of reconstruction. Furthermore, when the authors compared immediate to delayed reconstruction, rural location, chemotherapy, and radiation therapy were significantly predictive of delay. Conclusions This is the first population-based study to demonstrate distance to care and insurance plan as significant predictors of receipt of reconstruction. Additional research is needed to understand health care barriers and to determine whether distance to a plastic surgeon can be ameliorated by outreach programs. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III. PMID:27465180

  3. Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law

    PubMed Central

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-01-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773

  4. Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

    PubMed

    Dworsky, Amy; Ahrens, Kym; Courtney, Mark

    2013-04-01

    This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

  5. Military Personnel: DOD Should Develop a Plan to Evaluate the Effectiveness of Its Career Intermission Pilot Program

    DTIC Science & Technology

    2015-10-01

    MILITARY PERSONNEL DOD Should Develop a Plan to Evaluate the Effectiveness of Its Career Intermission Pilot...DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Military Personnel: DOD Should Develop a Plan to Evaluate the Effectiveness of Its... Career Intermission Pilot Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER

  6. Waste Isolation Pilot Plant disposal phase supplemental environmental impact statement. Implementation plan

    SciTech Connect

    1996-05-01

    The Implementation Plan for the Waste Isolation Pilot Plant Disposal Phase Supplemental Environmental Impact Statement (SEIS-II) has two primary purposes: (1) To report on the results of the scoping process (2) To provide guidance for preparing SEIS-II SEIS-II will be the National Environmental Policy Act (NEPA) review for WIPP`s disposal phase. Chapter 1 of this plan provides background on WIPP and this NEPA review. Chapter 2 describes the purpose and need for action by the Department of Energy (hereafter DOE or the Department), as well as a description of the Proposed Action and alternatives being considered. Chapter 3 describes the work plan, including the schedule, responsibilities, and planned consultations with other agencies and organizations. Chapter 4 describes the scoping process, presents major issues identified during the scoping process, and briefly indicates how issues will be addressed in SEIS-II.

  7. Group insurance: a better deal for most people than individual plans.

    PubMed

    McDevitt, Roland; Gabel, Jon; Lore, Ryan; Pickreign, Jeremy; Whitmore, Heidi; Brust, Tina

    2010-01-01

    This paper compares health plans currently available on the individual market with employer-sponsored plans. Points of comparison include the scope of benefits, cost-sharing provisions, premiums, expected out-of-pocket costs, and actuarial value. We draw from the 2007 KFF/HRET Health Benefits Survey, our own survey of individual-market plans, the MarketScan medical claims database, and a computer simulation of medical claims. We find that in 2007, employment-based plans covered 80 percent of all charges paid by the plan and the member, while individual plans covered 64 percent. For most people, premiums and out-of-pocket costs were more affordable in tax-advantaged employer plans than in individual-market plans. Proposed health reforms would fundamentally alter the plan offerings available to Americans, particularly those offered in the individual market.

  8. HUD PowerSaver Pilot Loan Program

    SciTech Connect

    Zimring, Mark; Hoffman, Ian

    2010-12-10

    The U.S. Department of Housing and Urban Development (HUD) recently announced the creation of a pilot loan program for home energy improvements. The PowerSaver loan program is a new, energy-focused variant of the Title I Property Improvement Loan Insurance Program (Title I Program) and is planned for introduction in early 2011. The PowerSaver pilot will provide lender insurance for secured and unsecured loans up to $25,000 to single family homeowners. These loans will specifically target residential energy efficiency and renewable energy improvements. HUD estimates the two-year pilot will fund approximately 24,000 loans worth up to $300 million; the program is not capped. The Federal Housing Administration (FHA), HUD's mortgage insurance unit, will provide up to $25 million in grants as incentives to participating lenders. FHA is seeking lenders in communities with existing programs for promoting residential energy upgrades.

  9. Toward Meaningful Care Plan Clinical Decision Support: Feasibility and Effects of a Simulated Pilot Study.

    PubMed

    Keenan, Gail M; Lopez, Karen Dunn; Yao, Yingwei; Sousa, Vanessa E C; Stifter, Janet; Febretti, Alessandro; Johnson, Andrew; Wilkie, Diana J

    Clinical decision support (CDS) tools-with easily understood and actionable information, at the point of care-are needed to help registered nurses (RNs) make evidence-based decisions. Not clear are the optimal formats of CDS tools. Thorough, preclinical testing is desirable to avoid costly errors associated with premature implementation in electronic health records. The aims of this study were to determine feasibility of the protocol designed to compare multiple CDS formats and evaluate effects of numeracy and graph literacy on RN adoption of best practices and care planning time in a simulated environment. In this pilot study, 60 RNs were randomly assigned to one of four CDS conditions (control, text, text + graph, and text + table) and asked to adjust the plan of care for two patient scenarios over three shifts. Fourteen best practices were identified for the two patients and sent as suggestions with evidence to the three CDS groups. Best practice adoption rates, care planning time, and their relationship to the RN's numeracy and graph literacy scores were assessed. CDS groups had a higher adoption rate of best practices (p < .001) across all shifts and decreased care planning time in shifts 2 (p = .01) and 3 (p = .02) compared with the control group. Higher numeracy and graph literacy were associated with shorter care planning times under text + table (p = .05) and text + graph (p = .01) conditions. No significant differences were found between the three CDS groups on adoption rate and care planning time. This pilot study shows the feasibility of our protocol. Findings show preliminary evidence that CDS improves the efficiency and effectiveness of care planning decisions and that the optimal format may depend on individual RN characteristics. We recommend a study with sufficient power to compare different CDS formats and assess the impact of potential covariates on adoption rates and care planning time.

  10. Health insurance reform legislation.

    PubMed

    DiSimone, R L

    1997-01-01

    The Health Insurance Portability and Accountability Act of 1996 (HIPAA), enacted on August 21, 1996 (Public Law 104-19), provides for improved access and renewability with respect to employment-related group health plans, to health insurance coverage sold in connection with group plans, and to the individual market (by amending the Public Health Service Act). The Act's provisions include improvements in portability and continuity of health insurance coverage; combatting waste, fraud, and abuse in health insurance and health care delivery; promoting the use of medical savings accounts; improving access to long-term care services and insurance coverage; administrative simplification; and addressing duplication and coordination of Medicare benefits.

  11. Developing Tsunami Evacuation Plans, Maps, And Procedures: Pilot Project in Central America

    NASA Astrophysics Data System (ADS)

    Arcos, N. P.; Kong, L. S. L.; Arcas, D.; Aliaga, B.; Coetzee, D.; Leonard, J.

    2015-12-01

    In the End-to-End tsunami warning chain, once a forecast is provided and a warning alert issued, communities must know what to do and where to go. The 'where to' answer would be reliable and practical community-level tsunami evacuation maps. Following the Exercise Pacific Wave 2011, a questionnaire was sent to the 46 Member States of Pacific Tsunami Warning System (PTWS). The results revealed over 42 percent of Member States lacked tsunami mass coastal evacuation plans. Additionally, a significant gap in mapping was exposed as over 55 percent of Member States lacked tsunami evacuation maps, routes, signs and assembly points. Thereby, a significant portion of countries in the Pacific lack appropriate tsunami planning and mapping for their at-risk coastal communities. While a variety of tools exist to establish tsunami inundation areas, these are inconsistent while a methodology has not been developed to assist countries develop tsunami evacuation maps, plans, and procedures. The International Tsunami Information Center (ITIC) and partners is leading a Pilot Project in Honduras demonstrating that globally standardized tools and methodologies can be applied by a country, with minimal tsunami warning and mitigation resources, towards the determination of tsunami inundation areas and subsequently community-owned tsunami evacuation maps and plans for at-risk communities. The Pilot involves a 1- to 2-year long process centered on a series of linked tsunami training workshops on: evacuation planning, evacuation map development, inundation modeling and map creation, tsunami warning & emergency response Standard Operating Procedures (SOPs), and conducting tsunami exercises (including evacuation). The Pilot's completion is capped with a UNESCO/IOC document so that other countries can replicate the process in their tsunami-prone communities.

  12. Family planning in the Sudan: a pilot project success story.

    PubMed

    el Tom, A R; Lauro, D; Farah, A A; McNamara, R; Ali Ahmed, E F

    1989-01-01

    In 1980, the Department of Community Medicine of the University of Khartoum designed an operations research project to test the possibility of getting village midwives to be involved in the delivery of maternal and child health and family planning (MCH/FP) services. From 1981-1983 the project was implemented by the University of Khartoum in cooperation with the Ministry of Health. The project area covered 100 km. It encompassed a largely agrarian population of 93,000 in 90 villages north of Khartoum along the banks of the Nile. The focus was on training and supervising village midwives. Information was provided on contraceptives for birth spacing, distribution of oral contraceptives, and referral for other methods. Also provided to midwives was information for mothers on oral rehydration therapy for children with diarrhea, and distribution of oral rehydration solution packets. Nutrition education was given midwives with emphasis on breastfeeding and weaning procedures. Information was also supplied about vaccination for children under 5 years of age (in collaboration with the Sudan Expanded Program on Immunization). The project was expensive, particularly regarding incentive payments for supervisors and midwives. The project had a very good start, but when incentive payments were withdrawn, it almost collapsed. At first, what midwives could do to provide maternal and child health services was targeted, but as the project went on, there was more concern for involvement of midwives in broader rural health delivery. The project area was a conservative, Islamic one. An extension area was selected 5 hours travelling time from Khartoum in Shendi District of Nile Province. The project was begun in 60 villages of 75,000 inhabitants. The land stretched for 120 km along both banks of the Nile. In the extension area, a small fee (US$.025) was charged per cycle, half going to the midwives, and half towards the health teams' expenses. 21 health zones were created, and a health

  13. Participation of plans and providers in Medicaid and SCHIP managed care. State Children's Health Insurance Program.

    PubMed

    Gold, Marsha; Mittler, Jesslca; Draper, Debra; Rousseau, David

    2003-01-01

    For Medicaid and SCHIP managed care programs to succeed, they must attract enough and the right kinds of plans and providers to meet access and care goals. In 2001 we analyzed practices and perceptions that bear on these goals by surveying managed care plans participating in Medicaid or SCHIP, or both, in eleven states. Participating plans appear supportive of both programs and are largely able to secure providers to participate, too. To date, SCHIP has not attracted many plans not already participating in Medicaid. While perceptions were positive in 2001, maintaining current plan and provider relationships in an environment that has become much more budget constrained will be challenging.

  14. Pilot of the BOOST-A™: An online transition planning program for adolescents with autism.

    PubMed

    Hatfield, Megan; Murray, Nina; Ciccarelli, Marina; Falkmer, Torbjörn; Falkmer, Marita

    2017-07-19

    Many adolescents with autism face difficulties with the transition from high school into post-school activities. The Better OutcOmes & Successful Transitions for Autism (BOOST-A™) is an online transition planning program which supports adolescents on the autism spectrum to prepare for leaving school. This study describes the development of the BOOST-A™ and aimed to determine the feasibility and viability of the program. Two pilot studies were conducted. In Pilot A, the BOOST-A™ was trialled by six adolescents on the autism spectrum, their parents, and the professionals who worked with them, to determine its feasibility. In Pilot B, 88 allied health professionals (occupational therapists, speech pathologists, and psychologists) reviewed the BOOST-A™ to determine its viability. Participants rated the BOOST-A™ as a feasible tool for transition planning. The majority of allied health professionals agreed that it was a viable program. Based on participant feedback, the BOOST-A™ was modified to improve usability and feasibility. The BOOST-A™ is a viable and feasible program that has the potential to assist adolescents with autism in preparing for transitioning out of high school. Future research will determine the effectiveness of the BOOST-A™ with adolescents across Australia. © 2017 Occupational Therapy Australia.

  15. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    PubMed Central

    Barnes, Andrew J.; Hanoch, Yaniv; Rice, Thomas

    2016-01-01

    Objective The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions. Study Setting Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. Study Design We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Data Collection Primary data were gathered using an online choice experiment and questionnaire. Principal Findings Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. Conclusions As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers’ decisions. PMID:27028008

  16. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    PubMed

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

    2016-01-01

    The Affordable Care Act's marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool--plan recommendations--in improving marketplace decisions. Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Primary data were gathered using an online choice experiment and questionnaire. Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers' decisions.

  17. Report on Pilot Test of State Agency Manpower Planning Methodology, Texas Water Quality Board Construction Grants Section.

    ERIC Educational Resources Information Center

    Texas State Dept. of Water Resources, Austin.

    This report presents the results of a pilot test by the Texas Water Quality Board (TWQB) of a manpower planning methodology developed by the U.S. Environmental Protection Agency (EPA), Office of Water Programs. Project outputs are described and illustrated in sections of the report dealing with work to be done, organizational staffing plan,…

  18. Report on Pilot Test of State Agency Manpower Planning Methodology, Texas Water Quality Board Construction Grants Section.

    ERIC Educational Resources Information Center

    Texas State Dept. of Water Resources, Austin.

    This report presents the results of a pilot test by the Texas Water Quality Board (TWQB) of a manpower planning methodology developed by the U.S. Environmental Protection Agency (EPA), Office of Water Programs. Project outputs are described and illustrated in sections of the report dealing with work to be done, organizational staffing plan,…

  19. Pilot-scale treatability test plan for the 200-BP-5 operable unit

    SciTech Connect

    Not Available

    1994-08-01

    This document presents the treatability test plan for pilot-scale pump and treat testing at the 200-BP-5 Operable Unit. This treatability test plan has been prepared in response to an agreement between the U.S. Department of Energy (DOE), the U.S. Environmental Protection Agency (EPA), and the State of Washington Department of Ecology (Ecology), as documented in Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement, Ecology et al. 1989a) Change Control Form M-13-93-03 (Ecology et al. 1994) and a recent 200 NPL Agreement Change Control Form (Appendix A). The agreement also requires that, following completion of the activities described in this test plan, a 200-BP-5 Operable Unit Interim Remedial Measure (IRM) Proposed Plan be developed for use in preparing an Interim Action Record of Decision (ROD). The IRM Proposed Plan will be supported by the results of this treatability test plan, as well as by other 200-BP-5 Operable Unit activities (e.g., development of a qualitative risk assessment). Once issued, the Interim Action ROD will specify the interim action(s) for groundwater contamination at the 200-BP-5 Operable Unit. The treatability test approach is to conduct a pilot-scale pump and treat test for each of the two contaminant plumes associated with the 200-BP-5 Operable Unit. Primary contaminants of concern are {sup 99}Tc and {sup 60}Co for underwater affected by past discharges to the 216-BY Cribs, and {sup 90}Sr, {sup 239/240}Pu, and Cs for groundwater affected by past discharges to the 216-B-5 Reverse Well. The purpose of the pilot-scale treatability testing presented in this testplan is to provide the data basis for preparing an IRM Proposed Plan. To achieve this objective, treatability testing must: Assess the performance of groundwater pumping with respect to the ability to extract a significant amount of the primary contaminant mass present in the two contaminant plumes.

  20. 26 CFR 1.105-11 - Self-insured medical reimbursement plan.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or employers. For purposes of determining whether such bargaining occurred, it is not material that... dental benefits. During the plan year Employee B, one of the 5 highest paid officers, received dental payments under the plan in the amount of $300. Because dental benefits are provided for highly compensated...

  1. 26 CFR 1.105-11 - Self-insured medical reimbursement plan.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... for purposes of this section. Accordingly, a cost-plus policy or a policy which in effect merely... dental benefits. During the plan year Employee B, one of the 5 highest paid officers, received dental payments under the plan in the amount of $300. Because dental benefits are provided for highly...

  2. 26 CFR 1.105-11 - Self-insured medical reimbursement plan.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... for purposes of this section. Accordingly, a cost-plus policy or a policy which in effect merely... dental benefits. During the plan year Employee B, one of the 5 highest paid officers, received dental payments under the plan in the amount of $300. Because dental benefits are provided for highly...

  3. Studies of planning behavior of aircraft pilots in normal, abnormal, and emergency situations

    NASA Technical Reports Server (NTRS)

    Johannsen, G.; Rouse, W. B.; Hillmann, K.

    1981-01-01

    A methodology for the study of human planning behavior in complex dynamic systems is presented and applied to the study of aircraft pilot behavior in normal, abnormal and emergency situations. The method measures the depth of planning, that is the level of detail employed with respect to a specific task, according to responses to a verbal questionnaire, and compares planning depth with variables relating to time, task criticality and the probability of increased task difficulty. In two series of experiments, depth of planning was measured on a five- or ten-point scale during various phases of flight in a HFB-320 simulator under normal flight conditions, abnormal scenarios involving temporary runway closure due to snow removal or temporary CAT-III conditions due to a dense fog, and emergency scenarios involving engine shut-down or hydraulic pressure loss. Results reveal a dichotomy between event-driven and time-driven planning, different effects of automation in abnormal and emergency scenarios and a low correlation between depth of planning and workload or flight performance.

  4. Feasibility of discharge planning in intensive care units: a pilot study.

    PubMed

    Holland, Diane E; Rhudy, Lori M; Vanderboom, Catherine E; Bowles, Kathryn H

    2012-07-01

    Although there is widespread acceptance that hospital discharge planning should begin at hospital admission, early discharge planning is usually delayed for clinically unstable patients in intensive care units. This pilot study explored the feasibility of beginning the hospital's discharge planning process within 24 hours of an admission to the intensive care unit. Medical records of 15 patients were used to create case summaries generated from information available within 24 hours of admission to the intensive care unit. Twelve unit staff members (registered nurses, clinical nurse specialists, social workers, and discharge planning nurses) predicted the presence and absence of patient self-care deficits at hospital discharge and rated their confidence in making predictions. More than half (55%) of patient self-care deficits present at hospital discharge were identified within 24 hours of admission to the unit. Although confidence in predicting deficits increased significantly when more information was available closer to hospital discharge for clinical nurse specialists and staff nurses, confidence for discharge planning nurses and social workers was as high for decisions based on admission information as it was for decisions based on information available at hospital discharge. The results provide a preliminary indication that staff in intensive care units may contribute to the early identification of patients' postacute care needs. The results also help to identify methods to study the discharge planning process within intensive care units.

  5. The Impact of Lifetime Drug Use on Hepatitis C Treatment Outcomes in Insured Members of an Integrated Health Care Plan

    PubMed Central

    Pauly, Mary Patricia; Moore, Charles Denton; Chia, Constance; Dorrell, Jennifer Mary; Cunanan, Renee Junko; Witt, Gayle

    2013-01-01

    Background The relation of drug use to HCV treatment outcome in an insured household population has not been previously reported. Methods Lifetime frequencies of marijuana use and non-medical use of stimulants, sedatives, and opioids; hallucinogens; and inhalants were retrospectively assessed in 259 privately insured members of an integrated health care plan treated for chronic hepatitis C virus infection (HCV+) with pegylated interferon alpha and ribavirin and examined with respect to rates of sustained virological response (SVR). Results The majority of patients reported chronic use of multiple illegal drugs; 61.6% reported injection drug use (IDU); 79.5% abstained from drug use during the six months prior to HCV treatment. Total frequency of individual drugs, multiple drugs, and length of abstention from drugs prior to HCV treatment were not related to impaired SVR rates. Sustained viral responses were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Marijuana use during HCV treatment, reported by 8.5% of patients, was associated with higher treatment adherence (95.5% compared with 78.9%, p=0.045), but lower SVR rates (40.9% compared with 62.5%, p=0.041). In addition, drug use during HCV treatment was associated with significantly higher relapse rates, 18.8% compared with 7.7% (p=.053). Conclusion A history of chronic illegal drug use should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are motivated to seek treatment and closely monitored, but drug use during HCV treatment, including marijuana use, should be discouraged. PMID:24262649

  6. Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Final rules.

    PubMed

    2012-02-15

    These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act.

  7. 29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... characteristics of both the assets and the liabilities of the insurer; (D) Actuarial opinion of the insurer's... individual and group life, health, disability, and annuity contracts. Experience rated general...

  8. Data evaluation plan for the 10 MWe solar thermal central receiver pilot plant power production phase

    SciTech Connect

    Radosevich, L.G.

    1984-10-01

    This report describes the planned data evaluation for the three-year Power Production Phase of the 10 MWe Solar Thermal Central Receiver Pilot Plant near Barstow, California. The Power Production Phase, which began in August 1984, will demonstrate the operational capability of the plant to reliably supply electrical power to the utility grid. Data evaluation will be performed for design point and annual plant energy output; heliostat optical performance and mirror module corrosion; receiver tube life and absorber coating life; storage fluid degradation and storage tank thermal stresses; plant availability, operating procedures, and operating costs; and component reliability and maintenance costs. The objective, test needs, data needs, approach, expected output, and planned data dissemination are presented for each evaluation.

  9. Evaluating the use of a pain assessment tool and care plan: a pilot study.

    PubMed

    Carr, E C

    1997-12-01

    Pain control in hospital has long been documented as ineffective and problematic. A multi-professional group of clinicians formed to consider how they might continue to improve pain management at a district general hospital. Following a pain audit, in general wards, it became apparent that pain assessment tools were not being used. The group devised a draft pilot assessment tool and care plan which was piloted over a 2-week period on a rehabilitation ward for elderly people. A review of these documents revealed that pain assessment using the body map ascertained considerable detail about the pain location, and the pain ruler elicited pain intensity and associated descriptors. None of the documented goals for pain were measurable, and interventions focused on analgesia and actions to relieve the physical cause of the pain. No psychosocial interventions were mentioned. All care plans were evaluated at least once but 44% of evaluations did not refer to the pain. On this ward, these outcomes suggest the pain assessment tool has the potential to improve communication of pain between the patient and the nurse but there is an urgent need for education to enable this information to be used effectively and develop pain management strategies which reflect the multidimensional nature of pain.

  10. Development and pilot demonstration program of a waste minimization plan at Argonne National Laboratory

    SciTech Connect

    Peters, R.W.; Wentz, C.A.; Thuot, J.R.

    1991-01-01

    In response to US Department of Energy directives, Argonne National Laboratory (ANL) has developed a waste minimization plan aimed at reducing the amount of wastes at this national research and development laboratory. Activities at ANL are primarily research- oriented and as such affect the amount and type of source reduction that can be achieved at this facility. The objective of ANL's waste minimization program is to cost-effectively reduce all types of wastes, including hazardous, mixed, radioactive, and nonhazardous wastes. The ANL Waste Minimization Plan uses a waste minimization audit as a systematic procedure to determine opportunities to reduce or eliminate waste. To facilitate these audits, a computerized bar-coding procedure is being implemented at ANL to track hazardous wastes from where they are generated to their ultimate disposal. This paper describes the development of the ANL Waste Minimization Plan and a pilot demonstration of the how the ANL Plan audited the hazardous waste generated within a selected divisions of ANL. It includes quantitative data on the generation and disposal of hazardous waste at ANL and describes potential ways to minimize hazardous wastes. 2 refs., 5 figs., 8 tabs.

  11. DOE's Notification of Planned Change to the EPA 40 CFR Part 194 Certification of the Waste Isolation Pilot Plant: Remote-Handled Transuranic Waste Characterization Plan

    EPA Pesticide Factsheets

    The U.S. Department of Energy's Carlsbad Field Office (DOE/CBFO) provided the U.S. Environmental Protection Agency (EPA) this Notification of Planned Change to accept remote-handled (RH) transuranic (TRU) waste at the Waste Isolation Pilot Plant (WIPP).

  12. The effect of physician and health plan market concentration on prices in commercial health insurance markets.

    PubMed

    Schneider, John E; Li, Pengxiang; Klepser, Donald G; Peterson, N Andrew; Brown, Timothy T; Scheffler, Richard M

    2008-03-01

    The objective of this paper is to describe the market structure of health plans (HPs) and physician organizations (POs) in California, a state with high levels of managed care penetration and selective contracting. First we calculate Herfindahl-Hirschman (HHI) concentration indices for HPs and POs in 42 California counties. We then estimate a multivariable regression model to examine the relationship between concentration measures and the prices paid by HPs to POs. Price data is from Medstat MarketScan databases. The findings show that any California counties exhibit what the Department of Justice would consider high HHI concentration measures, in excess of 1,800. More than three quarters of California counties exhibit HP concentration indices over 1,800, and 83% of counties have PO concentration levels in excess of 1,800. Half of the study counties exhibited PO concentration levels in excess of 3,600, compared to only 24% for plans. Multivariate price models suggest that PO concentration is associated with higher physician prices (p < or = 0.05), whereas HP concentration does not appear to be significantly associated with higher outpatient commercial payer prices.

  13. 1997 annual ground control operating plan for the Waste Isolation Pilot Plant

    SciTech Connect

    1997-02-01

    This plan presents background information and a working guide to assist Mine Operations and Engineering in developing strategies for addressing ground control issues at the Waste Isolation Pilot Plant (WIPP). With the anticipated receipt of waste in late 1997, this document provides additional detail to Panel 1 activities and options. The plan also serves as a foundation document for development and revision of the annual long-term ground control plan. Section 2.0 documents the current status of all underground excavations with respect to location, geology, geometry, age, ground support, operational use, projected life, and physical conditions. Section 3.0 presents the methods used to evaluate ground conditions, including visual observations of the roof, ribs, and floor, inspection of observation holes, and review of instrumentation data. Section 4.0 lists several ground support options and specific applications of each. Section 5.0 discusses remedial ground control measures that have been implemented to date. Section 6.0 presents projections and recommendations for ground control actions based on the information in Sections 2.0 through 5.0 of this plan and on a rating of the critical nature of each specific area. Section 7.0 presents a summary statement, and Section 8.0 includes references. Appendix A provides an overview and critique of ground control systems that have been, or may be, used at the site. Because of the dynamic nature of the underground openings and associated geotechnical activities, this plan will be revised as additional data are incorporated.

  14. Fertility awareness / natural family planning for adolescents and their families: report of multisite pilot project.

    PubMed

    Klaus, H; Bryan, L M; Bryant, M L; Fagan, M U; Harrigan, M B; Kearns, F

    1987-01-01

    Fertility awareness is experiential learning about cyclic fertility. This awareness, used as a family planning method, differs from contraception because it does not isolate the procreative capacity of either partner. The acceptability and effect of teaching fertility awareness on teen sexual activity and decision making was tested in a multisite pilot program which taught fertility awareness via the prospective marker of the cervical mucus (ovulation method of natural family planning). 200 US and 35 Guatemalan volunteer women ages 15-17 in a structured 1 year curriculum, monitored cycle charting and explored the implications of experiencing one's signs of fertility. Control subjects were recruited from the general population and from family planning clinics. 9% of the US study group were sexually active prior to entry. By cycle 12, 1/2 had discontinued activity. Conception rate was 0.0044. The continuation rate dropped from 90% at cycle 7 to 71% at cycle 8 due to scheduling constraints for 2 classes and to 57% at cycle 12. Postprogram follow-up of early leavers showed only 1/3 the expected rate of onset of sexual activity and pregnancy. Parent involvement correlated positively with postponement and/or discontinuation of sexual activity. Reported movement away from peer group pressure appeared 3 months after entry.

  15. National Geoscience Data Repository System, Phase 2: Planning and pilot study. Progress report, third quarter, July--September, 1995

    SciTech Connect

    1995-11-01

    Two tasks are described. The Planning and Specification task includes: organization, operations and management plan; data audit and prioritization; data preparation, transcription, imaging, and preservation; data catalog and indexing; and data access, distribution, and delivery. The Pilot Projects task includes digital seismic data transfer; core and cuttings processing; catalog and index database; and paper records data capture. The status of each of these are briefly discussed.

  16. Development and pilot testing of a mental healthcare plan in Nepal

    PubMed Central

    Jordans, M. J. D.; Luitel, N. P.; Pokhrel, P.; Patel, V.

    2016-01-01

    Background Mental health service delivery models that are grounded in the local context are needed to address the substantial treatment gap in low- and middle-income countries. Aims To present the development, and content, of a mental healthcare plan (MHCP) in Nepal and assess initial feasibility. Method A mixed methods formative study was conducted. Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from patients (n = 135) during the pilot-testing phase in two health facilities. Results The resulting MHCP consists of 12 packages, divided over community, health facility and organisation platforms. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers and high drop-out rates. Conclusions The MHCP follows a collaborative care model encompassing community and primary healthcare interventions. PMID:26447173

  17. The use of significant event analysis and personal development plans in developing CPD: a pilot study.

    PubMed

    Wright, P D; Franklin, C D

    2007-07-14

    This paper describes the work undertaken by the Postgraduate Primary Care Trust (PCT) Dental Tutor for South Yorkshire and East Midlands Regional Postgraduate Dental Education Office during the first year of a two-year pilot. The tutor has special responsibility for facilitating the writing of Personal Development Plans (PDPs) and the introduction of Significant Event Analysis to the 202 general dental practitioners in the four Sheffield PCTs. Data were collected on significant events and the educational needs highlighted as a result. A hands-on workshop format was used in small practice groups and 45% of Sheffield general dental practitioners now have written PDPs compared with a 16% national average. A library of significant events has also been collated from the data collected.

  18. Health Insurance: Most College Students Are Covered through Employer-Sponsored Plans, and Some Colleges and States Are Taking Steps to Increase Coverage. Report to the Committee on Health, Education, Labor, and Pensions, U.S. Senate. GAO-08-389

    ERIC Educational Resources Information Center

    Dicken, John E.

    2008-01-01

    College students face challenges obtaining health insurance: they may not have access to insurance through an employer, and as they get older, they may lose dependent coverage obtained through a parent's plan. Federal law ensures continued access to health insurance for some, but not all, such students. Without health insurance, college students…

  19. About Insurance.

    ERIC Educational Resources Information Center

    Pieslak, Raymond F.

    The student manual for high school level special needs students was prepared to acquaint deaf students with the various types of insurance protection that will be available to them in their future life. Seven units covering the topics of what insurance is, automobile insurance, life insurance, health insurance, social security, homeowner's…

  20. Aviation and insurance

    NASA Technical Reports Server (NTRS)

    Mayo, R H

    1922-01-01

    This article considers some of the causes which hinder the development of aircraft insurance. Different risks are discussed as well as the causes of aircraft accidents. Pilot error, poor airdromes, weather conditions, poorly adapted airplanes, and engine failures are all examined and some conclusions are made.

  1. Pilot-testing an applied competency-based approach to health human resources planning.

    PubMed

    Tomblin Murphy, Gail; MacKenzie, Adrian; Alder, Rob; Langley, Joanne; Hickey, Marjorie; Cook, Amanda

    2013-10-01

    A competency-based approach to health human resources (HHR) planning is one that explicitly considers the spectrum of knowledge, skills and judgement (competencies) required for the health workforce based on the health needs of the relevant population in some specific circumstances. Such an approach is of particular benefit to planners challenged to make optimal use of limited HHR as it allows them to move beyond simply estimating numbers of certain professionals required and plan instead according to the unique mix of competencies available from the existing health workforce. This kind of flexibility is particularly valuable in contexts where healthcare providers are in short supply generally (e.g. in many developing countries) or temporarily due to a surge in need (e.g. a pandemic or other disease outbreak). A pilot application of this approach using the context of an influenza pandemic in one health district of Nova Scotia, Canada, is described, and key competency gaps identified. The approach is also being applied using other conditions in other Canadian jurisdictions and in Zambia.

  2. 78 FR 32126 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY: Department of Veterans Affairs... rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Under...

  3. 29 CFR 2590.732 - Special rules relating to group health plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Liability insurance, including general liability insurance and automobile liability insurance; (iv) Coverage...) Automobile medical payment insurance; (vii) Credit-only insurance (for example, mortgage insurance); and... through insurance, reimbursement, or otherwise. (2) Determination of number of plans. (b)...

  4. 29 CFR 2590.732 - Special rules relating to group health plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Liability insurance, including general liability insurance and automobile liability insurance; (iv) Coverage...) Automobile medical payment insurance; (vii) Credit-only insurance (for example, mortgage insurance); and... through insurance, reimbursement, or otherwise. (2) Determination of number of plans. (b)...

  5. Dental insurance! Are we ready?

    PubMed

    Toor, Ravi S S; Jindal, R

    2011-01-01

    Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI) bill which was put forward in the winter session of the Lok Sabha (2008) focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

  6. New York City Energy-Water Integrated Planning: A Pilot Study

    SciTech Connect

    Bhatt,V.; Crosson, K. M.; Horak, W.; Reisman, A.

    2008-12-16

    The New York City Energy-Water Integrated Planning Pilot Study is one of several projects funded by Sandia National Laboratories under the U.S. Department of Energy Energy-Water Nexus Program. These projects are intended to clarify some key issues and research needs identified during the Energy-Water Nexus Roadmapping activities. The objectives of the New York City Pilot Project are twofold: to identify energy-water nexus issues in an established urban area in conjunction with a group of key stakeholders and to define and apply an integrated energy and water decision support tool, as proof-of-concept, to one or more of these issues. During the course of this study, the Brookhaven National Laboratory project team worked very closely with members of a Pilot Project Steering Committee. The Steering Committee members brought a breadth of experience across the energy, water and climate disciplines, and all are well versed in the particular issues faced by an urban environment, and by New York City in particular. The first task was to identify energy-water issues of importance to New York City. This exercise was followed by discussion of the qualities and capabilities that an ideal decision support tool should display to address these issues. The decision was made to start with an existing energy model, the New York City version of the MARKAL model, developed originally at BNL and now used globally by many groups for energy analysis. MARKAL has the virtue of being well-vetted, transparent, and capable of calculating 'material' flows, such as water use by the energy system and energy requirements of water technology. The Steering Committee members defined five scenarios of interest, representing a broad spectrum of New York City energy-water issues. Brookhaven National Laboratory researchers developed a model framework (Water-MARKAL) at the desired level of detail to address the scenarios, and then attempted to gather the New York City-specific information required to

  7. Economic Effects of Legislations and Policies to Expand Mental Health and Substance Abuse Benefits in Health Insurance Plans: A Community Guide Systematic Review

    PubMed Central

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A.; Goetzel, Ron Z.; Finnie, Ramona; Thota, Anilkrishna B.

    2015-01-01

    Background Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. Aims of the Study This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. Methods The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. Results The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. Discussion and Limitations This review is unable to determine the overall economic value of policies that expand MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when

  8. Legislations and policies to expand mental health and substance abuse benefits in health insurance plans: a community guide systematic economic review.

    PubMed

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A; Goetzel, Ron Z; Finnie, Ramona; Thota, Anilkrishna B

    2015-03-01

    Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. This review is unable to determine the overall economic value of policies that expanded MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when long-term MH/SA patient-level data becomes available to researchers. A

  9. 29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Rating agency reports on the financial strength and claims-paying ability of the insurer; (C) Risk... in the conduct of an enterprise of a like character and with like aims, taking into account all...

  10. Consumers' misunderstanding of health insurance.

    PubMed

    Loewenstein, George; Friedman, Joelle Y; McGill, Barbara; Ahmad, Sarah; Linck, Suzanne; Sinkula, Stacey; Beshears, John; Choi, James J; Kolstad, Jonathan; Laibson, David; Madrian, Brigitte C; List, John A; Volpp, Kevin G

    2013-09-01

    We report results from two surveys of representative samples of Americans with private health insurance. The first examines how well Americans understand, and believe they understand, traditional health insurance coverage. The second examines whether those insured under a simplified all-copay insurance plan will be more likely to engage in cost-reducing behaviors relative to those insured under a traditional plan with deductibles and coinsurance, and measures consumer preferences between the two plans. The surveys provide strong evidence that consumers do not understand traditional plans and would better understand a simplified plan, but weaker evidence that a simplified plan would have strong appeal to consumers or change their healthcare choices. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Development and pilot testing of a mobile health solution for asthma self-management: asthma action plan smartphone application pilot study.

    PubMed

    Licskai, Christopher; Sands, Todd W; Ferrone, Madonna

    2013-01-01

    Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. To design, develop and pilot a mobile health system to support asthma self-management. The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smartphone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts. Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047). A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

  12. Evaluation of medication therapy management services for patients with cardiovascular disease in a self-insured employer health plan.

    PubMed

    Wittayanukorn, Saranrat; Westrick, Salisa C; Hansen, Richard A; Billor, Nedret; Braxton-Lloyd, Kimberly; Fox, Brent I; Garza, Kimberly B

    2013-06-01

    Cardiovascular disease (CVD) is a major cause of mortality in the United States, representing the highest total expenditures among major diseases. To improve CVD-associated outcomes, medication therapy management (MTM) services have been included in essential health benefit packages offered by various health plans. Nevertheless, the impact of such MTM services on outcomes is still unclear, especially from the perspective of the self-insured employer.  To (a) compare economic outcomes between patients who received and those who did not receive MTM services from the self-insured employer's perspective and (b) compare clinical outcomes before and after receiving MTM services.  This study consisted of 2 pre- and post-retrospective designs: (1) a cohort study with comparison groups and (2) a cohort study within group comparison. Patients were beneficiaries aged 19 years or older who were diagnosed with CVD conditions according to ICD-9-CM codes and continuously enrolled in a public university-sponsored insurance plan between 2008-2010. Patients were divided into MTM and non-MTM groups. The first MTM encounter was assigned as the index date for the MTM group. Match-paired patients who did not receive MTM services were randomly assigned the index date based on age category, gender, and comorbidity. Measures for pharmacy, medical, and total expenditures were obtained from medical and pharmacy claims. Paired t-tests and independent t-tests using data generated from 1000 bootstraps compared mean cost difference within and between groups. The return on investment (ROI) was calculated by dividing the average net benefit from MTM services by the average cost of MTM services. Clinical parameters, including blood pressure (BP) and body mass index (BMI), were retrieved from electronic medical records from a pharmacist-provided clinic where MTM services took place. Paired-t tests were used to compare the mean difference between baseline and endpoint values. Further, this study

  13. Developing Items to Measure Theory of Planned Behavior Constructs for Opioid Administration for Children: Pilot Testing.

    PubMed

    Vincent, Catherine; Riley, Barth B; Wilkie, Diana J

    2015-12-01

    The Theory of Planned Behavior (TpB) is useful to direct nursing research aimed at behavior change. As proposed in the TpB, individuals' attitudes, perceived norms, and perceived behavior control predict their intentions to perform a behavior and subsequently predict their actual performance of the behavior. Our purpose was to apply Fishbein and Ajzen's guidelines to begin development of a valid and reliable instrument for pediatric nurses' attitudes, perceived norms, perceived behavior control, and intentions to administer PRN opioid analgesics when hospitalized children self-report moderate to severe pain. Following Fishbein and Ajzen's directions, we were able to define the behavior of interest and specify the research population, formulate items for direct measures, elicit salient beliefs shared by our target population and formulate items for indirect measures, and prepare and test our questionnaire. For the pilot testing of internal consistency of measurement items, Cronbach alphas were between 0.60 and 0.90 for all constructs. Test-retest reliability correlations ranged from 0.63 to 0.90. Following Fishbein and Ajzen's guidelines was a feasible and organized approach for instrument development. In these early stages, we demonstrated good reliability for most subscales, showing promise for the instrument and its use in pain management research. Better understanding of the TpB constructs will facilitate the development of interventions targeted toward nurses' attitudes, perceived norms, and/or perceived behavior control to ultimately improve their pain behaviors toward reducing pain for vulnerable children.

  14. Detailed project plan: Design, construction and operation of pilot scale Charfuel{reg_sign} process. Topical report, Task 2

    SciTech Connect

    Not Available

    1993-09-01

    In this project, a pilot-scale facility for the flash hydropyrolysis of coal will be designed, built and operated to demonstrate the integrated operation of critical components of the CHARFUEL process and to obtain scale-up data for subsequent demonstration facility for the production of a clean coal slurry fuel. This report presents project plans which includes detailed construction plan; procurement of materials and equipment; construction, test and start-up; potential problems and solutions during operations; data collection and analysis; and feasibility analysis.

  15. Description of the computations and pilot procedures for planning fuel-conservative descents with a small programmable calculator

    SciTech Connect

    Vicroy, D.D.; Knox, C.E.

    1983-05-01

    A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. The flight management descent algorithm and the vertical performance modeling required for the DC-10 airplane is described.

  16. Description of the computations and pilot procedures for planning fuel-conservative descents with a small programmable calculator

    NASA Technical Reports Server (NTRS)

    Vicroy, D. D.; Knox, C. E.

    1983-01-01

    A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. The flight management descent algorithm and the vertical performance modeling required for the DC-10 airplane is described.

  17. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan.

    PubMed

    Christensen, Dale B; Roth, Mary; Trygstad, Troy; Byrd, John

    2007-01-01

    To assess the feasibility of a pharmacist-based medication therapy management (MTM) service for North Carolina State Health Plan enrollees. Before/after design with two control groups. Community pharmacies and an ambulatory care clinic in North Carolina serving patients from October 2004 to March 2005. 67 patients who used a large number of prescription drugs, 10 community/ambulatory care pharmacists, and more than 600 participants from two control groups. Pharmacist-conducted MTM reviews for volunteering patients. Process measures (type and frequency of drug therapy problems detected and services performed), economic measures (number and cost of medications dispensed), and humanistic measures (patient satisfaction with services). Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service. A voluntary MTM program targeted at ambulatory patients using a large number of medications reduced the number of PDTPs but did not necessarily result in reductions in prescription drug use or cost. Nearly all patients received some form of medication adherence or disease

  18. Acute Whiplash Injury Study (AWIS): a protocol for a cluster randomised pilot and feasibility trial of an Active Behavioural Physiotherapy Intervention in an insurance private setting

    PubMed Central

    Wiangkham, Taweewat; Duda, Joan; Haque, M Sayeed; Price, Jonathan; Rushton, Alison

    2016-01-01

    Introduction Whiplash-associated disorder (WAD) causes substantial social and economic burden internationally. Up to 60% of patients with WAD progress to chronicity. Research therefore needs to focus on effective management in the acute stage to prevent the development of chronicity. Approximately 93% of patients are classified as WADII (neck complaint and musculoskeletal sign(s)), and in the UK, most are managed in the private sector. In our recent systematic review, a combination of active and behavioural physiotherapy was identified as potentially effective in the acute stage. An Active Behavioural Physiotherapy Intervention (ABPI) was developed through combining empirical (modified Delphi study) and theoretical (social cognitive theory focusing on self-efficacy) evidence. This pilot and feasibility trial has been designed to inform the design of an adequately powered definitive randomised controlled trial. Methods and analysis Two parallel phases. (1) An external pilot and feasibility cluster randomised double-blind (assessor and participants), parallel two-arm (ABPI vs standard physiotherapy) clinical trial to evaluate procedures and feasibility. Six UK private physiotherapy clinics will be recruited and cluster randomised by a computer-generated randomisation sequence. Sixty participants (30 each arm) will be assessed at recruitment (baseline) and at 3 months postbaseline. The planned primary outcome measure is the neck disability index. (2) An embedded exploratory qualitative study using semistructured indepth interviews (n=3–4 physiotherapists) and a focus group (n=6–8 patients) and entailing the recruitment of purposive samples will explore perceptions of the ABPI. Quantitative data will be analysed descriptively. Qualitative data will be coded and analysed deductively (identify themes) and inductively (identify additional themes). Ethics and dissemination This trial is approved by the University of Birmingham Ethics Committee (ERN_15-0542). Trial

  19. Project Management Plan for the Idaho National Engineering Laboratory Waste Isolation Pilot Plant Experimental Test Program

    SciTech Connect

    Connolly, M.J.; Sayer, D.L.

    1993-11-01

    EG&G Idaho, Inc. and Argonne National Laboratory-West (ANL-W) are participating in the Idaho National Engineering Laboratory`s (INEL`s) Waste Isolation Pilot Plant (WIPP) Experimental Test Program (WETP). The purpose of the INEL WET is to provide chemical, physical, and radiochemical data on transuranic (TRU) waste to be stored at WIPP. The waste characterization data collected will be used to support the WIPP Performance Assessment (PA), development of the disposal No-Migration Variance Petition (NMVP), and to support the WIPP disposal decision. The PA is an analysis required by the Code of Federal Regulations (CFR), Title 40, Part 191 (40 CFR 191), which identifies the processes and events that may affect the disposal system (WIPP) and examines the effects of those processes and events on the performance of WIPP. A NMVP is required for the WIPP by 40 CFR 268 in order to dispose of land disposal restriction (LDR) mixed TRU waste in WIPP. It is anticipated that the detailed Resource Conservation and Recovery Act (RCRA) waste characterization data of all INEL retrievably-stored TRU waste to be stored in WIPP will be required for the NMVP. Waste characterization requirements for PA and RCRA may not necessarily be identical. Waste characterization requirements for the PA will be defined by Sandia National Laboratories. The requirements for RCRA are defined in 40 CFR 268, WIPP RCRA Part B Application Waste Analysis Plan (WAP), and WIPP Waste Characterization Program Plan (WWCP). This Project Management Plan (PMP) addresses only the characterization of the contact handled (CH) TRU waste at the INEL. This document will address all work in which EG&G Idaho is responsible concerning the INEL WETP. Even though EG&G Idaho has no responsibility for the work that ANL-W is performing, EG&G Idaho will keep a current status and provide a project coordination effort with ANL-W to ensure that the INEL, as a whole, is effectively and efficiently completing the requirements for WETP.

  20. FY2017 Pilot Project Plan for the Nuclear Energy Knowledge and Validation Center Initiative

    SciTech Connect

    Ren, Weiju

    2016-10-30

    To prepare for technical development of computational code validation under the Nuclear Energy Knowledge and Validation Center (NEKVAC) initiative, several meetings were held by a group of experts of the Idaho National Laboratory (INL) and the Oak Ridge National Laboratory (ORNL) to develop requirements of, and formulate a structure for, a transient fuel database through leveraging existing resources. It was concluded in discussions of these meetings that a pilot project is needed to address the most fundamental issues that can generate immediate stimulus to near-future validation developments as well as long-lasting benefits to NEKVAC operation. The present project is proposed based on the consensus of these discussions. Analysis of common scenarios in code validation indicates that the incapability of acquiring satisfactory validation data is often a showstopper that must first be tackled before any confident validation developments can be carried out. Validation data are usually found scattered in different places most likely with interrelationships among the data not well documented, incomplete with information for some parameters missing, nonexistent, or unrealistic to experimentally generate. Furthermore, with very different technical backgrounds, the modeler, the experimentalist, and the knowledgebase developer that must be involved in validation data development often cannot communicate effectively without a data package template that is representative of the data structure for the information domain of interest to the desired code validation. This pilot project is proposed to use the legendary TREAT Experiments Database to provide core elements for creating an ideal validation data package. Data gaps and missing data interrelationships will be identified from these core elements. All the identified missing elements will then be filled in with experimental data if available from other existing sources or with dummy data if nonexistent. The resulting hybrid

  1. Patient Protection and Affordable Care Act; establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges. Final rule.

    PubMed

    2014-02-24

    The U.S. Office of Personnel Management (OPM) is issuing a final rule implementing modifications to the Multi-State Plan (MSP) Program based on the experience of the Program to date. OPM established the MSP Program pursuant to the Affordable Care Act. This rule clarifies the approach used to enforce the applicable standards of the Affordable Care Act with respect to health insurance issuers that contract with OPM to offer MSP options; amends MSP standards related to coverage area, benefits, and certain contracting provisions under section 1334 of the Affordable Care Act; and makes non-substantive technical changes.

  2. Made in the USA: the import of American Consumer Assessment of Health Plan Surveys (CAHPS) into the Dutch social insurance system.

    PubMed

    Delnoij, Diana M J; ten Asbroek, Guus; Arah, Onyebuchi A; de Koning, Johan S; Stam, Piet; Poll, Aldien; Vriens, Barbara; Schmidt, Paul; Klazinga, Niek S

    2006-12-01

    In the Netherlands, managed competition between health plans has been introduced. For Dutch health plans this implies that they need to collect data about their own performance and that of the care providers they contract. To that end, Consumer Assessment of Health Plan Surveys (CAHPS) instruments have recently been adopted by a large Dutch health plan. This paper presents the results of a validation study of the Dutch version of the CAHPS Adult Commercial questionnaire. The questions addressed are as follows: Can this questionnaire be adapted for use in the context of the Dutch insurance system? and Can it generate valid information about the quality of health care and the performance of Dutch health plans? The translated questionnaire has been mailed to a sample of 977 enrollees. The psychometric properties of the translated instrument have been studied, and the results have been compared with those of other Dutch and American studies. The net response rate was 51% (n = 500). In general, the questionnaires were filled out completely and consistently. Principal component analyses revealed a factor that can be labelled as patient-centredness in the primary process. It contains the domains that in the CAHPS literature are described as 'courteous/helpful staff' and 'doctors communicating well'. The translated version of the CAHPS Adult Commercial questionnaire is a promising tool for Dutch health plans. More research is needed on the external and the content validity of these questionnaires in the Dutch context.

  3. 75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-13

    ... health insurance coverage. The text of those temporary regulations also serves as the text of these... Department of Health and Human Services (the joint rulemaking). The text of those temporary regulations also serves as the text of these proposed regulations. The preamble to the temporary regulations explains...

  4. Piloting Utility Modeling Applications (PUMA): Planning for Climate Change at the Portland Water Bureau

    NASA Astrophysics Data System (ADS)

    Heyn, K.; Campbell, E.

    2016-12-01

    The Portland Water Bureau has been studying the anticipated effects of climate change on its primary surface water source, the Bull Run Watershed, since the early 2000's. Early efforts by the bureau were almost exclusively reliant on outside expertise from climate modelers and researchers, particularly those at the Climate Impacts Group (CIG) at the University of Washington. Early work products from CIG formed the basis of the bureau's understanding of the most likely and consequential impacts to the watershed from continued GHG-caused warming. However, by mid-decade, as key supply and demand conditions for the bureau changed, it found it lacked the technical capacity and tools to conduct more refined and updated research to build on the outside analysis it had obtained. Beginning in 2010 through its participation in the Pilot Utility Modeling Applications (PUMA) project, the bureau identified and began working to address the holes in its technical and institutional capacity by embarking on a process to assess and select a hydrologic model while obtaining downscaled climate change data to utilize within it. Parallel to the development of these technical elements, the bureau made investments in qualified staff to lead the model selection, development and utilization, while working to establish productive, collegial and collaborative relationships with key climate research staff at the Oregon Climate Change Research Institute (OCCRI), the University of Washington and the University of Idaho. This presentation describes the learning process of a major metropolitan area drinking water utility as its approach to addressing the complex problem of climate change evolves, matures, and begins to influence broader aspects of the organization's planning efforts.

  5. Social health insurance: can we ever make a case for Pakistan?

    PubMed

    Abrejo, Farina Gul; Shaikh, Babar Tasneem

    2008-05-01

    Social Health Insurance has been used as an approach to increase efficiency of healthcare system and consumer satisfaction in provision of healthcare services. Many developed countries have successfully planned and implemented insurance models which provide almost universal coverage and addresses issues of equity. The phenomenon is established however, developing countries especially Eastern Mediterranean region is still struggling to present one successful model of social health insurance which can be compared with European or Scandinavian countries. Pakistan likewise faces huge challenges in public sector healthcare provision and considerable proportion of population prefers to go to private sector. Quality of care, access and rising costs make healthcare, somehow, a luxury. Rising national economy, political will to carry out health sector reforms and the creation of district health system after devolution presents an opportunity to launch at least some pilot initiatives of social health insurance. This will give us some food for thought to further up scale and replicate the model all over the country.

  6. Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

    PubMed

    Amundson, Bruce

    2005-01-01

    The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

  7. Health Insurance

    MedlinePlus

    Health insurance helps protect you from high medical care costs. It is a contract between you and ... Many people in the United States get a health insurance policy through their employers. In most cases, ...

  8. Insurance crisis

    SciTech Connect

    Williams, P.L.

    1996-11-01

    The article discusses the effects of financing and technology advances on the availability of insurance for independent power producers operating gas turbines. Combined cycle units which require new materials and processes make it difficult to assess risk. Insurers are denying coverage, or raising prices and deductibles. Many lenders, however, are requiring insurance prior to financing. Some solutions proposed include information sharing by industry participants and insurers and increased risk acceptance by plant owners/operators.

  9. Agriculture Insurance: Adaptation to Vulnerability of Climate Change in Bali, Indonesia

    NASA Astrophysics Data System (ADS)

    Ambarawati, I. G. A. A.; Hongo, C.; Mirah Adi, A. A. A.; Tamura, E.

    2014-12-01

    Bali province of Indonesia is worldwide known for its tourist destination and it contributes more than 60 per cent to the regional domestic product. Meanwhile, agricultural sector including rice production still plays an important role in the Bali economy because of its 30 per cent contribution. Rice production in Bali is not just susceptible to loss caused by flood, drought and pest and disease attack but also from the climate change. The impact of climate change on food production in Indonesia is expected to decline in 2050, ranging from 38 per cent to more than ten-folds of the current production (Syaukat, 2011). Accordingly, adaptation to climate changes is required to minimize the risk along with the plans and strategies for food security and sustainable development. The government of Indonesia (GoI) has launched several pilot projects including agriculture insurance program to minimize the risk in production failure particularly rice farming, unfortunately Bali was excluded from the projects. Implementation of agriculture insurance in Indonesia has the legal basis now after the announcement of the Farmer Protection and Empowerment Act (Law No. 19/2013). Agriculture insurance is seen better in mitigating farmer's risk than that of the other program in rice production. The GoI plans to implement the insurance scheme in the beginning of 2015. This scheme is something "new" to farmers in Bali and Indonesia. Considering the importance of crop insurance to agriculture, this study attempts to explore the potential of such insurance to reveal a clear picture of opportunities and challenges in agriculture insurance implementation in Bali. The study empirically presents awareness and perception of farmers towards the insurance and adaptation to vulnerability of climate change. The study concludes with various suggestions for increasing the awareness of farmers for ensuring better penetration of agriculture insurance in Bali. Key words: agriculture insurance, farmer

  10. The Affordable Care Act's plan for consumer assistance with insurance moves states forward but remains a work in progress.

    PubMed

    Grob, Rachel; Schlesinger, Mark; Davis, Sarah; Cohen, Deborah; Lapps, Joshua

    2013-02-01

    The Affordable Care Act provides support for state-run consumer assistance programs to help privately insured consumers who experience problems with their coverage. Its provisions signify the first national commitment to such assistance and to using cases aggregated by these state programs to inform policy. We interviewed state-level administrators and analyzed program documents to assess whether federal support for state-run consumer assistance programs achieved certain goals. We found that some federally supported programs made substantial progress in supporting and empowering patients by reorienting state agencies to become active advocates for their citizens. Yet progress across the country was inconsistent, and there was little evidence that programs addressed systemic problems experienced by consumers. On balance, the consumer assistance provisions of health care reform do not yet ensure protection for all privately insured Americans because of uneven implementation-a problem likely to be of further concern as coverage is expanded and health insurance exchanges come on line in 2014. At the same time, the demonstrated impact of consumer assistance programs in the most innovative states is arguably a useful "proof of concept" for this young federal program.

  11. Unmanned Aerial Systems: Air Force and Army Should Improve Strategic Human Capital Planning for Pilot Workforces

    DTIC Science & Technology

    2017-01-01

    that the Army has validated that the Armed Services Vocational Aptitude Battery is a valid predictor of the training performance or job performance ...Vocational Aptitude Battery is an effective predictor of success of UAS pilot candidates in training or job performance . Army officials told us that...Aptitude Battery is an effective predictor of UAS candidate performance in UAS pilot training and job performance , the Army may not be basing decisions

  12. Changes in Consumer Cost-Sharing for Health Plans Sold in the ACA's Insurance Marketplaces, 2015 to 2016.

    PubMed

    Gabel, Jon; Green, Matthew; Call, Adrienne; Whitmore, Heidi; Stromberg, Sam; Oran, Rebecca

    2016-05-01

    This brief examines changes in consumer health plan cost-sharing--deductibles, copayments, coinsurance, and out-of-pocket limits--for coverage offered in the Affordable Care Act's marketplaces between 2015 and 2016. Three of seven measures studied rose moderately in 2016, an increase attributable in part to a shift in the mix of plans offered in the marketplaces, from plans with higher actuarial value (platinum and gold plans) to those that have less generous coverage (bronze and silver plans). Nearly 60 percent of enrollees in marketplace plans receive cost-sharing reductions as part of income-based assistance. For enrollees without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits remain considerably higher under bronze and silver plans than under employer-based plans; cost-sharing is similar in gold plans and employer plans. Marketplace plans are more likely than employer-based plans to impose a deductible for prescription drugs but no less likely to do so for primary care visits.

  13. 12 CFR 360.10 - Resolution plans required for insured depository institutions with $50 billion or more in total...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... core business lines. (xv) Capital structure; funding sources. Provide detailed descriptions of the... and extent to which parent company or parent company affiliates serve as a source of funding to the... resolution plan. (i) Each resolution plan submitted shall be credible. A resolution plan is credible if its...

  14. How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

    PubMed

    Trish, Erin E; Herring, Bradley J

    2015-07-01

    The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration.

  15. Stratum-specific positive predictive values of claims for acute pancreatitis among commercial health insurance plan enrollees with diabetes mellitus.

    PubMed

    Dore, David D; Chaudhry, Saadia; Hoffman, Clorinda; Seeger, John D

    2011-02-01

    To estimate the positive predictive value (PPV) of claims for acute pancreatitis among initiators of antihyperglycemic drugs in commercial health insurance claims data. As part of a systematic study of the occurrence of acute pancreatitis among antihyperglycemic drug initiators (N=260,255) within a large US health insurer's claims database, we identified potential cases of acute pancreatitis and confirmed them through medical record review. Potential cases had an International Classification of Diseases, 9th revision diagnosis code for acute pancreatitis (577.0) associated with an inpatient or emergency department claim. We sought 860 medical records to confirm potential cases and received 585 (70%), which were reviewed by a clinical adjudication committee. We estimated the PPV and 95% confidence intervals (CI) of claims for these medical records and a subset that had the diagnosis code listed in the first position of an inpatient claim. The PPV was 0.50 (95% CI 0.44-0.53) for an acute pancreatitis diagnosis code in any position and 0.60 (95% CI 0.55-0.65) if in the first position of an inpatient claim. The estimated PPV varied across strata defined by patient characteristics and was generally lower within strata where potential risk factors for acute pancreatitis were present. These data indicate that health insurance claims-based identification of acute pancreatitis might overestimate actual cases and introduce appreciable bias, usually toward the null. Further case confirmation or relative risk correction may be necessary to address potential bias. Copyright © 2010 John Wiley & Sons, Ltd.

  16. Your Insurance Dollar. Money Management.

    ERIC Educational Resources Information Center

    Baran, Nancy H., Ed.

    This booklet provides some practical guidelines for determining total insurance needs, examining options, and comparing costs. It discusses how to fit insurance costs into an overall financial plan, the necessity of adequate liability coverage, and the importance of keeping policies up to date. The next four sections highlight the basic types of…

  17. Your Insurance Dollar. Money Management.

    ERIC Educational Resources Information Center

    Baran, Nancy H., Ed.

    This booklet provides some practical guidelines for determining total insurance needs, examining options, and comparing costs. It discusses how to fit insurance costs into an overall financial plan, the necessity of adequate liability coverage, and the importance of keeping policies up to date. The next four sections highlight the basic types of…

  18. Insurance against climate change and flood risk: Insurability and decision processes of insurers

    NASA Astrophysics Data System (ADS)

    Hung, Hung-Chih; Hung, Jia-Yi

    2016-04-01

    1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

  19. Improved cost, health, and satisfaction with a health home benefit plan for self-insured employers and small physician practices.

    PubMed

    Reeves, Jerry; Kapp, Brian

    2013-01-01

    We compared the impacts on total costs, health, and satisfaction among 615 adults enrolled 2 years in an employer's health home benefit plan to their baseline year in a standard preferred provider organization plan. The new plan combined strong continuity care incentives with nurse coaching support. After 24 months, total medical costs were 23% lower than the baseline year, biometric measures improved for more than 85% of members, and patient satisfaction exceeded 85%. Emergency department visits decreased by 16% and hospital days decreased by 48%. Health home benefit plans engaging small primary care physician practices and members in coordinated continuity care can deliver high value.

  20. Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

    PubMed Central

    Shidhaye, Rahul; Shrivastava, Sanjay; Murhar, Vaibhav; Samudre, Sandesh; Ahuja, Shalini; Ramaswamy, Rohit; Patel, Vikram

    2016-01-01

    Background The large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care. Aims To operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district. Method Mixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility. Results The MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment. Conclusions There are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models. PMID:26447172

  1. SU-C-202-05: Pilot Study of Online Treatment Evaluation and Adaptive Re-Planning for Laryngeal SBRT

    SciTech Connect

    Mao, W; Liu, C; Zhong, H; Rozario, T; Lu, W; Gu, X; Yan, Y; Jia, X; Sumer, B; Schwartz, D

    2016-06-15

    Purpose: We have instigated a phase I trial of 5-fraction stereotactic body radiotherapy (SBRT) for advanced-stage laryngeal cancer. We conducted this pilot dosimetric study to confirm the potential utility of online adaptive re-planning to preserve treatment quality. Methods: Ten cases of larynx cancer were evaluated. Baseline and daily SBRT treatment plans were generated per trial protocol. Daily volumetric images were acquired prior to every fraction of treatment. Reference simulation CT images were deformably registered to daily volumetric images using Eclipse. Planning contours were then deformably propagated to daily images. Reference SBRT plans were directly copied to calculate delivered dose distributions on deformed reference CT images. In-house software platform has been developed to calculate cumulative dose over a course of treatment in four steps: 1) deforming delivered dose grid to reference CT images using deformation information exported from Eclipse; 2) generating tetrahedrons using deformed dose grid as vertices; 3) resampling dose to a high resolution within every tetrahedron; 4) calculating dose-volume histograms. Our inhouse software was benchmarked with a commercial software, Mirada. Results: In all ten cases including 49 fractions of treatments, delivered daily doses were completely evaluated and treatment could be re-planned within 10 minutes. Prescription dose coverage of PTV was less than intended in 53% of fractions of treatment (mean: 94%, range: 84%–98%) while minimum coverage of CTV and GTV was 94% and 97%, respectively. Maximum bystander point dose limits to arytenoids, parotids, and spinal cord remained respected in all cases, although variances in carotid artery doses were observed in a minority of cases. Conclusion: Although GTV and CTV coverage is preserved by in-room 3D image guidance of larynx SBRT, PTV coverage can vary significantly from intended plans. Online adaptive treatment evaluation and re-planning is potentially

  2. Greenbelt Homes Pilot Program: Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

    SciTech Connect

    Wiehagen, J.; Del Bianco, M.; Mallay, D.

    2015-05-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. It presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements.

  3. STRATEGIC PLAN FOR THE ANALYSIS OF THE NATIONAL HUMAN EXPOSURE ASSESSMENT SURVEY (NHEXAS) PILOT STUDY DATA

    EPA Science Inventory

    The Office of Research and Development (ORD) of the U.S. Environmental Protection Agency (EPA) initiated the National Human Exposure Assessment Survey (NHEXAS) in the early 1990's. It was a population-based pilot study of the exposure of over 500 people in three areas of the U....

  4. Insurance: Teacher's Guide. IIC.

    ERIC Educational Resources Information Center

    University of the South Pacific, Suva (Fiji).

    The document presents a guide for teaching insurance protection based on the needs of students in the South Pacific. It is presented as a unit of study within the area of consumer education. Suggestions for unit objectives, student activities, time allocation, teaching methods, and reference materials are offered. A lesson plan is outlined based…

  5. 28 CFR 36.212 - Insurance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Insurance. 36.212 Section 36.212 Judicial... COMMERCIAL FACILITIES General Requirements § 36.212 Insurance. (a) This part shall not be construed to... benefit plan that is not subject to State laws that regulate insurance. (b) Paragraphs (a) (1), (2),...

  6. 28 CFR 36.212 - Insurance.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Insurance. 36.212 Section 36.212 Judicial... COMMERCIAL FACILITIES General Requirements § 36.212 Insurance. (a) This part shall not be construed to... benefit plan that is not subject to State laws that regulate insurance. (b) Paragraphs (a) (1), (2),...

  7. 28 CFR 36.212 - Insurance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Insurance. 36.212 Section 36.212 Judicial... COMMERCIAL FACILITIES General Requirements § 36.212 Insurance. (a) This part shall not be construed to... benefit plan that is not subject to State laws that regulate insurance. (b) Paragraphs (a) (1), (2),...

  8. 28 CFR 36.212 - Insurance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Insurance. 36.212 Section 36.212 Judicial... COMMERCIAL FACILITIES General Requirements § 36.212 Insurance. (a) This part shall not be construed to... benefit plan that is not subject to State laws that regulate insurance. (b) Paragraphs (a) (1), (2),...

  9. Inadequate health insurance: costs and consequences.

    PubMed

    Donelan, K; DesRoches, C M; Schoen, C

    2000-08-11

    Changes in the healthcare marketplace have begun to test the nature and adequacy of health insurance. The complex nature of insurance is driving us away from the notion that there are 2 distinct groups - the insured and the uninsured - toward an idea that insurance is best represented along a continuum, from the very well insured to the chronically uninsured, with a wide range of quality of coverage in between. The objective of this study was to examine the experiences of insured adults as they try to get needed healthcare and balance the payment for these services against other basic needs. Using data from the Commonwealth Fund 1999 Survey of Workers' Health Insurance, the study analyzes the cost and access problems of insured adults by a number of different variables including income, plan satisfaction, health status, and insurance stability. Bivariate results indicate that insured adults with low incomes and those reporting fair or poor health are more likely to experience problems getting and paying for healthcare. These groups are also more likely to have problems paying for basic living expenses. The most essential notion of insurance is that it will provide protection against financial risk and assurance that we can get healthcare services when we are sick. Yet, we find substantial proportions of low- and modest-income, insured adults who struggle to afford insurance premiums; we also find that their insurance plans do not provide them with either access to care when needed or financial protection from the cost of that care.

  10. 29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... interest rate implicit in an index of publicly traded obligations, the identity of the index, the manner in... plan's participants and beneficiaries; prohibits self-dealing and conflicts of interest; and...

  11. 78 FR 63143 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO86 VA Dental Insurance Program--Federalism AGENCY: Department of... its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of...

  12. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO85 VA Dental Insurance Program--Federalism AGENCY: Department of... direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and...

  13. Political risk insurance

    SciTech Connect

    Fritz, C. )

    1993-11-01

    As international project development continues to expand, the insurance risks faced require more careful planning and consideration. Successful risk management and insurance needs for non-US projects demand careful thought and planning. Understanding the options available and the various pitfalls to avoid can be beneficial to project development. The concept of a successful implementation of a non-recourse, asset-based financing for an independent power producer in the electricity generation-starved areas of the world creates many opportunities. Developers, investment bankers, attorneys and equipment suppliers are positioning their companies in this emerging market. In the last year, opportunities have expanded around the world. In response, much time, effort and money have been consumed in developing projects. Insurance, often overlooked until the later phases of project development, has caused problems for a number of projects -- some of them insurmountable. On a macro basis, the project's broker will need to answer certain questions. For example, are the risks the same as they would be for project development in the United States or United Kingdom Are the underwriting philosophies of insurance companies the same Can insurance be purchased on the same term and conditions as usual, leading to successful project financing conclusions Without any question, the risks are greater, underwriters' philosophies are different, the terms and conditions offered by local markets will be significantly different and the procurement of insurance is much different from in the United States. The developer who can deal with governmental and special interest considerations, which often force the profile of insurance programs to become much more complicated, cumbersome and costly, will have an advantage.

  14. Pilot Fullerton plans menu as packaged food and beverages float around him

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Pilot C. Gordon Fullerton, wearing the communications carrier assembly (ASSY) mini headset (HDST), beings food preparation on the middeck. Canned goods, sealed packages, beverage containers, etc are attached with velcro to meal tray assemblies (secured on middeck forward lockers) and freefloat around Fullerton. JSC water dispenser kit and portrait of G.W.S. Abbey appears behind Fullerton on port side bulkhead and potable water tank appears below him.

  15. The ISO STEP Pilot Product Logistic Support Application Protocol Suite Development Plan

    DTIC Science & Technology

    1994-07-01

    and harmonized data models ( IDEFIX ) for each of the APs (see Fig. 8) included in the pilot PLS APs. b. Develop a data element dictionary for the data...1992). 60. CALS/LSAR IDEFIX Data Model 61. CALS/CE ISG SALSA Technical Committee working paper - "Covering an Opportunity to Further Integrate...develop data models for each of the proposed PLS APs using IDEFIX methodology. Each AP data model (key-only) shall be the result of the harmonization and

  16. C-17 Pilot Manning: The Need for a Plan Based on Capabilities and Lessons Learned

    DTIC Science & Technology

    1985-04-01

    system’ was designated a tactical airlift system. Houeuer , the drain on the tactical airlift pilot creu force uas...and detailed assignment and creu ratio determination. This the active force manning requirements. Active force manning...tructurc and mix, cr«u r*tlo Is th« only ramainins variable to the manning requirtmant aquation. i i ’ Creu ratio establishes

  17. Private Health Insurance Exchanges

    PubMed Central

    Buttorff, Christine; Nowak, Sarah; Syme, James; Eibner, Christine

    2017-01-01

    Abstract Private health insurance exchanges offer employer health insurance, combining online shopping, increased plan choice, benefit administration, and cost-containment strategies. This article examines how private exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's (ACA's) Small Business Health Options Program (SHOP) Marketplaces. The authors found that private exchanges could encourage employees to select less-generous plans. This could expose employees to higher out-of-pocket costs, but premium contributions would drop substantially, so net spending would decrease. On the other hand, employee spending may increase if, in moving to private exchanges, employers decrease their health insurance contributions. Most employers can avoid the ACA's “Cadillac tax” by reducing the generosity of the plans they offer, regardless of whether they move to a private exchange. There is not yet enough evidence to determine whether the private exchanges will become prominent in the insurance market and how they will affect employers and their employees. PMID:28845340

  18. Introducing personalised care planning into Newham: outcomes of a pilot project.

    PubMed

    Walker, R; Davison, C; Maher, A-M; Law, J; Reilly, P; Fordjour, G

    2012-08-01

    To explore the feasibility and acceptability of implementing a personalised care planning approach for diabetes care in general practice. A four-stage care planning process was introduced for diabetes annual review, involving patients (1) being made aware of the new process, (2) attending an appointment to gather clinical data, (3) receiving and reviewing their results and (4) attending a care planning consultation. The latter is a collaborative discussion with the health professional about their response to their results, their goals and desired action plan. Health professionals received specialist training in personalised care planning, including practice observations and feedback. Sixty-six per cent of patients eligible to participate in the project attended both appointments and received an annual review. Of these, 89% also agreed a personalised care plan. Staff reported greater engagement among patients who had read and understood their results. Fourteen per cent of patients reported that they had not agreed a care plan but would have liked one. Patients reported increased confidence in managing their condition with 75% feeling that their ideas and goals were discussed completely. Introducing personalised care planning to general practice diabetes care is possible and well received. Our model for implementation of personalised care planning, which includes specialist training for practice teams and ongoing support from local colleagues and health organizations, can help to meet national recommendations for the provision of personalised care plans for people with long-term conditions. When implementing personalised care planning, efficient administration is vital and behaviour change is necessary for both staff and patients. © 2011 The Author. Diabetic Medicine © 2011 Diabetes UK.

  19. Clinical Realization of Sector Beam Intensity Modulation for Gamma Knife Radiosurgery: A Pilot Treatment Planning Study

    SciTech Connect

    Ma, Lijun; Mason, Erica; Sneed, Penny K.; McDermott, Michael; Polishchuk, Alexei; Larson, David A.; Sahgal, Arjun

    2015-03-01

    Purpose: To demonstrate the clinical feasibility and potential benefits of sector beam intensity modulation (SBIM) specific to Gamma Knife stereotactic radiosurgery (GKSRS). Methods and Materials: SBIM is based on modulating the confocal beam intensities from individual sectors surrounding an isocenter in a nearly 2π geometry. This is in contrast to conventional GKSRS delivery, in which the beam intensities from each sector are restricted to be either 0% or 100% and must be identical for any given isocenter. We developed a SBIM solution based on available clinical planning tools, and we tested it on a cohort of 12 clinical cases as a proof of concept study. The SBIM treatment plans were compared with the original clinically delivered treatment plans to determine dosimetric differences. The goal was to investigate whether SBIM would improve the dose conformity for these treatment plans without prohibitively lengthening the treatment time. Results: A SBIM technique was developed. On average, SBIM improved the Paddick conformity index (PCI) versus the clinically delivered plans (clinical plan PCI = 0.68 ± 0.11 vs SBIM plan PCI = 0.74 ± 0.10, P=.002; 2-tailed paired t test). The SBIM plans also resulted in nearly identical target volume coverage (mean, 97 ± 2%), total beam-on times (clinical plan 58.4 ± 38.9 minutes vs SBIM 63.5 ± 44.7 minutes, P=.057), and gradient indices (clinical plan 3.03 ± 0.27 vs SBIM 3.06 ± 0.29, P=.44) versus the original clinical plans. Conclusion: The SBIM method is clinically feasible with potential dosimetric gains when compared with conventional GKSRS.

  20. Multiple pollutant removal using the condensing heat exchanger: Preliminary test plan for Task 2, Pilot scale IFGT testing

    SciTech Connect

    Jankura, B.J.

    1995-11-01

    The purpose of Task 2 (IFGT Pilot-Scale Tests at the B&W Alliance Research Center) is to evaluate the emission reduction performance of the Integrated Flue Gas Treatment (IFGT) process for coal-fired applications. The IFGT system is a two-stage condensing heat exchanger that captures multiple pollutants -- while recovering waste heat. The IFGT technology offers the potential of addressing the emission of S0{sub 2} and particulate from electric utilities currently regulated under the Phase 1 and Phase 2 requirements defined in Title IV, and many of the air pollutants that will soon be regulated under Title III of the Clean Air Act. The performance data will be obtained at pilot-scale conditions similar to full-scale operating systems. The Task 2 IFGT tests have been designed to investigate several aspects of IFGT process conditions at a broader range of variables than would be feasible at a larger scale facility. The data from these tests greatly expands the IFGT performance database for coals and is needed for the technology to progress from the component engineering phase to system integration and commercialization. The performance parameters that will be investigated are as follows: SO{sub 2} removal; particulate removal; removal of mercury and other heavy metals; NO{sub x} removal; HF and HCl removal; NH{sub 3} removal; ammonia-sulfur compounds generation; and steam injection for particle removal. For all of the pollutant removal tests, removal efficiency will be based on measurements at the inlet and outlet of the IFGT facility. Heat recovery measurements will also be made during these tests to demonstrate the heat recovery provided by the IFGT technology. This report provides a preliminary test plan for all of the Task 2 pilot-scale IFGT tests.

  1. 12 CFR 360.10 - Resolution plans required for insured depository institutions with $50 billion or more in total...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., American Samoa and the Virgin Islands. (c) Resolution Plans to be submitted by CIDI to FDIC. (1) General...) Interconnectedness to Parent Company's Organization; Potential Barriers or Material Obstacles to Orderly Resolution... of the CIDI. Identify potential barriers or other material obstacles to an orderly resolution of...

  2. 75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ... Internal Revenue Service 26 CFR Part 54 RIN 1545-BJ58 Requirement for Group Health Plans and Health... Care Act (the Affordable Care Act) regarding preventive health services. The IRS is issuing the... Health and Human Services are issuing substantially similar interim final regulations with respect to...

  3. 76 FR 58379 - Resolution Plans Required for Insured Depository Institutions With $50 Billion or More in Total...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... risks, complexities in structure and operations, and other factors that impact risk to the Deposit... activities of their subsidiaries), size and other relevant factors. Because each Resolution Plan is expected... and operations of the CIDI, such as servicing, information technology support and operations, human...

  4. Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon

    PubMed Central

    Noubiap, Jean Jacques N; Joko, Walburga Yvonne A; Obama, Joel Marie N; Bigna, Jean Joel R

    2013-01-01

    Introduction For the last two decades, promoted by many governments and international number in sub-Saharan Africa. In 2005 in Cameroon, there were only 60 Community-based health insurance (CBHI) schemes nationwide, covering less than 1% of the population. In 2006, the Cameroon government adopted a national strategy aimed at creating at least one CBHI scheme in each health district and covering at least 40% of the population with CBHI schemes by 2015. Unfortunately, there is almost no published data on the awareness and the implementation of CBHI schemes in Cameroon. Methods Structured interviews were conducted in January 2010 with 160 informal sectors workers in the Bonassama health district (BHD) of Douala, aiming at evaluating their knowledge, concern and preferences on CBHI schemes and their financial plan to cover health costs. Results The awareness on the existence of CHBI schemes was poor awareness schemes among these informal workers. Awareness of CBHI schemes was significantly associated with a high level of education (p = 0.0001). Only 4.4% of respondents had health insurance, and specifically 1.2% were involved in a CBHI scheme. However, 128 (86.2%) respondents thought that belonging to a CBHI scheme could facilitate their access to adequate health care, and were thus willing to be involved in CBHI schemes. Our respondents would have preferred CBHI schemes run by missionaries to CBHI schemes run by the government or people of the same ethnic group (p). Conclusion There is a very low participation in CBHI schemes among the informal sector workers of the BHD. This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity based community associations to which the vast majority of this target population belong are prime areas for sensitization on CBHI schemes. Hence these associations could possibly federalize to create CBHI schemes. PMID:24498466

  5. Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon.

    PubMed

    Noubiap, Jean Jacques N; Joko, Walburga Yvonne A; Obama, Joel Marie N; Bigna, Jean Joel R

    2013-01-01

    For the last two decades, promoted by many governments and international number in sub-Saharan Africa. In 2005 in Cameroon, there were only 60 Community-based health insurance (CBHI) schemes nationwide, covering less than 1% of the population. In 2006, the Cameroon government adopted a national strategy aimed at creating at least one CBHI scheme in each health district and covering at least 40% of the population with CBHI schemes by 2015. Unfortunately, there is almost no published data on the awareness and the implementation of CBHI schemes in Cameroon. Structured interviews were conducted in January 2010 with 160 informal sectors workers in the Bonassama health district (BHD) of Douala, aiming at evaluating their knowledge, concern and preferences on CBHI schemes and their financial plan to cover health costs. The awareness on the existence of CHBI schemes was poor awareness schemes among these informal workers. Awareness of CBHI schemes was significantly associated with a high level of education (p = 0.0001). Only 4.4% of respondents had health insurance, and specifically 1.2% were involved in a CBHI scheme. However, 128 (86.2%) respondents thought that belonging to a CBHI scheme could facilitate their access to adequate health care, and were thus willing to be involved in CBHI schemes. Our respondents would have preferred CBHI schemes run by missionaries to CBHI schemes run by the government or people of the same ethnic group (p). There is a very low participation in CBHI schemes among the informal sector workers of the BHD. This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity based community associations to which the vast majority of this target population belong are prime areas for sensitization on CBHI schemes. Hence these associations could possibly federalize to create CBHI schemes.

  6. Self-insurance in times of growing and retreating managed care.

    PubMed

    Gabel, Jon R; Jensen, Gail A; Hawkins, Samantha

    2003-01-01

    This paper examines trends in self-insurance and in the content of self-insured plans from 1993 to 2001. The percentage of employees enrolled in self-insured plans fell during these years. Much of the decrease was attributable to the decline of indemnity insurance and the rise of HMO and point-of-service plan enrollment. If the product mix had remained constant throughout these years, self-insured enrollment would have grown between 1993 and 1996 and then declined to its current 50 percent level. As a result of the Health Insurance Portability and Accountability Act (HIPAA), the use of preexisting condition clauses declined dramatically in self-insured plans. Self-insured and purchased plans cost similar amounts and provide similar benefits. Cost sharing is somewhat lower in self-insured PPO plans. During periods of rapid inflation, premiums increase more slowly for self-insured than for fully insured plans.

  7. Use of a Team-Based Approach to Assistive Technology Assessment and Planning for Children with Multiple Disabilities: A Pilot Study

    ERIC Educational Resources Information Center

    Copley, Jodie; Ziviani, Jenny

    2007-01-01

    This pilot study trialed a team-based assistive technology assessment and planning process for children with multiple disabilities and their educational teams, in order to inform a wider study using explanatory case study methodology. Fourteen students and their educational teams participated in the process, which incorporated use of the Lifespace…

  8. ENVIRONMENTAL TECHNOLOGY VERIFICATION PROGRAM: QUALITY AND MANAGEMENT PLAN FOR THE PILOT PERIOD (1995-2000)

    EPA Science Inventory

    Based upon the structure and specifications in ANSI/ASQC E4-1994, Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs, the Environmental Technology Verification (ETV) program Quality and Management Plan (QMP) f...

  9. ENVIRONMENTAL TECHNOLOGY VERIFICATION PROGRAM: QUALITY AND MANAGEMENT PLAN FOR THE PILOT PERIOD (1995-2000)

    EPA Science Inventory

    Based upon the structure and specifications in ANSI/ASQC E4-1994, Specifications and Guidelines for Quality Systems for Environmental Data Collection and Environmental Technology Programs, the Environmental Technology Verification (ETV) program Quality and Management Plan (QMP) f...

  10. Developing a monitoring and verification plan with reference to the Australian Otway CO2 pilot project

    SciTech Connect

    Dodds, K.; Daley, T.; Freifeld, B.; Urosevic, M.; Kepic, A.; Sharma, S.

    2009-05-01

    The Australian Cooperative Research Centre for Greenhouse Gas Technologies (CO2CRC) is currently injecting 100,000 tons of CO{sub 2} in a large-scale test of storage technology in a pilot project in southeastern Australia called the CO2CRC Otway Project. The Otway Basin, with its natural CO{sub 2} accumulations and many depleted gas fields, offers an appropriate site for such a pilot project. An 80% CO{sub 2} stream is produced from a well (Buttress) near the depleted gas reservoir (Naylor) used for storage (Figure 1). The goal of this project is to demonstrate that CO{sub 2} can be safely transported, stored underground, and its behavior tracked and monitored. The monitoring and verification framework has been developed to monitor for the presence and behavior of CO{sub 2} in the subsurface reservoir, near surface, and atmosphere. This monitoring framework addresses areas, identified by a rigorous risk assessment, to verify conformance to clearly identifiable performance criteria. These criteria have been agreed with the regulatory authorities to manage the project through all phases addressing responsibilities, liabilities, and to assure the public of safe storage.

  11. 42 CFR 457.348 - Determinations of Children's Health Insurance Program eligibility by other insurance...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Determinations of Children's Health Insurance Program eligibility by other insurance affordability programs. 457.348 Section 457.348 Public Health... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan...

  12. 42 CFR 457.348 - Determinations of Children's Health Insurance Program eligibility by other insurance...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Determinations of Children's Health Insurance Program eligibility by other insurance affordability programs. 457.348 Section 457.348 Public Health... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan...

  13. 42 CFR 457.348 - Determinations of Children's Health Insurance Program eligibility by other insurance...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Determinations of Children's Health Insurance Program eligibility by other insurance affordability programs. 457.348 Section 457.348 Public Health... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES State Plan...

  14. Designing Insurance to Promote Use of Childhood Obesity Prevention Services

    PubMed Central

    Rask, Kimberly J.; Gazmararian, Julie A.; Kohler, Susan S.; Hawley, Jonathan N.; Bogard, Jenny; Brown, Victoria A.

    2013-01-01

    Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage. PMID:23691284

  15. "Any Willing Provider" laws not preempted by Employee Retirement Income Security Act (ERISA). Kentucky Association of Health Plans, Inc. et. al. v. Miller, Commissioner, Kentucky Department of Insurance.

    PubMed

    2004-01-01

    "Any Willing Provider" laws are not preempted by ERISA because they are state laws regulating insurance if they are (1) specifically directed toward entities engaged in insurance and (2) substantially affect the risk-pooling arrangement between the insurer and the insured. Thus, a state may prohibit health maintenance organizations (HMOs) from creating exclusive "provider networks" of doctors, hospitals and other health care providers by excluding other providers who are "willing and able" to comply with all the HMO's contractual terms if the law meets the new two-prong test established by the Supreme Court in this case. The Court made a "clean break" from using the McCarran-Ferguson Act factors for determining whether certain practices constitute "the business of insurance," when deciding when they regulate insurance for purposes of ERISA preemption.

  16. Pilot Fullerton plans menu as packaged food and beverages float around him

    NASA Image and Video Library

    1982-03-31

    S82-28912 (March 1982) --- This picture, photographed with a 35mm camera operated by astronaut Jack R. Lousma, STS-3 commander, shows astronaut C. Gordon Fullerton, crew pilot, busy with mealtime preparations aboard the Earth-orbiting Columbia. The astronaut has positioned himself in the corner of the middeck area. Fullerton holds a beverage in his right hand in an accordion-like squeeze dispenser. Many packages of pre-packaged dehydrated foods and other meal items can be seen in the photo. Many are fastened to the locker doors and to trays in the locker doors by velcro. Reminiscent of STS-2 days, a portrait of George W. S. Abbey, director of flight operations at JSC, is at left edge. Photo credit: NASA

  17. The Five-Year Strategic Plan for Pilots, Demonstration Research and Evaluations, July 2000-June 2005.

    ERIC Educational Resources Information Center

    Van Horn, Carl; Fichtner, Aaron; Altman, Jennifer; Whittaker, Julie

    This report contains the strategic vision for the Department of Labor (DOL)/Employment and Training Administration's research efforts for the next five years. Section I discusses the scope of the research plan and the development process. Section II is a review of literature concerning functioning of the labor market and identification of areas…

  18. Pricing behaviour of nonprofit insurers in a weakly competitive social health insurance market.

    PubMed

    Douven, Rudy C H M; Schut, Frederik T

    2011-03-01

    In this paper we examine the pricing behaviour of nonprofit health insurers in the Dutch social health insurance market. Since for-profit insurers were not allowed in this market, potential spillover effects from the presence of for-profit insurers on the behaviour of nonprofit insurers were absent. Using a panel data set for all health insurers operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of nonprofit health insurers. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. In the presence of weak price competition, health insurers did not set premiums to maximize profits. Nevertheless, our findings suggest that regulations on financial reserves are needed to restrict premiums. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. RISK CORRIDORS AND REINSURANCE IN HEALTH INSURANCE MARKETPLACES: Insurance for Insurers.

    PubMed

    Layton, Timothy J; McGuire, Thomas G; Sinaiko, Anna D

    2016-01-01

    Health Insurance Marketplaces established by the Affordable Care Act implement reinsurance and risk corridors. Reinsurance limits insurer costs associated with specific individuals, while risk corridors protect against aggregate losses. Both tighten the insurer's distribution of expected costs. This paper compares the economic costs and consequences of reinsurance and risk corridors. We simulate the insurer's cost distribution under reinsurance and risk corridors using data for a group of individuals likely to enroll in Marketplace plans from the Medical Expenditure Panel Survey. We compare reinsurance and risk corridors in terms of risk reduction and incentives for cost containment. We find that reinsurance and one-sided risk corridors achieve comparable levels of risk reduction for a given level of incentives. We also find that the policies being implemented in the Marketplaces (a mix of reinsurance and two-sided risk corridor policies) substantially limit insurer risk but perform similarly to a simpler stand-alone reinsurance policy.

  20. Early introduction of palliative care and advanced care planning for children with complex chronic medical conditions: a pilot study.

    PubMed

    Liberman, D B; Song, E; Radbill, L M; Pham, P K; Derrington, S F

    2016-05-01

    Children with complex chronic medical conditions benefit from early introduction of palliative care services and advanced care planning for symptom management and to support quality of life and medical decision-making. This study evaluated whether introducing palliative care during primary care appointments (1) was feasible; (2) increased access and improved knowledge of palliative care; and (3) facilitated advanced care planning. Pilot study of a multi-modal intervention including targeted education for primary care providers (PCPs), an informational packet for families and presence of a palliative care team member in the outpatient clinic. PCPs completed pre- and post-surveys assessing experience, knowledge and comfort with palliative care. Enrolled families received an information packet; a subset also met a palliative care team member. All families were encouraged to make an appointment with the palliative care team, during which the team assessed palliative care needs and goals of care. Upon study completion, the investigators assessed family and PCP satisfaction and collected feedback on project feasibility. Twenty families were enrolled and received the information packet; 15 met a palliative care team member. Of the 17 participating families who were reached and completed a post-study survey, 11 families had never heard of palliative care and 13 were unaware that the palliative care team existed. Most families perceived palliative care information as 'very helpful' and 'very important'. All would recommend palliative care team services to others. Nine families followed up with the palliative care team, but none was prepared to complete an advanced care plan. PCPs reported lack of training in communicating bad news and conducting goals of care discussions. However, they felt increasingly comfortable introducing palliative care to families and supported program continuation. Initiating palliative care services in the outpatient primary care setting is

  1. Value-based Insurance Design.

    PubMed

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2017-03-01

    The increasing awareness of the scarcity of health care resources is forcing the health care industry to improve quality while lowering the cost. One method by which employers and insurance companies are attempting to do this is with value-based insurance design. In these plans, patients pay a lower amount for certain services that are considered high value and a higher amount for services that are considered low value.

  2. Value-based Insurance Design.

    PubMed

    Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R

    2017-02-17

    The increasing awareness of the scarcity of health care resources is forcing the health care industry to improve quality while lowering the cost. One method by which employers and insurance companies are attempting to do this is with value-based insurance design. In these plans, patients pay a lower amount for certain services that are considered high value and a higher amount for services that are considered low value.

  3. Nutritional education through internet-delivered menu plans among adults with type 2 diabetes mellitus: pilot study.

    PubMed

    Bader, Abeer; Gougeon, Réjeanne; Joseph, Lawrence; Da Costa, Deborah; Dasgupta, Kaberi

    2013-10-11

    A potential barrier to weight loss and vascular risk reduction is difficulty in operationalizing dietary education into a concrete plan. Although a variety of Internet-based software tools are now available to address this issue, there has been little formal evaluation of these tools. The aim of this single-arm pilot study is to determine the effect of a 24-week Internet-based menu-planning program, by examining pre- to postintervention changes in the body weight, blood pressure, and glycemia, specifically among overweight adults with type 2 diabetes mellitus (DM2), a clinical population at high risk for vascular diseases. A total of 33 adults with DM2 were recruited by collaborating registered dietitians to a 24-week Internet-based menu-planning program. Individualized dietary prescriptions were operationalized into weekly Internet-delivered menu plans through an adapted version of a commercially available service. Adherence was defined as logging into the program at least once per week for a minimum of 18 of the 24 weeks. Multiple imputations were used for missing data. Using baseline and postintervention assessments, we calculated the weight changes (mean, 95% CI) and investigated the corresponding effects (linear regression models) on blood pressure (systolic, diastolic) and hemoglobin A1C (ie, glycemia). The mean age was 58 (SD 7) years and the mean baseline body mass index was 34.4 (SD 4.6) kg/m(2). The results of this study showed that ≥5% weight reduction was achieved by 6/33 participants (18%) and by 5/18 adherent participants (28%). A mean weight change of -2.0% (95% CI -2.6 to -1.4) was observed, with changes occurring in the adherent (-3.6%, 95% CI -4.5 to -2.8) but not in the nonadherent (0%, 95% CI -0.6 to 0.7). It was found that each 1% reduction in body weight was associated with a -2.4 mmHg change in systolic (95% CI -3.5 to -1.2) and a -0.8 mmHg change in diastolic blood pressure (95% CI -1.4 to -0.2). Percent weight change was not found to be

  4. Military and Veterans Disability System. Pilot Has Achieved Some Goals, but Further Planning and Monitoring Needed

    DTIC Science & Technology

    2010-12-01

    improve DOD and VA’s planning for expansion of the new disability evaluation system, including developing a systematic monitoring process and... improved servicemember satisfaction relative to the existing “legacy” system and met their established goal of delivering VA benefits to active duty...the IDES is still an improvement over the 540 days that DOD and VA estimated the legacy process takes to deliver VA benefits to members. However, the

  5. A Fighter Pilot’s Intelligent Aide for Tactical Mission Planning.

    DTIC Science & Technology

    1985-12-01

    airfields and to project the effects of implementing the plan" ( Callero et al, 1984:v). This system can project the effects of implementing a...The rules were developed, based on information provided by experienced air targeteers ( Callero et al, 1981:3). They represent the domain ex- perts...resources and enemy target elements" ( Callero et al, 1984:4). The preparation of the Air Tasking Order (ATO) is the final phase. The transmission of

  6. A pilot beta-thalassaemia screening program in the Albanian population for a health planning program.

    PubMed

    Baghernajad-Salehi, Leila; D'Apice, Maria Rosaria; Babameto-Laku, Anila; Biancolella, Michela; Mitre, Anila; Russo, Silvia; Di Daniele, Nicola; Sangiuolo, Federica; Mokini, Vahe; Novelli, Giuseppe

    2009-01-01

    In Albania, no definite national screening programme of beta-thalassaemia has yet been developed for carrier detection. Only limited information about the occurrence and the types of haemoglobin abnormalities is available. Thus, an educational and screening programme was carried out in one high school with a total of 217 young students from the coastal province of Lushnja in Albania. The pilot programme included a systematic sampling of whole saliva, DNA genomic extraction and the determination of defective beta-thalassaemia genes by reverse dot-blot hybridization with 22 probes specific for the Mediterranean populations.Of the 201 subjects tested, 17 (8.4%) students turned out to be carriers of beta-thalassaemia mutations and haemoglobin variants. The most common mutation is HbS (c.20A-->T) with a frequency of 3.2%, followed by IVS-I-110 (G-->A) (c.93-21G-->A) substitution identified in 4 out of 402 chromosomes (1%). In the province of Lushnja, the frequency of beta-thalassaemia carriers was high. As expected, the results show that identified mutations in this population are similar to those found in the east Mediterranean area, suggesting the same origin for mutant alleles during migratory streams. Implementation of a routine carrier-screening programme is significantly facilitated by the presence of only two mutations and would be a wise approach to prevent beta-thalassaemia in the region. Copyright (c) 2009 S. Karger AG, Basel.

  7. Fully automatic guidance and control for rotorcraft nap-of-the-Earth flight following planned profiles. Volume 1: Real-time piloted simulation

    NASA Technical Reports Server (NTRS)

    Clement, Warren F.; Gorder, Peter J.; Jewell, Wayne F.

    1991-01-01

    Developing a single-pilot, all-weather nap-of-the-earth (NOE) capability requires fully automatic NOE (ANOE) navigation and flight control. Innovative guidance and control concepts are investigated in a four-fold research effort that: (1) organizes the on-board computer-based storage and real-time updating of NOE terrain profiles and obstacles in course-oriented coordinates indexed to the mission flight plan; (2) defines a class of automatic anticipative pursuit guidance algorithms and necessary data preview requirements to follow the vertical, lateral, and longitudinal guidance commands dictated by the updated flight profiles; (3) automates a decision-making process for unexpected obstacle avoidance; and (4) provides several rapid response maneuvers. Acquired knowledge from the sensed environment is correlated with the forehand knowledge of the recorded environment (terrain, cultural features, threats, and targets), which is then used to determine an appropriate evasive maneuver if a nonconformity of the sensed and recorded environments is observed. This four-fold research effort was evaluated in both fixed-based and moving-based real-time piloted simulations, thereby, providing a practical demonstration for evaluating pilot acceptance of the automated concepts, supervisory override, manual operation, and re-engagement of the automatic system. Volume one describes the major components of the guidance and control laws as well as the results of the piloted simulations. Volume two describes the complete mathematical model of the fully automatic guidance system for rotorcraft NOE flight following planned flight profiles.

  8. NASA Explorer Institutes: Exploring the Possibilities for Collaboration with the Informal Education Community. Report of the NASA Explorer Institutes--Focus Groups and Pilot Workshops, September 2004-March 2005; Planning and Evaluation Meeting, March 14-17, 2005

    ERIC Educational Resources Information Center

    Gallaway, Debbie; Freeman, Jason; Walker, Gretchen; Davis, Hilarie

    2005-01-01

    This report contains summary information and conclusions from the pilot workshops, focus groups, and the NEI (NASA Explorer Institutes) Planning and Evaluation Conference which united representatives of the workshops, focus groups, and NASA education. The culmination of these NEI pilot initiatives resulted in the identification of strategies that…

  9. [Insurance and preventive medicine].

    PubMed

    Delachaux, A; Stark, E W; von Schroeder, F

    1978-12-01

    Not only do insurance companies have to pay in case of death, injuries or disease, they are also concerned with their prevention. This is particularly true for the "Swiss National Accident Insurance Fund" (Caisse nationale suisse d'assurance en cas d'accidents--(CNA): for them the prevention of work related accidents and occupational diseases is required by law. Preventive activities in this area are very promising. The progress in the sickness insurance programmes for preventive medicine in the general population has, however, not been as successful. To date, the legislation denies payment for preventive medical care. Why is there this difference? In the case of accidents and occupational diseases, the cause of the pathologies are for the most part exogenous and develop in well known and controlled environments. In the case of disease or invalidity in the general population, the factors are in a large part endogenous and therefore very difficult to supervise, as they develop in much more complex and uncontrolled environments. Nevertheless progress has been done in this field as well. At present, some selected scientifically proven preventive examinations could be included in insurance programmes as part of a general plan and with strict quality control of laboratory findings.

  10. Developing tools for the safety specification in risk management plans: lessons learned from a pilot project.

    PubMed

    Cooper, Andrew J P; Lettis, Sally; Chapman, Charlotte L; Evans, Stephen J W; Waller, Patrick C; Shakir, Saad; Payvandi, Nassrin; Murray, Alison B

    2008-05-01

    Following the adoption of the ICH E2E guideline, risk management plans (RMP) defining the cumulative safety experience and identifying limitations in safety information are now required for marketing authorisation applications (MAA). A collaborative research project was conducted to gain experience with tools for presenting and evaluating data in the safety specification. This paper presents those tools found to be useful and the lessons learned from their use. Archive data from a successful MAA were utilised. Methods were assessed for demonstrating the extent of clinical safety experience, evaluating the sensitivity of the clinical trial data to detect treatment differences and identifying safety signals from adverse event and laboratory data to define the extent of safety knowledge with the drug. The extent of clinical safety experience was demonstrated by plots of patient exposure over time. Adverse event data were presented using dot plots, which display the percentages of patients with the events of interest, the odds ratio, and 95% confidence interval. Power and confidence interval plots were utilised for evaluating the sensitivity of the clinical database to detect treatment differences. Box and whisker plots were used to display laboratory data. This project enabled us to identify new evidence-based methods for presenting and evaluating clinical safety data. These methods represent an advance in the way safety data from clinical trials can be analysed and presented. This project emphasises the importance of early and comprehensive planning of the safety package, including evaluation of the use of epidemiology data.

  11. Physician cultural sensitivity in African American advance care planning: a pilot study.

    PubMed

    Wallace, Mervin P; Weiner, Joseph S; Pekmezaris, Renee; Almendral, Alicia; Cosiquien, Reginald; Auerbach, Charles; Wolf-Klein, Gisele

    2007-06-01

    Physician cultural sensitivity is particularly important for end-of-life care. This study correlates physicians' own racial background, clinical experience, and cultural sensitivity training with their attitudes, perceptions, and knowledge of advance care planning issues for African American patients. A cross-sectional self-report questionnaire was distributed to 236 physicians at three major teaching hospitals. Seventy-eight percent of all surveys were returned (183/236). The respondent racial characteristics were 53% white, 28% Asian, and 17% black. While 72% of physicians agreed that different ethnic groups have distinct attitudes towards advance directives, 58% acknowledged lack of familiarity with end-of-life preferences of African American patients. Black physicians (African American and non-U.S.-born) rated the cultural sensitivity training they received on a 0-10 Likert-type scale as 5.43 (n=28) versus a 3.74 rating by white physicians (n=91; p=0.022). Black physicians (African American and non-U.S.-born, n=27) rated their familiarity with advance care planning preferences of African Americans as 5.89 and white physicians (n=90) rated theirs as 4.14 on a 10-point Likert-type scale (p=0.002). Finally, 88% of U.S.-born black physicians (7/8) versus 35% of white physicians (32/91) perceived that the Tuskegee experiment has impacted African American medical decision-making (p=0.014). Similarly, a greater proportion of African American physicians perceived that the Tuskegee experiment has impacted African American medical decision making, compared to non-U.S.-born black physicians (88% (7/8) versus 26% (5/19), p=0.008). The majority of the physicians surveyed routinely provide end-of-life care and believe they are aware of racial differences in advance care planning. Yet, most were unfamiliar with specific end-of-life preferences of African American patients. We advocate for further research and cultural sensitivity training to improve end-of-life care for

  12. Patients' handling of a standardized medication plan: a pilot study and method development.

    PubMed

    Botermann, Lea; Krueger, Katrin; Eickhoff, Christiane; Kloft, Charlotte; Schulz, Martin

    2016-01-01

    The Action Plan for Medication Safety by the German Federal Ministry of Health introduced a standardized medication plan (MP), a printable document for the patient. The practical handling needs to be tested before the nationwide implementation in Germany. Therefore, the aims of our study were 1) to develop an instrument to evaluate the usage of the standardized MP, 2) to assess if patients can locate, and 3) understand important information. Moreover, we explored patients' opinion and suggestions regarding the standardized MP template. We conducted a cross-sectional study to evaluate the practical handling of the standardized MP. We interviewed 40 adult patients in seven community pharmacies in Germany, who took at least five medicines regularly and gave their written informed consent. The interview consisted of questions regarding finding and understanding information provided on a mock-up MP, patients' opinion and the execution of the information on the MP by filling pill boxes. We eventually developed a new evaluation method to quantify the practical handling of the MP by rating the pill boxes filled by the patients. Overall, the participants rated the MP positively. Thirty-nine (98%) participants found important information on a mock-up standardized MP. Patients were questioned to identify if they understood information on medical intake as it relates to meals. In particular, they were questioned about medicine intake "1 hour before a meal", which 98% (n=39) interpreted correctly, and "during a meal", which 100% (n=40) interpreted correctly. The less precise advice of "before a meal" was interpreted correctly by 73% (n=29), and only 15% (n=6) correctly interpreted the term "after the meal". The evaluation of the filled pill boxes resulted in the "Evaluation Tool to test the handling of the Medication Plan" (ET-MP) - a weighted scoring system. The standardized MP is clearly arranged, and patients are able to find important information. The findings of this study

  13. Use of Performance Assessment in Support of Waste Isolation Pilot Plant (WIPP) Programmatic Activity Planning

    SciTech Connect

    BASABILVAZO,GEORGE; JOW,HONG-NIAN; LARSON,KURT W.; MARIETTA,MELVIN G.

    1999-09-22

    The Waste Isolation Pilot Plant (WIPP) is being developed by the U.S. Department of Energy (DOE) for the geologic (deep underground) disposal of transuranic (TRU) waste. A Compliance Certification Application (CCA) of the WIPP for such disposal was submitted to the U.S. Environmental Protection Agency (EPA) in October 1996, and was approved by EPA in May 1998. In June 1998, two separate, but related, lawsuits were filed, one against DOE and one against EPA. On March 22, 1999, the court ruled in favor of DOE, and on March 26, 1999, DOE formally began disposal operations at the WIPP for non-mixed (non-hazardous) TRU waste. Before the WIPP can begin receiving mixed (hazardous) TRU waste, a permit from the State of New Mexico for hazardous waste disposal needs to be issued. It is anticipated that the State of New Mexico will issue a hazardous waste permit by November 1999. It is further anticipated that the EPA lawsuit will be resolved by July 1999. Congress (Public Law 102-579, Section 8(f)) requires the WIPP project to be recertified by the EPA at least as frequently as once every five years from the first receipt of TRU waste at the WIPP site. As part of the DOE's WIPP project recertification strategy, Sandia National Laboratories (SNL) has used systems analysis and performance assessment to prioritize its scientific and engineering research activities. Two 1998 analyses, the near-field systems analysis and the annual sensitivity analysis, are discussed here. Independently, the two analyses arrived at similar conclusions regarding important scientific activities associated with the WIPP. The use of these techniques for the recent funding allocations at SNL's WIPP project had several beneficial effects. It increased the level of acceptance among project scientists that management had fairly and credibly compared alternatives when making prioritization decisions. It improved the ability of SNL and its project sponsor, the Carlsbad Area Office of the DOE, to

  14. Outpatient advance care planning for patients with metastatic cancer: a pilot quality improvement initiative.

    PubMed

    Obel, Jennifer; Brockstein, Bruce; Marschke, Michael; Robicsek, Ari; Konchak, Chad; Sefa, Meredith; Ziomek, Nicole; Benfield, Tiffany; Peterson, Carrie; Gustafson, Cory; Eriksson, Joann; Harper, Abigail; Tabachow, Cory; Raymond, Michael; Hensing, Thomas

    2014-11-01

    Despite American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines recommending that oncologists discuss advance care planning (ACP) with patients with stage IV cancer early in treatment, in standard practice ACP remains a late step of a terminal illness. ACP preserves comfort and dignity at the end of life, ensuring patients receive the care that they desire. A feasibility study in patients with stage IV cancer was developed to test whether incorporating ACP immediately after a stage IV cancer diagnosis is feasible. Inclusion criteria were consecutive new gastrointestinal and thoracic oncology patients treated by one of two oncologists. The project included creation of new workflow; development of an ACP patient education guidebook; training seminars for oncology staff; and enhancements to the electronic health record (EHR) to improve ACP documentation. The oncologists recorded 33 of 48 (69%) advance directive notes (ADNs) and 22 of 48 (46%) code status orders (CSOs) in the EHR of patients newly diagnosed with stage IV cancer by following ACP protocol during the 6-month trial period. Twenty-one of 33 ADNs were entered within 7 days of first consultation. The median time to ADN placement was 1 day after consultation. Twenty-two of 33 patients with ADNs had CSOs placed, of which 16 were do-not-resuscitate (DNR) and 6 were full code. One year prior to the feasibility study, only 1 of 75 deceased patients of the two oncologists had outpatient ADNs and CSOs. Outpatient ACP is feasible early in the care of patients with stage IV cancer through systematic improvement in workflow and motivated providers. Education and infrastructure were pivotal to routine development of advance care plans.

  15. Planning a distribution automation pilot project at B.C. Hydro

    SciTech Connect

    Benedictson, E.; Dwyer, A.; Herejk, I.

    1994-12-31

    In 1989, a small team of engineers and managers from B.C. Hydro`s Customer Services Group made an exploratory partnership trip to a DA product supplier. While the partnership initiative failed, it served to raise corporate awareness of the need for a comprehensive DA approach. Shortly thereafter, the Window 2000 Project name were formulated. From the inception of the Window 2000 Project, it was clear that the team faced a major strategy challenge, due to recent corporate history. The corporation had just completed a major generation and transmission system expansion program, and enjoyed a considerable energy and capacity surplus, coupled with increased debt load. Concurrently, a select segment of the corporation was developing what was to become the internationally successful Power Smart energy conservation initiative. The team developed a communication plan based on several key principles. Presentations were made to various stakeholders including Customer Services and Corporate Management committees. Permission to proceed with the Window 2000 project was obtained in 1990. A multi-disciplined team of employees representing Customer Services, Power Smart, Production, System Planning, and Stations Engineering was assembled. Leadership was provided by a full-time project leader, and by a senior management steering committee. In addition, the project leader assembled an informal group of advisors for the purpose of defining alternative approaches, generating new information, and testing of ideas. The team members were encouraged to avoid concentrating on corporate or personal turf issues, and the team environment was maintained free of {open_quotes}politics{close_quotes}. This fostered cooperation and objectivity in idea generation and evaluation. The team was given an open mandate to define and to recommend DA functions for implementation.

  16. Conceptual plan: Two-Phase Flow Laboratory Program for the Waste Isolation Pilot Plant

    SciTech Connect

    Howarth, S.M.

    1993-07-01

    The Salado Two-Phase Flow Laboratory Program was established to address concerns regarding two-phase flow properties and to provide WIPP-specific, geologically consistent experimental data to develop more appropriate correlations for Salado rock to replace those currently used in Performance Assessment models. Researchers in Sandia`s Fluid Flow and Transport Department originally identified and emphasized the need for laboratory measurements of Salado threshold pressure and relative permeability. The program expanded to include the measurement of capillary pressure, rock compressibility, porosity, and intrinsic permeability and the assessment of core damage. Sensitivity analyses identified the anhydrite interbed layers as the most likely path for the dissipation of waste-generated gas from waste-storage rooms because of their relatively high permeability. Due to this the program will initially focus on the anhydrite interbed material. The program may expand to include similar rock and flow measurements on other WIPP materials including impure halite, pure halite, and backfill and seal materials. This conceptual plan presents the scope, objectives, and historical documentation of the development of the Salado Two-Phase Flow Program through January 1993. Potential laboratory techniques for assessing core damage and measuring porosity, rock compressibility, capillary and threshold pressure, permeability as a function of stress, and relative permeability are discussed. Details of actual test designs, test procedures, and data analysis are not included in this report, but will be included in the Salado Two-Phase Flow Laboratory Program Test Plan pending the results of experimental and other scoping activities in FY93.

  17. Advanced Monitoring Is Associated with Fewer Alarm Events During Planned Moderate Procedure-Related Sedation: A 2-Part Pilot Trial

    PubMed Central

    Lenart, John; Malkin, Mathew; Meineke, Minhthy N.; Qoshlli, Silvana; Neumann, Monica; Jacobson, J. Paul; Kruger, Alison; Ching, Jeffrey; Hassanian, Mohammad; Um, Michael

    2016-01-01

    BACKGROUND: Diagnostic and interventional procedures are often facilitated by moderate procedure-related sedation. Many studies support the overall safety of this sedation; however, adverse cardiovascular and respiratory events are reported in up to 70% of these procedures, more frequently in very young, very old, or sicker patients. Monitoring with pulse oximetry may underreport hypoventilation during sedation, particularly if supplemental oxygen is provided. Capnometry may result in false alarms during sedation when patients mouth breathe or displace sampling devices. Advanced monitor use during sedation may allow event detection before complications develop. This 2-part pilot study used advanced monitors during planned moderate sedation to (1) determine incidences of desaturation, low respiratory rate, and deeper than intended sedation alarm events; and (2) determine whether advanced monitor use is associated with fewer alarm events. METHODS: Adult patients undergoing scheduled gastroenterology or interventional radiology procedures with planned moderate sedation given by dedicated sedation nurses under the direction of procedural physicians (procedural sedation team) were monitored per standard protocols (electrocardiography blood pressure, pulse oximetry, and capnometry) and advanced monitors (acoustic respiratory monitoring and processed electroencephalograpy). Data were collected to computers for analysis. Advanced monitor parameters were not visible to teams in part 1 (standard) but were visible to teams in part 2 (advanced). Alarm events were defined as desaturation—Spo2 ≤92%; respiratory depression, acoustic respiratory rate ≤8 breaths per minute, and deeper than intended sedation, indicated by processed electroencephalograpy. The number of alarm events was compared. RESULTS: Of 100 patients enrolled, 10 were excluded for data collection computer malfunction or consent withdrawal. Data were analyzed from 90 patients (44 standard and 46 advanced

  18. 29 CFR 2580.412-18 - Naming of insureds.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of the plan or plans as insured will provide for such recovery. Where it is not clear that such... benefit and use of the plan suffering a loss. Such rider or agreement shall always be required as...

  19. Patients’ handling of a standardized medication plan: a pilot study and method development

    PubMed Central

    Botermann, Lea; Krueger, Katrin; Eickhoff, Christiane; Kloft, Charlotte; Schulz, Martin

    2016-01-01

    Purpose The Action Plan for Medication Safety by the German Federal Ministry of Health introduced a standardized medication plan (MP), a printable document for the patient. The practical handling needs to be tested before the nationwide implementation in Germany. Therefore, the aims of our study were 1) to develop an instrument to evaluate the usage of the standardized MP, 2) to assess if patients can locate, and 3) understand important information. Moreover, we explored patients’ opinion and suggestions regarding the standardized MP template. Patients and methods We conducted a cross-sectional study to evaluate the practical handling of the standardized MP. We interviewed 40 adult patients in seven community pharmacies in Germany, who took at least five medicines regularly and gave their written informed consent. The interview consisted of questions regarding finding and understanding information provided on a mock-up MP, patients’ opinion and the execution of the information on the MP by filling pill boxes. We eventually developed a new evaluation method to quantify the practical handling of the MP by rating the pill boxes filled by the patients. Results Overall, the participants rated the MP positively. Thirty-nine (98%) participants found important information on a mock-up standardized MP. Patients were questioned to identify if they understood information on medical intake as it relates to meals. In particular, they were questioned about medicine intake “1 hour before a meal”, which 98% (n=39) interpreted correctly, and “during a meal”, which 100% (n=40) interpreted correctly. The less precise advice of “before a meal” was interpreted correctly by 73% (n=29), and only 15% (n=6) correctly interpreted the term “after the meal”. The evaluation of the filled pill boxes resulted in the “Evaluation Tool to test the handling of the Medication Plan” (ET-MP) – a weighted scoring system. Conclusion The standardized MP is clearly arranged, and

  20. Deep Space Network-Wide Portal Development: Planning Service Pilot Project

    NASA Technical Reports Server (NTRS)

    Doneva, Silviya

    2011-01-01

    The Deep Space Network (DSN) is an international network of antennas that supports interplanetary spacecraft missions and radio and radar astronomy observations for the exploration of the solar system and the universe. DSN provides the vital two-way communications link that guides and controls planetary explorers, and brings back the images and new scientific information they collect. In an attempt to streamline operations and improve overall services provided by the Deep Space Network a DSN-wide portal is under development. The project is one step in a larger effort to centralize the data collected from current missions including user input parameters for spacecraft to be tracked. This information will be placed into a principal repository where all operations related to the DSN are stored. Furthermore, providing statistical characterization of data volumes will help identify technically feasible tracking opportunities and more precise mission planning by providing upfront scheduling proposals. Business intelligence tools are to be incorporated in the output to deliver data visualization.

  1. Deep Space Network-Wide Portal Development: Planning Service Pilot Project

    NASA Technical Reports Server (NTRS)

    Doneva, Silviya

    2011-01-01

    The Deep Space Network (DSN) is an international network of antennas that supports interplanetary spacecraft missions and radio and radar astronomy observations for the exploration of the solar system and the universe. DSN provides the vital two-way communications link that guides and controls planetary explorers, and brings back the images and new scientific information they collect. In an attempt to streamline operations and improve overall services provided by the Deep Space Network a DSN-wide portal is under development. The project is one step in a larger effort to centralize the data collected from current missions including user input parameters for spacecraft to be tracked. This information will be placed into a principal repository where all operations related to the DSN are stored. Furthermore, providing statistical characterization of data volumes will help identify technically feasible tracking opportunities and more precise mission planning by providing upfront scheduling proposals. Business intelligence tools are to be incorporated in the output to deliver data visualization.

  2. [State of emergency plans for massive influx of injured (PEMAF) in Italian hospitals. Pilot study].

    PubMed

    D'Alessandro, D; Fizzano, M R; Barletta, C; Pietrantonio, F

    2012-01-01

    Aim of this study is to assess the level of implementation of plans for the massive influx of injured (PEMAF) in Italian hospitals. An anonymous questionnaire was administered to a sample of 100 hospitals selected through the network of the Italian Society of Emergency Medicine (SIMEU). Each answer of the questionnaire was assigned a score, then reported on a scale of compliance (maximum 65 points, threshold 35 points). The average scores were analyzed by hospital's venue, level of activity and previous experience of managing a real emergency. Student's t-test was used to compare means. Thirty-two hospitals sent the questionnaire, representing 33% of those selected. Five were excluded for incomplete data. The data analyzed refers to 27 hospitals of various levels of complexity, from all around the country: 55.6% from the Northern Section, 22.2% from the Centre and 22.2% from the Southern section and the Islands; and only 55.6% are above the minimum threshold of compliance. The weakest PEMAF's area is the one related to the specific training of health workers, therefore the percentage of hospitals complying the requirements in this field is down to 37%. Ten hospitals (37%) had managed a real maxi-emergence in the past: belonging to such group of hospitals is associated with an average level of compliance significantly higher than the others (p < 0.005). Due to a limited percentage of responders, the study involved so far a too small amount of hospitals; happily, they were evenly distributed in the different sections of the Country; therefore it will be appropriate to obtain a larger compliance before reaching clear-cut conclusions, but it already appears that the most critical point is the lack of specific education to maxi-emergencies in the hospital personnel.

  3. HEALTH INSURANCE COVERAGE FOR WORKERS ON LAYOFF.

    ERIC Educational Resources Information Center

    KOLODRUBETZ, WALTER W.

    ESTIMATES OF GROUP HEALTH INSURANCE COVERAGE BY INDUSTRY INDICATE THAT EXTENDED PROTECTION DURING LAYOFF IS GUARANTEED TO NO MORE THAN A TENTH OF THE APPROXIMATELY 50 MILLION WORKERS COVERED BY GROUP HEALTH INSURANCE PLANS. THIS COVERAGE HAS LARGELY DEVELOPED DURING THE PAST 15 YEARS. FRAGMENTARY DATA SUGGEST THAT INCREASED COST ATTRIBUTABLE TO…

  4. The Consumer Looks at His Automobile Insurance.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

    This publication on the hows and whys of automobile insurance is designed as a module for one of a series of consumer education courses in New York high schools. The course is planned to help students understand how the insurance system works, the costs involved, proposed legislation, and changes in automobile design. After completing the course…

  5. Initial Experience with "Honoring Choices Wisconsin": Implementation of an Advance Care Planning Pilot in a Tertiary Care Setting.

    PubMed

    Peltier, Wendy L; Gani, Faiz; Blissitt, Jennifer; Walczak, Katherine; Opper, Kristi; Derse, Arthur R; Johnston, Fabian M

    2017-09-01

    Although previous research on advance care planning (ACP) has associated ACP with improved quality of care at the end of life, the appropriate use of ACP remains limited. To evaluate the impact of a pilot program using the "Honoring Choices Wisconsin" (HCW) model for ACP in a tertiary care setting, and to understand barriers to system-wide implementation. Retrospective review of prospectively collected data. Patients who received medical or surgical oncology care at Froedtert and the Medical College of Wisconsin. Patient demographics, disease characteristics, patient satisfaction, and clinical outcomes. Data from 69 patients who died following the implementation of the HCW program were reviewed; 24 patients were enrolled in the HCW program while 45 were not. Patients enrolled in HCW were proportionally less likely to be admitted to the ICU (12.5% vs. 17.8%) and were more likely to be "do not resuscitate" (87.5% vs. 80.0%), as well as have a completed ACP (83.3% vs. 79.1%). Furthermore, admission to a hospice was also higher among patients who were enrolled in the HCW program (79.2% vs. 25.6%), with patients enrolled in HCW more likely to die in hospice (70.8% vs. 53.3%). The HCW program was favorably viewed by patients, patient caregivers, and healthcare providers. Implementation of a facilitator-based ACP care model was associated with fewer ICU admissions, and a higher use of hospice care. System-level changes are required to overcome barriers to ACP that limit patients from receiving end-of-life care in accordance with their preferences.

  6. A novel website to prepare diverse older adults for decision making and advance care planning: a pilot study.

    PubMed

    Sudore, Rebecca L; Knight, Sara J; McMahan, Ryan D; Feuz, Mariko; Farrell, David; Miao, Yinghui; Barnes, Deborah E

    2014-04-01

    We have reconceptualized advance care planning (ACP) as a multistep process focused on preparing patients with skills needed for communication and in-the-moment decision making. To operationalize this paradigm, we created an easy-to-use ACP website (prepareforyourcare.org) based on a theoretical framework of behavior change and pilot-tested its efficacy to engage older adults in ACP. At baseline and 1 week after viewing the PREPARE website, we assessed behavior change in ACP by using a validated survey that includes Process Measures (knowledge, contemplation, self-efficacy, and readiness, 5-point Likert scales) and Action Measures (yes/no whether an ACP behavior was completed). We also assigned participants into behavior change stages (i.e., precontemplation, contemplation, preparation, action, maintenance) and determined the percentage of participants who moved from precontemplation at baseline to higher stages at 1 week. We also assessed PREPARE ease-of-use (10-point scale, 10 being the easiest). Changes were assessed with Wilcoxon signed rank sum tests and McNemar's tests. Mean age of the participants was 68.4 years (SD 6.6), and 65% were nonwhite. Behavior Change Process Measures average Likert scores increased from 3.1 (0.9) to 3.7 (0.7), P < 0.001. Action Measures did not change significantly. However, precontemplation significantly decreased for most actions (e.g., talking to doctor about desired medical care, 61% to 35%, P < 0.003), with a mean decrease of 21% (range, 16%-33%). PREPARE was rated a nine of ten (±1.9) for ease-of-use. A new, patient-centered ACP website that focuses on preparing patients for communication and decision making significantly improves engagement in the process of ACP and behavior change. A clinical trial of PREPARE is currently underway. Published by Elsevier Inc.

  7. A Novel Website to Prepare Diverse Older Adults for Decision Making and Advance Care Planning: A Pilot Study

    PubMed Central

    Sudore, Rebecca L.; Knight, Sara J.; McMahan, Ryan D.; Feuz, Mariko; Farrell, David; Miao, Yinghui; Barnes, Deborah E.

    2014-01-01

    Context We have reconceptualized advance care planning (ACP) as a multi-step process focused on preparing patients with skills needed for communication and in-the-moment decision making. Objectives To operationalize this paradigm, we created an easy-to-use ACP website (prepareforyourcare.org) based on a theoretical framework of behavior change and pilot-tested its efficacy to engage older adults in ACP. Methods At baseline and one week after viewing the PREPARE website, we assessed behavior change in ACP using a validated survey that includes Process Measures (knowledge, contemplation, self-efficacy, and readiness, 5-point Likert scales) and Action Measures (yes/no whether an ACP behavior was completed). We also assigned participants into behavior change stages (i.e., precontemplation, contemplation, preparation, action, maintenance) and determined the percentage of participants who moved from precontemplation at baseline to higher stages at one week. We also assessed PREPARE ease-of-use (10-point scale, 10 being the easiest). Changes were assessed with paired t-tests and McNemar’s tests. Results Participants’ mean age was 68.4 years (SD 6.6) and 65% were non-white. Process Measures average Likert scores increased from 3.1 (0.9) to 3.7 (0.7), P <0.001. Action Measures did not change significantly. However, precontemplation significantly decreased for most actions, (e.g., talking to doctor about desired medical care, 61% to 35%, P<0.003), with a mean decrease of 21% (range, 16%-33%). PREPARE was rated a 9 out of 10 (±1.9) for ease-of-use. Conclusion A new, patient-centered ACP website that focuses on preparing patients for communication and decision making significantly improves engagement in the process of ACP and behavior change. A clinical trial of PREPARE is currently underway. PMID:23972574

  8. VA Dental Insurance Program--federalism. Direct final rule.

    PubMed

    2013-10-22

    The Department of Veterans Affairs (VA) is taking direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule will add language to clarify the limited preemptive effect of certain criteria in the VADIP regulations.

  9. Recent developments in health insurance, life insurance, and disability insurance case law.

    PubMed

    Hasman, Joseph J; Chittenden, William A; Doolin, Elizabeth G; Wall, Julie F

    2008-01-01

    This survey reviews significant state and federal court decisions from 2006 and 2007 involving health, life, and disability insurance. Also reviewed is a June 2008 Supreme Court decision in the disability insurance realm, affirming that a conflict of interest exists when an ERISA plan sponsor or insurer fulfills the dual role of determining plan benefits and paying those benefits but noting that the conflict is merely one factor in considering the legality of benefit denials. In addition, this years' survey includes compelling decisions in the life and health arena, including cases addressing statutory penalties and mandated benefits, as well as some ERISA decisions of note. This year, the Texas Supreme Court held that Texas's most recent version of the prompt payment statute abolished the common law interpleader exception and allowed the prevailing adverse claimant in an interpleader action filed beyond the sixty-day statutory period to recover statutory interest and attorney fees from the insurer. Meanwhile, the Court of Appeals of New York upheld the constitutionality of a statute mandating coverage for contraceptives in those employer-sponsored health plans that offer prescription drug coverage, including those plans sponsored by faith-based social service organizations. In the ERISA context, litigants continue to fight over the standard of review with varying results. In a unique assault on the arbitrary and capricious standard of review, the Fourth Circuit found that an ERISA plan abused its discretion when it failed to apply the doctrine of contra proferentem to construe ambiguous plan terms against itself. In more hopeful news for plan insurers, the Tenth Circuit held that claimants are not entitled to review and rebut medical opinions generated during the administrative appeal of a claim denial before a final decision is reached unless such reports contain new factual information.

  10. Using Chat and Text Technologies to Answer Sexual and Reproductive Health Questions: Planned Parenthood Pilot Study

    PubMed Central

    Kantor, Leslie M; Levine, Deborah S; Arons, Whitney

    2013-01-01

    Background Teens and young adults in the United States are in need of sexual and reproductive health information, as evidenced by elevated rates of sexually transmitted infections (STIs), pregnancy, and births among this population. In-person sexuality education programs are helpful, but they are unlikely to rapidly accommodate teens and young adults in a moment of crisis. Evidence suggests that technologies such as instant messaging (IM) and text messaging may be effective ways to provide teens and young adults with sexual and reproductive health information. In September 2010, Planned Parenthood Federation of America launched a text and IM program designed to provide immediate answers to urgent sexual and reproductive health questions from a reliable and confidential source and to link young people to sexual and reproductive health services if needed. Objective To assess whether this program is successful in reaching the target population, whether user characteristics vary by mode (IM vs text), and whether mode is associated with reaching individuals with high levels of worry or reducing worry postchat. Methods Data were collected from prechat and postchat surveys for all IM and text message conversations between September 2010 and August 2011. A bivariate analysis was conducted using chi-square tests for differences in the main covariates by mode of conversation. In the multivariable analysis, logistic regression was used to identify factors that were independently associated with prechat levels of worry and changes in worry postchat. Results A total of 32,589 conversations occurred during the program’s first year. The odds of feeling very worried prechat were highest for IM users (adjusted odds ratio [AOR] 1.43, 95% CI 1.20-1.72), users 17 years and younger (AOR 1.62, 95% CI 1.50-1.74), Latino/Hispanic users (AOR 1.36, 95% CI 1.27-1.46), and black users (AOR 1.40, 95% CI 1.30-1.50). After controlling for the study covariates, there was no significant

  11. Self-Insurance (Waukegan Style).

    ERIC Educational Resources Information Center

    Falkinham, Ken

    The health and dental self-insurance program instituted in the Waukegan (Illinois) Public Schools can credit three major factors for much of its success. First, claims are processed in-house by the district, resulting in improved communications about claim decisions, faster payments, and higher employee satisfaction. Second, the plan is…

  12. Test plan for the pilot cell test of inert anodes: Report on the June 1991 meeting at the Reynolds Metals Company facility

    NASA Astrophysics Data System (ADS)

    Windisch, C. F., Jr.; Alcorn, T. R.; Tabereaux, A. T.

    1991-09-01

    The Inert Electrodes Program at the Pacific Northwest Laboratory (PNL) is supported by the Office of Industrial Processes (OIP) of the U.S. Department of Energy (DOE) and is aimed at improving the energy efficiency of Hall-Heroult cells through the development of inert anodes. The inert anodes currently under study are composed of a cermet material of the general composition NiO-NiFe2O4-Cu. The program has three primary objectives: (1) evaluate the anode material in a pilot cell facility, (2) investigate the mechanisms of the electrochemical reactions at the anodes surface, and (3) develop sensors for monitoring various anode and/or electrolyte conditions. This report discusses a test plan that has been developed for the pilot cell test of the inert anodes.

  13. Test plan for the pilot cell test of inert anodes: Report on the June 1991 meeting at the Reynolds Metals Company facility

    SciTech Connect

    Windisch, C.F. Jr. ); Alcorn, T.R.; Tabereaux, A.T. . Mfg. Technology Lab.)

    1991-09-01

    The Inert Electrodes Program at the Pacific Northwest Laboratory (PNL) is supported by the Office of Industrial Processes (OIP) of the US Department of Energy (DOE) and is aimed at improving the energy efficiency of Hall-Heroult cells through the development of inert anodes. The inert anodes currently under study are composed of a cermet material of the general composition NiO-NiFe{sub 2}O{sub 4}-Cu. The program has three primary objectives: (1) evaluate the anode material in a pilot cell facility, (2) investigate the mechanisms of the electrochemical reactions at the anodes surface, and (3) develop sensors for monitoring various anode and/or electrolyte conditions. This report discusses a test plan that has been developed for the pilot cell test of the inert anodes. 6 refs., 7 figs., 4 tabs.

  14. Assessing Early Implementation of State Autism Insurance Mandates

    ERIC Educational Resources Information Center

    Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

  15. 45 CFR 152.28 - Preventing insurer dumping.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Preventing insurer dumping. 152.28 Section 152.28...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.28 Preventing insurer dumping. (a) General rule... constituting exclusive remedies for violations of this section or as preventing States from applying or...

  16. 45 CFR 152.28 - Preventing insurer dumping.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Preventing insurer dumping. 152.28 Section 152.28...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.28 Preventing insurer dumping. (a) General rule... constituting exclusive remedies for violations of this section or as preventing States from applying or...

  17. 45 CFR 152.28 - Preventing insurer dumping.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preventing insurer dumping. 152.28 Section 152.28...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.28 Preventing insurer dumping. (a) General rule... constituting exclusive remedies for violations of this section or as preventing States from applying or...

  18. Assessing Early Implementation of State Autism Insurance Mandates

    ERIC Educational Resources Information Center

    Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

    2016-01-01

    In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

  19. Equity in health care access to: assessing the urban health insurance reform in China.

    PubMed

    Liu, Gordon G; Zhao, Zhongyun; Cai, Renhua; Yamada, Tetsuji; Yamada, Tadashi

    2002-11-01

    This study evaluates changes in access to health care in response to the pilot experiment of urban health insurance reform in China. The pilot reform began in Zhenjiang and Jiujiang cities in 1994, followed by an expansion to 57 other cities in 1996, and finally to a nationwide campaign in the end of 1998. Specifically, this study examines the pre- and post-reform changes in the likelihood of obtaining various health care services across sub-population groups with different socioeconomic status and health conditions, in an attempt to shed light on the impact of reform on both vertical and horizontal equity measures in health care utilization. Empirical estimates were obtained in an econometric model using data from the annual surveys conducted in Zhenjiang City from 1994 through 1996. The main findings are as follows. Before the insurance reform, the likelihood of obtaining basic care at outpatient setting was much higher for those with higher income, education, and job status at work, indicating a significant measure of horizontal inequity against the lower socioeconomic groups. On the other hand, there was no evidence suggesting vertical inequity against people of chronic disease conditions in access to care at various settings. After the reform, the new insurance plan led to a significant increase in outpatient care utilization by the lower socioeconomic groups, making a great contribution to achieving horizontal equity in access to basic care. The new plan also has maintained the measure of vertical equity in the use of all types of care. Despite reform, people with poor socioeconomic status continue to be disadvantaged in accessing expensive and advanced diagnostic technologies. In conclusion, the reform model has demonstrated promising advantages over pre-reform insurance programs in many aspects, especially in the improvement of equity in access to basic care provided at outpatient settings. It also appears to be more efficient overall in allocating health

  20. Commercial Insurance vs Community-Based Health Plans: Time for a Policy Option With Clinical Emphasis to Address the Cost Spiral

    ERIC Educational Resources Information Center

    Amundson, Bruce

    2005-01-01

    The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship…

  1. Commercial Insurance vs Community-Based Health Plans: Time for a Policy Option With Clinical Emphasis to Address the Cost Spiral

    ERIC Educational Resources Information Center

    Amundson, Bruce

    2005-01-01

    The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship…

  2. Collaborating With Parents of Children With Chronic Conditions and Professionals to Design, Develop and Pre-pilot PLAnT (the Parent Learning Needs and Preferences Assessment Tool).

    PubMed

    Nightingale, Ruth; Wirz, Lucy; Cook, Wendy; Swallow, Veronica

    This study aimed to design, develop and pre-pilot an assessment tool (PLAnT) to identify parents' learning needs and preferences when carrying out home-based clinical care for their child with a chronic condition. A mixed methods, two-phased design was used. Phase 1: a total of 10 parents/carers and 13 professionals from six UK's children's kidney units participated in qualitative interviews. Interview data were used to develop the PLAnT. Eight of these participants subsequently took part in an online survey to refine the PLAnT. Phase 2: thirteen parents were paired with one of nine professionals to undertake a pre-pilot evaluation of PLAnT. Data were analyzed using the Framework approach. A key emergent theme identifying parents' learning needs and preferences was identified. The importance of professionals being aware of parents' learning needs and preferences was recognised. Participants discussed how parents' learning needs and preferences should be identified, including: the purpose for doing this, the process for doing this, and what would the outcome be of identifying parents' needs. The evidence suggests that asking parents directly about their learning needs and preferences may be the most reliable way for professionals to ascertain how to support individual parents' learning when sharing management of their child's chronic condition. With the increasing emphasis on parent-professional shared management of childhood chronic conditions, professionals can be guided by PLAnT in their assessment of parents' learning needs and preferences, based on identified barriers and facilitators to parental learning. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Approval of information collection requirements for the joint interim rules for health insurance portability for group health plans, and the individual market health insurance reform: portability from group to individual coverage; federal rules for access in the individual market; state alternative mechanisms to federal rules--IRS, DOL, HCFA. Interim rules with request for comments; approval of information collection requirements.

    PubMed

    1997-07-02

    On April 8, 1997, the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (Departments) published joint interim rules governing the access, portability and renewability requirements for group health plans and issuers offering group health insurance coverage in connection with a group health plan. The rules implemented changes made to certain provisions of the Internal Revenue Code of 1986 (Code), the Employee Retirement Income Security Act of 1974 (ERISA), and the Public Health Service Act (PHS Act) enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In the April 8 publication, the Departments submitted the group market information collection requirements, for, among other things, establishing creditable coverage, notice of special enrollment rights, and notice of pre-existing condition exclusion periods, to be Office of Management and Budget (OMB) for emergency review under the Paperwork Reduction Act of 1995 (PRA 95). In addition, on April 8, 1997 the Department of Health and Human Services submitted the HIPAA individual market information collection requirements to OMB for emergency review under the PRA 1995. This document amends the April 8 Federal Register documents to properly display the OMB control numbers.

  4. Unemployment Insurance Management.

    ERIC Educational Resources Information Center

    Pope, Daniel C.

    1979-01-01

    An insurance management system has the goal of minimizing unemployment insurance costs. Components of a model system should include general administration, claims management, and appeals process. (Author)

  5. Insuring RLV transportation services

    NASA Astrophysics Data System (ADS)

    Greenberg, Joel S.

    1998-01-01

    Future deliveries of payloads to orbit are likely to utilize space transportation services that employ a fleet of reusable launch vehicles. To achieve this capability will require the investment of billions of dollars. Such sizable investments will require the formulation of detailed business plans that demonstrate the financial viability of the proposed business and that the business can function within an acceptable level of risk. Besides coping with the normal business risks associated with achievable level of technical performance, demand for launch services, competition, etc., the business must also cope with the risks associated with transportation system failures and delays. This requires the development of a viable risk management plan. This paper is concerned with describing a risk management scenario that can demonstrate and provide an assurance, at the time that investment decisions must be made, that the necessary insurance cover at affordable prices will be available.

  6. Smart Choice Health Insurance©: A New, Interdisciplinary Program to Enhance Health Insurance Literacy.

    PubMed

    Brown, Virginia; Russell, Mia; Ginter, Amanda; Braun, Bonnie; Little, Lynn; Pippidis, Maria; McCoy, Teresa

    2016-03-01

    Smart Choice Health Insurance© is a consumer education program based on the definition and emerging measurement of health insurance literacy and a review of literature and appropriate theoretical frameworks. An interdisciplinary team of financial and health educators was formed to develop and pilot the program, with the goal of reducing confusion and increasing confidence in the consumer's ability to make a smart health insurance decision. Educators in seven states, certified to teach the program, conducted workshops for 994 consumers. Results show statistically significant evidence of increased health insurance literacy, confidence, and capacity to make a smart choice health insurance choice. Discussion centers on the impact the program had on specific groups, next steps to reach a larger audience, and implications for educators, consumers, and policymakers nationwide.

  7. Disaster: Planning, Preparation, Prevention.

    ERIC Educational Resources Information Center

    Rutherford, Christine

    1990-01-01

    Discusses causes of library disasters and provides several examples of disasters. Emphasis is on the importance of awareness, insurance protection, a written disaster plan, cooperation with the fire marshall and insurance agent in planning, and staff training. Several elements of the written plan are listed. (22 references) (MES)

  8. Medicaid and Children's Health Insurance Programs: essential health benefits in alternative benefit plans, eligibility notices, fair hearing and appeal processes, and premiums and cost sharing; exchanges: eligibility and enrollment. Final rule.

    PubMed

    2013-07-15

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act. This final rule finalizes new Medicaid eligibility provisions; finalizes changes related to electronic Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices and delegation of appeals; modernizes and streamlines existing Medicaid eligibility rules; revises CHIP rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; and amends requirements for benchmark and benchmark-equivalent benefit packages consistent with sections 1937 of the Social Security Act (which we refer to as ``alternative benefit plans'') to ensure that these benefit packages include essential health benefits and meet certain other minimum standards. This rule also implements specific provisions including those related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also updates and simplifies the complex Medicaid premium and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities. It includes transition policies for 2014 as applicable.

  9. Dropped out or pushed out? Insurance market exit and provider market power in Medicare Advantage.

    PubMed

    Pelech, Daria

    2017-01-01

    This paper explores how provider and insurer market power affect which markets an insurer chooses to operate in. A 2011 policy change required that certain private insurance plans in Medicare form provider networks de novo; in response, insurers cancelled two-thirds of the affected plans. Using detailed data on pre-policy provider and insurer market structure, I compare markets where insurers built networks to those they exited. Overall, insurers in the most concentrated hospital and physician markets were 9 and 13 percentage points more likely to exit, respectively, than those in the least concentrated markets. Conversely, insurers with more market power were less likely to exit than those with less, and an insurer's market power had the largest effect on exit in concentrated hospital markets. These findings suggest that concentrated provider markets contribute to insurer exit and that insurers with less market power have more difficulty surviving in concentrated provider markets.

  10. 29 CFR 2580.412-16 - Amount of bond required in given types of bonds or where more than one plan is insured in the...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR TEMPORARY... all the plans covered under the bond. For example, X is the administrator of two welfare plans run...

  11. 78 FR 4593 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ..., and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair... Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans...-equivalent plan'' where they appear together and are replacing these terms with ``Alternative Benefit Plan...

  12. Medicaid: Legislation Needed to Improve Collections From Private Insurers

    DTIC Science & Technology

    1990-11-01

    over insurers that operate only incidentally in the state. 2. States’ limited authority over ERISA plans2 does not allow them to pro- hibit these plans...certain minimal requirements. The Department of Labor is responsible for administering ERISA . In this report, we refer to welfare benefit plans, which...include health benefits, that are covered under ERISA . as " ERISA plans." Page 1 . I1W󈨟 -Z Medicaid Collections From Private Insurers B-238267 they do

  13. ENVIRONMENTAL ASSESSMENT FOR OTEC PILOT PLANTS

    SciTech Connect

    Wilde, P.

    1980-06-01

    Logical and orderly progression of the OTEC program from conceptual designs through component testing to the goal of commercially viable OTEC plants require that the socio-legal requirements be met and the proper operating permits be obtained and maintained. This function is accomplished in a series of activities including: (1) Development and annual revision of a published OTEC Environmental Development Plan (EDP); (2) Compliance with NEPA/EPA and other regulatory requirements; and (3) Studies and research in support of the above. The Environmental Development Plan (EDP) lists the concerns, outlines the program to consider the effects and validity of such concerns on the OTEC program, and gives the time-table to meet the schedule, integrated with that of the engineering and design programs. The schedules of compliance activities and, to a lesser degree, research also are governed by the development progress of the technology. However, because of the lead time necessary to insure proper review the appropriate regulatory agencies, the environmental assessment program for the OTEC pilot plants (initially starting with the 10/40 MWe unit) is founded on the strategy of progressive improvement of previously accepted documentation. Based on experience with OTEC-1, the procedure for pilot plants will be: (1) Produce generic Environmental Assessment (EA) at the appropriate level of technology in advance of hardware contract; (2) Produce generic Environmental Impact Statement (EIS) at approximately the same time as the hardware procurement; (3) Monitor production of site specific supplement to the generic EIS prepared by the hardware contractor; (4) Assist pilot plant operator in applying and obtaining permits by providing current research and modeling data; (5) Monitor environmental program as required by regulatory agency; and (6) Use new site data for refining models for future pilot plant. assessments.

  14. Accuracy and reproducibility of preoperative three-dimensional planning for total hip arthroplasty using biplanar low-dose radiographs : A pilot study.

    PubMed

    Mainard, D; Barbier, O; Knafo, Y; Belleville, R; Mainard-Simard, L; Gross, J-B

    2017-06-01

    In total hip arthroplasty (THA), the acetabular cup and femoral stem must be correctly sized and positioned to avoid intraoperative and postoperative complications, achieve good functional outcomes and ensure long-term survival. Current two-dimensional (2D) techniques do not provide sufficient accuracy, while low-dose biplanar X-rays (EOS) had not been assessed in this indication. Therefore, we performed a case-control study to : (1) evaluate the prediction of stem and cup size for a new 3D planning technique (stereoradiographic imaging plus 3D modeling) in comparison to 2D templating on film radiographs and (2) evaluate the accuracy and reproducibility of this 3D technique for preoperative THA planning. Accuracy and reproducibility are better with the 3D vs. 2D method. Stem and cup sizes were retrospectively determined by two senior surgeons, twice, for a total of 31 unilateral primary THA patients in this pilot study, using 3D preplanning software on low-dose biplanar X-rays and with 2D templating on conventional anteroposterior (AP) film radiographs. Patients with a modular neck or dual-mobility prosthesis were excluded. All patients but one had primary osteoarthritis; one following trauma did not have a cup implanted. The retrospectively planned sizes were compared to the sizes selected during surgery, and intraclass coefficients (ICC) calculated. 3D planning predicted stem size more accurately than 2D templating: stem sizes were planned within one size in 26/31 (84%) of cases in 3D versus 21/31 (68%) in 2D (P=0.04). 3D and 2D planning accuracies were not significantly different for cup size: cup sizes were planned within one size in 28/30 (92%) of cases in 3D versus 26/30 (87%) in 2D (P=0.30). ICC for stem size were 0.88 vs. 0.91 for 3D and 2D, respectively. Inter-operator ICCs for cup size were 0.84 vs. 0.71, respectively. Repetitions of the 3D planning were within one size (except one stem), with the majority predicting the same size. Increased accuracy in

  15. One fish, two fish, red fish, blue fish: effects of price frames, brand names, and choice set size on Medicare Part D insurance plan decisions.

    PubMed

    Barnes, Andrew J; Hanoch, Yaniv; Wood, Stacey; Liu, Pi-Ju; Rice, Thomas

    2012-08-01

    Because many seniors choose Medicare Part D plans offering poorer coverage at greater cost, the authors examined the effect of price frames, brand names, and choice set size on participants' ability to choose the lowest cost plan. A 2×2×2 within-subjects design was used with 126 participants aged 18 to 91 years old. Mouselab, a web-based program, allowed participants to choose drug plans across eight trials that varied using numeric or symbolic prices, real or fictitious drug plan names, and three or nine drug plan options. Results from the multilevel models suggest numeric versus symbolic prices decreased the likelihood of choosing the lowest cost plan (-8.0 percentage points, 95% confidence interval=-14.7 to -0.9). The likelihood of choosing the lowest cost plan decreased as the amount of information increased suggesting that decision cues operated independently and collectively when selecting a drug plan. Redesigning the current Medicare Part D plan decision environment could improve seniors' drug plan choices.

  16. 20 CFR 323.5 - Submitting proposed plan for Board approval.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844...

  17. 20 CFR 323.5 - Submitting proposed plan for Board approval.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844...

  18. 20 CFR 323.5 - Submitting proposed plan for Board approval.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844...

  19. 20 CFR 323.5 - Submitting proposed plan for Board approval.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844...

  20. 20 CFR 323.5 - Submitting proposed plan for Board approval.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844 Rush...

  1. 78 FR 54996 - Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-09

    ... on Health Insurance Coverage Offered Under Employer-Sponsored Plans AGENCY: Internal Revenue Service... credit to help individuals and families afford health insurance coverage purchased through an Affordable... health insurance coverage offered by an employer to the employee that is (1) a governmental plan,...

  2. Military Disability System: Increased Supports for Servicemembers and Better Pilot Planning Could Improve the Disability Evaluation Process

    DTIC Science & Technology

    2008-09-01

    i p t H q l To view the full product , including the scope and methodology, click on GAO-08-1137. For more information, contact Daniel Bertoni at...additional support mechanisms and treamlining efforts, but faces challenges in meeting internal goals and emonstrating impact. Most significantly, the...larger scale. DOD and VA have established a omprehensive mechanism for measuring key aspects of the pilot. However, hey have not yet decided on

  3. 33 CFR 385.12 - Pilot projects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

  4. 33 CFR 385.12 - Pilot projects.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

  5. Improving Adjuvant Hormone Therapy Use in Medicaid Managed Care-Insured Women, New York State, 2012-2014.

    PubMed

    Wagner, Victoria L; Jing, Wei; Boscoe, Francis P; Schymura, Maria J; Roohan, Patrick J; Gesten, Foster C

    2016-09-01

    In 2010, national guidelines recommended that women with nonmetastatic, hormone receptor-positive breast cancer take adjuvant hormone therapy for 5 years. As results from randomized clinical trials became available, guidelines were revised in 2014 to recommend 10 years of therapy. Despite evidence of its efficacy, low initiation rates have been documented among women insured by New York State Medicaid. This article describes a coordinated quality improvement pilot conducted by a state department of health and Medicaid managed care plans to engage women in guideline-concordant adjuvant hormone therapy. Women enrolled in Medicaid managed care with nonmetastatic, hormone receptor-positive breast cancer and who had surgery from May 1, 2012, through November 30, 2012, were identified using linked Medicaid and Cancer Registry data. Adjuvant hormone therapy status was determined from Medicaid pharmacy data. Contact information for nonadherent women was supplied to health plan care managers who conducted outreach activities. Adjuvant hormone therapy status in the 6 months following outreach was evaluated. In the 6 months postoutreach, 61% of women in the contacted group filled at least 1 prescription, compared with 52% in the noncontacted group. Among those with at least 1 filled prescription, 50% of the contacted group were adherent, compared with 25% in the noncontacted group. This pilot suggests outreach conducted by health plan care managers, facilitated by linked Medicaid and Cancer Registry data, is an effective method to improve adjuvant hormone therapy initiation and adherence rates in Medicaid managed care-insured women.

  6. Selection on Moral Hazard in Health Insurance

    PubMed Central

    Einav, Liran; Finkelstein, Amy; Ryan, Stephen; Schrimpf, Paul

    2012-01-01

    We use employee-level panel data from a single firm to explore the possibility that individuals may select insurance coverage in part based on their anticipated behavioral (“moral hazard”) response to insurance, a phenomenon we label “selection on moral hazard.” Using a model of plan choice and medical utilization, we present evidence of heterogeneous moral hazard as well as selection on it, and explore some of its implications. For example, we show that, at least in our context, abstracting from selection on moral hazard could lead to over-estimates of the spending reduction associated with introducing a high-deductible health insurance option. PMID:24748682

  7. Health insurance premium tax credit. Final regulations.

    PubMed

    2013-02-01

    This document contains final regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.These final regulations provide guidance to individuals related to employees who may enroll in eligible employer-sponsored coverage and who wish to enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit.

  8. Promoting Value for Consumers: Comparing Individual Health Insurance Markets Inside and Outside the ACA's Exchanges.

    PubMed

    McCue, Michael J; Hall, Mark A

    2016-06-01

    The new health insurance exchanges are the core of the Affordable Care Act's (ACA) insurance reforms, but insurance markets beyond the exchanges also are affected by the reforms. This issue brief compares the markets for individual coverage on and off of the exchanges, using insurers' most recent projections for ACA-compliant policies. In 2016, insurers expect that less than one-fifth of ACA-compliant coverage will be sold outside of the exchanges. Insurers that sell mostly through exchanges devote a greater portion of their premium dollars to medical care than do insurers selling only off of the exchanges, because exchange insurers project lower administrative costs and lower profit margins. Premium increases on exchange plans are less than those for off-exchange plans, in large part because exchange enrollment is projected to shift to closed-network plans. Finally, initial concerns that insurers might seek to segregate higher-risk subscribers on the exchanges have not been realized.

  9. Interim rules for group health plans and health insurance issuers under the Newborns' and Mothers' Health Protection Act--IRS; DoL; HCFA. Interim rules with request for comments.

    PubMed

    1998-10-27

    This document contains interim rules governing the Newborns' and Mothers' Health Protection Act of 1996 (NMHPA). The interim rules provide guidance to employers, group health plans, health insurance issuers, and participants and beneficiaries relating to new requirements for hospital lengths of stay in connection with childbirth. The rules contained in this document implement changes to the Employee Retirement Income Security Act of 1974 (ERISA) and the Public Health Service Act (PHS Act) made by NMHPA, and changes to the Internal Revenue Code of 1986 (Code) enacted as part of the Taxpayer Relief Act of 1997 (TRA '97). Interested persons are invited to submit comments on the interim rules for consideration by the Department of the Treasury, the Department of Labor, and the Department of Health and Human Services (Departments) in developing final rules.

  10. HealthMarts, HIPCs (health insurance purchasing cooperatives), MEWAs (multiple employee welfare arrangements), and AHPs (association health plans): a guide for the perplexed.

    PubMed

    Hall, M A; Wicks, E K; Lawlor, J S

    2001-01-01

    This paper considers how pending proposals to authorize new forms of group purchasing arrangements for health insurance would fit and function within the existing, highly complex market and regulatory landscape and whether these proposals are likely to meet their stated objectives and avoid unintended consequences. Cost savings are more likely to result from increased risk segmentation than through true market efficiencies. Thus, these proposals could erode previous market reforms whose goal is increased risk pooling. On the other hand, these proposals contain important enhancements, clarifications, and simplification of state and federal regulatory oversight of group purchasing vehicles. Also, they address some of the problems that have hampered the performance of purchasing cooperatives. On balance, although these proposals should receive cautious and careful consideration, they are not likely to produce a significant overall reduction in premiums or increase in coverage.

  11. Women's Health Insurance Coverage

    MedlinePlus

    ... Medicaid expansions, private insurance reforms, and premium tax credits. This factsheet reviews major sources of coverage for ... individually purchased insurance market by offering premium tax credits to help individuals purchase coverage in state-based ...

  12. Women's Health Insurance Coverage

    MedlinePlus

    ... Home Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Oct 21, 2016 Facebook Twitter ... for certain low-income uninsured women. 11 Uninsured Women Approximately 11% of women ages 19 to 64 ( ...

  13. 24 CFR 266.602 - Mortgage insurance premium: Insured advances.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured...

  14. 29 CFR 2580.412-16 - Amount of bond required in given types of bonds or where more than one plan is insured in the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... instant case, Plan B would be able to recover the full $40,000 of its loss. Where the funds or other... required to be protected. Thus, in the instant case, if funds or other property were commingled, and...

  15. 29 CFR 2580.412-16 - Amount of bond required in given types of bonds or where more than one plan is insured in the...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... instant case, Plan B would be able to recover the full $40,000 of its loss. Where the funds or other... required to be protected. Thus, in the instant case, if funds or other property were commingled, and...

  16. 38 CFR 8.15 - Provision for paid-up insurance; other than 5-year level premium term or limited convertible 5...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... SERVICE LIFE INSURANCE Extended Term and Paid-up Insurance § 8.15 Provision for paid-up insurance; other... Service Life Insurance policy on any plan other than 5-year level premium term or limited convertible 5... complete surrender of the insurance with all claims thereunder, after the expiration of the first policy...

  17. Finance, providers issue brief: insurer liability.

    PubMed

    Rothouse, M

    1999-07-01

    When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those are questions 29 states considered in 1998, and at least 35 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

  18. Finance, providers issue brief: insurer liability.

    PubMed

    Rothouse, M; Stauffer, M

    2000-05-24

    When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those were questions 35 states considered in 1999, and at least 32 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

  19. A Pilot Study Assessing the Impact of 3-D Printed Models of Aortic Aneurysms on Management Decisions in EVAR Planning.

    PubMed

    Tam, Matthew D; Latham, Tom R; Lewis, Mark; Khanna, Kunal; Zaman, Ali; Parker, Mike; Grunwald, Iris Q

    2016-01-01

    Endovascular repair of aortic aneurysms with difficult anatomy is challenging. There is no consensus for planning such procedures. Six cases of aortic aneurysms with challenging anatomical features, such as short, angulated, and conical necks and tortuous iliacs were harvested. The computed tomography (CT) scans were anonymized. Lifesize 3-dimensional (3-D) printed models were created of the lumen. Endovascular operators were asked to review the CT angiography (CTA), make a management plan, and give an indication of their confidence. They were then presented with the equivalent model and asked to review their decision. Their attitudes to such models were briefly surveyed. A total of 28 endovascular operators reviewed 144 cases. After review of the physical model, the management plan changed in 29 (20.1%) of 144 cases. Initial plan after CTA review was endovascular 73.6%, open repair 22.9%, and second opinion 3.5%. After model review, this became endovascular 67.4%, open repair 19.4%, and second opinion 4.8%. Although the general trend was toward more open procedures, off-label techniques reduced from 19.4% to 15.2% following model review. When the management plan did not change, level of confidence did increase in 37 (43.5%) of 85 cases. The majority of operators stated that they would find models useful for planning in some procedures. For 1 case, the change in the percentage of participants being sure in the management plan was statistically significant (P = .031). The 3-D printed models may be potentially useful in planning cases with EVAR. It is a paradigm that warrants further investigation. © The Author(s) 2016.

  20. Insurers lose court battle

    SciTech Connect

    Lucas, A.

    1994-09-28

    Recent court disputes concerning insurance coverage of Superfund costs have resulted in the retrial of a proinsurer ruling on environmental cleanup costs for potentially responsible parties. The court rejected the insurance industry`s pollution exclusion clause by Aetna and two nonchemical companies. Supposedly this is good news for the chemical industry, because there will be more access to insurance money in Superfund cleanups.

  1. 29 CFR 2510.3-3 - Employee benefit plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., insurance service or insurance organization licensed to do business in a State, and are legally enforceable by the sole choice of the individual against the insurance company, insurance service or insurance... the date on which the individual has satisfied the plan's age and service requirements...

  2. Influence of optimizing protocol choice on the integral dose value in prostate radiotherapy planning by dynamic techniques - Pilot study.

    PubMed

    Zaleska, Anna; Bogaczyk, Krzysztof; Piotrowski, Tomasz

    2017-01-01

    The purpose of this study was to compare the values of integral dose, calculated for treatment plans of dynamic radiotherapy techniques prepared with two different optimization protocols. Delivering radiation by IMRT, VMAT and also HT techniques has an influence on the low dose deposition of large areas of the patient body. Delivery of low dose can induce injury of healthy cells. In this situation, a good solution would be to reduce the area, which receives a low dose, but with appropriate dose level for the target volume. To calculate integral dose values of plans structures, we used 90 external beam radiotherapy plans prepared for three techniques (intensity modulated radiotherapy, volumetric modulated arc therapy and helical tomotherapy). One technique includes three different geometry combinations. 45 plans were prepared with classic optimization protocol and 45 with rings optimization protocol which should reduce the low doses in the normal tissue. Differences in values of the integral dose depend on the geometry and technique of irradiation, as well as optimization protocol used in preparing treatment plans. The application of the rings optimization caused the value of normal tissue integral dose (NTID) to decrease. It is possible to limit the area of low dose irradiation and reduce NTID in dynamic techniques with the same clinical constraints for OAR and PTV volumes by using an optimization protocol other than the classic one.

  3. Variations in health insurance coverage: benefits vs. premiums.

    PubMed

    Wilensky, G R; Farley, P J; Taylor, A K

    1984-01-01

    Renewed national interest in market forces to promote more efficient and cost-conscious behavior by patients and providers increasingly focuses on the structure of private health insurance benefits. Two features of procompetitive legislative proposals are considered: a ceiling on tax-free employer insurance premiums and offering greater choice of insurance plans. The interests of efficiency and equity invoke different kinds of risks and transfers; no single institutional approach is likely to yield the promised benefits.

  4. Health plans--enforcement of right to reimbursement not available under ERISA section 502(a)(3). Great-West Life & Annuity Insurance Company v. Knudson.

    PubMed

    2003-01-01

    The United States Supreme Court reaffirmed its reluctance "to tamper with [the] enforcement scheme" embodied in ERISA by authorizing remedies not specifically authorized by ERISA's text, and held that section 502(c)(3) does not authorize a plan to bring an action to enforce the plan's reimbursement provisions because recovering monetary damages for reimbursement is not relief typically available in equity and, therefore, is not "other equitable relief" within the meaning of section 502(a)(3). An action to impose personal liability on the Knudsons for a contractual obligation to pay money is an action seeking legal, not equitable, relief and is not authorized by section 502(a)(3).

  5. Application of Rapid Prototyping Pelvic Model for Patients with DDH to Facilitate Arthroplasty Planning: A Pilot Study.

    PubMed

    Xu, Jie; Li, Deng; Ma, Ruo-fan; Barden, Bertram; Ding, Yue

    2015-11-01

    Total hip arthroplasty (THA) is challenging in cases of osteoarthritis secondary to developmental dysplasia of the hip (DDH). Acetabular deficiency makes the positioning of the acetabular component difficult. Computer tomography based, patient-individual three dimensional (3-D) rapid prototype technology (RPT)-models were used to plan the placement of acetabular cup so that a surgeon was able to identify pelvic structures, assess the ideal extent of reaming and determine the size of cup after a reconstructive procedure. Intraclass correlation coefficients (ICCs) were used to analyze the agreement between the sizes of chosen components on the basis of preoperative planning and the actual sizes used in the operation. The use of the 3-D RPT-model facilitates the surgical procedures due to better planning and improved orientation. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Wastewater planning in Djenné, Mali. A pilot project for the local infiltration of domestic wastewater.

    PubMed

    Alderlieste, M C; Langeveld, J G

    2005-01-01

    The city of Djenné (Mali) is famous for its mosque which is the world's largest adobe building. Djenné is considered to be one of the most interesting cities in Western Africa from an architectural point of view. Since 1988, Djenné is listed as a UNESCO World Heritage Site. In the 1990s, a drinking water supply network was provided by foreign development organisations. However, no facilities were provided for the disposal of wastewater, resulting in an increase of waterborne diseases. This paper describes the urban drainage problem in Djenné and discusses the systematic evaluation of possible solutions and the subsequent pilot project for the local infiltration of sullage. The infiltration of sullage proved to be an appropriate technology for solving the urban drainage problem in Djenné.

  7. The ins and outs of dental insurance.

    PubMed

    Inge, Ronald

    2005-02-01

    In the past three decades, dental insurance has become a permanent fixture in the delivery of dental services. Some would argue that this has not been good for dentists. However, none will dispute that it is here to stay and that dentists must make some very important decisions in their practices with regard to dental insurance. This article will explore some of those decisions and offer some guidance on how to decide wisely. Dental insurance now is a permanent fixture in the delivery of dental care. Each dentist must decide if participation with a dental insurance company is in his or her best interest. To make this decision, a dentist must have as much information as possible to evaluate each specific dental plan. If a dentist does decide to participate, the dentist must know the rules. Participation with a dental insurance company may influence the dentist-patient relationship. Dentists must be prepared to answer the question, "Why do I need this service if my dental insurance does not cover it?" Non-participation with a dental insurance company may result in a reduced number of new patients.

  8. 7 CFR 2.44 - Administrator, Risk Management Agency and Manager, Federal Crop Insurance Corporation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agency. (2) Conduct pilot programs involving revenue insurance, risk management savings accounts, or the... a study and issue a report on the efficacy and accuracy of the application of pack factors regarding...

  9. 7 CFR 2.44 - Administrator, Risk Management Agency and Manager, Federal Crop Insurance Corporation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Agency. (2) Conduct pilot programs involving revenue insurance, risk management savings accounts, or the... a study and issue a report on the efficacy and accuracy of the application of pack factors regarding...

  10. 24 CFR 1000.139 - What are the standards for insurance entities owned and controlled by recipients?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ACTIVITIES Affordable Housing Activities § 1000.139 What are the standards for insurance entities owned and... entity, tribal self-insurance plan, tribal risk retention group, or Indian housing self-insurance risk...-insurance; (B) The management staff must have at least one senior manager who has a minimum of five years...

  11. 24 CFR 1000.139 - What are the standards for insurance entities owned and controlled by recipients?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... ACTIVITIES Affordable Housing Activities § 1000.139 What are the standards for insurance entities owned and... entity, tribal self-insurance plan, tribal risk retention group, or Indian housing self-insurance risk...-insurance; (B) The management staff must have at least one senior manager who has a minimum of five years...

  12. 26 CFR 46.4371-2 - Imposition of tax on policies issued by foreign insurers; scope of tax.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...-INSURED HEALTH PLANS, AND OBLIGATIONS NOT IN REGISTERED FORM Tax on Policies Issued by Foreign Insurers... a nonresident alien individual, a foreign partnership, or a foreign corporation, as insurer (unless... “indemnity bond,” see section 4372(c). (b) Life insurance, sickness, and accident policies, and annuity...

  13. 75 FR 81544 - Request for Information Regarding Value-Based Insurance Design in Connection With Preventive Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ... Labor; Office of Consumer Information and Insurance Oversight, Department of Health and Human Services... health plans and health insurance issuers can employ value-based insurance design in the coverage of... following address ONLY: Office of Consumer Information and Insurance Oversight, Department of Health...

  14. Surgical accuracy of three-dimensional virtual planning: a pilot study of bimaxillary orthognathic procedures including maxillary segmentation.

    PubMed

    Stokbro, K; Aagaard, E; Torkov, P; Bell, R B; Thygesen, T

    2016-01-01

    This retrospective study evaluated the precision and positional accuracy of different orthognathic procedures following virtual surgical planning in 30 patients. To date, no studies of three-dimensional virtual surgical planning have evaluated the influence of segmentation on positional accuracy and transverse expansion. Furthermore, only a few have evaluated the precision and accuracy of genioplasty in placement of the chin segment. The virtual surgical plan was compared with the postsurgical outcome by using three linear and three rotational measurements. The influence of maxillary segmentation was analyzed in both superior and inferior maxillary repositioning. In addition, transverse surgical expansion was compared with the postsurgical expansion obtained. An overall, high degree of linear accuracy between planned and postsurgical outcomes was found, but with a large standard deviation. Rotational difference showed an increase in pitch, mainly affecting the maxilla. Segmentation had no significant influence on maxillary placement. However, a posterior movement was observed in inferior maxillary repositioning. A lack of transverse expansion was observed in the segmented maxilla independent of the degree of expansion.

  15. The Unified Language Testing Plan: Speaking Proficiency Test. Spanish and English Pilot Validation Studies. Report Number 1.

    ERIC Educational Resources Information Center

    Thornton, Julie A.

    This report describes one segment of the Federal Language Testing Board's Unified Language Testing Plan (ULTP), the validation of speaking proficiency tests in Spanish and English. The ULTP is a project to increase standardization of foreign language proficiency measurement and promote sharing of resources among testing programs in the federal…

  16. Joint Applications Pilot of the National Climate Predictions and Projections Platform and the North Central Climate Science Center: Delivering climate projections on regional scales to support adaptation planning

    NASA Astrophysics Data System (ADS)

    Ray, A. J.; Ojima, D. S.; Morisette, J. T.

    2012-12-01

    The DOI North Central Climate Science Center (NC CSC) and the NOAA/NCAR National Climate Predictions and Projections (NCPP) Platform and have initiated a joint pilot study to collaboratively explore the "best available climate information" to support key land management questions and how to provide this information. NCPP's mission is to support state of the art approaches to develop and deliver comprehensive regional climate information and facilitate its use in decision making and adaptation planning. This presentation will describe the evolving joint pilot as a tangible, real-world demonstration of linkages between climate science, ecosystem science and resource management. Our joint pilot is developing a deliberate, ongoing interaction to prototype how NCPP will work with CSCs to develop and deliver needed climate information products, including translational information to support climate data understanding and use. This pilot also will build capacity in the North Central CSC by working with NCPP to use climate information used as input to ecological modeling. We will discuss lessons to date on developing and delivering needed climate information products based on this strategic partnership. Four projects have been funded to collaborate to incorporate climate information as part of an ecological modeling project, which in turn will address key DOI stakeholder priorities in the region: Riparian Corridors: Projecting climate change effects on cottonwood and willow seed dispersal phenology, flood timing, and seedling recruitment in western riparian forests. Sage Grouse & Habitats: Integrating climate and biological data into land management decision models to assess species and habitat vulnerability Grasslands & Forests: Projecting future effects of land management, natural disturbance, and CO2 on woody encroachment in the Northern Great Plains The value of climate information: Supporting management decisions in the Plains and Prairie Potholes LCC. NCCSC's role in

  17. F-18-FDG-PET Confined Radiotherapy of Locally Advanced NSCLC With Concomitant Chemotherapy: Results of the PET-PLAN Pilot Trial

    SciTech Connect

    Fleckenstein, Jochen; Hellwig, Dirk; Kremp, Stephanie; Grgic, Aleksandar; Groeschel, Andreas; Kirsch, Carl-Martin; Nestle, Ursula; Ruebe, Christian

    2011-11-15

    Purpose: The integration of fluoro-deoxy-D-glucose positron emission tomography (FDG-PET) in the process of radiotherapy (RT) planning of locally advanced non-small-cell lung cancer (NSCLC) may improve diagnostic accuracy and minimize interobserver variability compared with target volume definition solely based on computed tomography. Furthermore, irradiating only FDG-PET-positive findings and omitting elective nodal regions may allow dose escalation by treating smaller volumes. The aim of this prospective pilot trial was to evaluate the therapeutic safety of FDG-PET-based RT treatment planning with an autocontour-derived delineation of the primary tumor. Methods and Materials: Eligible patients had Stages II-III inoperable NSCLC, and simultaneous, platinum-based radiochemotherapy was indicated. FDG-PET and computed tomography acquisitions in RT treatment planning position were coregistered. The clinical target volume (CTV) included the FDG-PET-defined primary tumor, which was autodelineated with a source-to-background algorithm, plus FDG-PET-positive lymph node stations. Limited by dose restrictions for normal tissues, prescribed total doses were in the range of 66.6 to 73.8 Gy. The primary endpoint was the rate of out-of-field isolated nodal recurrences (INR). Results: As per intent to treat, 32 patients received radiochemotherapy. In 15 of these patients, dose escalation above 66.6 Gy was achieved. No Grade 4 toxicities occurred. After a median follow-up time of 27.2 months, the estimated median survival time was 19.3 months. During the observation period, one INR was observed in 23 evaluable patients. Conclusions: FDG-PET-confined target volume definition in radiochemotherapy of NSCLC, based on a contrast-oriented source-to-background algorithm, was associated with a low risk of INR. It might provide improved tumor control because of dose escalation.

  18. Redefining private insurance in a changing market structure.

    PubMed

    Chollet, D J

    1996-01-01

    This discussion on likely changes and challenges for the health insurance industry over the coming decade assumes that significant national reform of health care financing for the privately insured population will not occur--or, if it does, that it will mirror the insurance market reforms that many states already have undertaken. First, the changes in private insurance coverage during the past several years are considered, with particular attention to the erosion of employer-based coverage and to the rising influence of public insurance programs--especially Medicaid--on the private insurance market. Next is a description of the changing web of state laws and regulations governing private health insurance. At this writing, virtually every state has enacted or is considering reforms of the small group market to limit what many perceive as unfair or destructive insurer practices and to set new ground rules for competition among insurance arrangements. The changing nature of private insurance contracts in the United States is considered next. Evolving from conventional fee-for-service contracts, private insurance is increasingly a complex mixture of capitation, partial capitation, and reinsurance of capitated arrangements. Finally, this chapter discusses three issues of increasing importance in shaping the marketplace for private insurers: (1) the federal preemption of states' regulatory authority over self-insured employer plans; (2) emerging state regulation to restructure competition in the health insurance and health care markets; and (3) the growing interest of both federal and state governments in medical savings accounts to finance health insurance and health care spending.

  19. 77 FR 30377 - Health Insurance Premium Tax Credit

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... Internal Revenue Service 26 CFR Parts 1 and 602 RIN 1545-BJ82 Health Insurance Premium Tax Credit AGENCY... regulations relating to the health insurance premium tax credit enacted by the Patient Protection and... (Exchanges) and claim the premium tax credit, and to Exchanges that make qualified health plans available...

  20. 76 FR 50931 - Health Insurance Premium Tax Credit

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BJ82 Health Insurance Premium Tax Credit AGENCY: Internal.... SUMMARY: This document contains proposed regulations relating to the health insurance premium tax credit... tax credit, and to Exchanges that make qualified health plans available to individuals and ]...

  1. Long-Term Quality Control Program Plan for Cord Blood Banks in Korea: A Pilot Study for Cryopreservation Stability.

    PubMed

    Seo, Soo Hyun; Shin, Sue; Roh, Eun Youn; Song, Eun Young; Oh, Sohee; Kim, Byoung Jae; Yoon, Jong Hyun

    2017-03-01

    Maintaining the quality of cryopreserved cord blood is crucial. In this pilot study, we describe the results of the internal quality control program for a cord blood bank thus far. Donated cord blood units unsuitable for transplantation were selected for internal quality control once a month. One unit of cord blood, aliquoted into 21 capillaries, was cryopreserved and thawed annually to analyze the total nucleated cell count, CD34⁺ cell count, cell viability test, and colony-forming units assay. No significant differences in the variables (total nucleated cell count, cell viability, CD34⁺ cell count) were observed between samples cryopreserved for one and two years. Upon comparing the variables before cryopreservation and post thawing with the capillaries of one year of storage, cell viability and CD34⁺ cell counts decreased significantly. The use of cord blood samples in capillaries, which can be easily stored for a long period, was similar to the methods used for testing segments attached to the cord blood unit. The results of this study may be useful for determining the period during which the quality of cryopreserved cord blood units used for transplantation is maintained.

  2. Long-Term Quality Control Program Plan for Cord Blood Banks in Korea: A Pilot Study for Cryopreservation Stability

    PubMed Central

    Seo, Soo Hyun; Shin, Sue; Roh, Eun Youn; Song, Eun Young; Oh, Sohee; Kim, Byoung Jae

    2017-01-01

    Background Maintaining the quality of cryopreserved cord blood is crucial. In this pilot study, we describe the results of the internal quality control program for a cord blood bank thus far. Methods Donated cord blood units unsuitable for transplantation were selected for internal quality control once a month. One unit of cord blood, aliquoted into 21 capillaries, was cryopreserved and thawed annually to analyze the total nucleated cell count, CD34+ cell count, cell viability test, and colony-forming units assay. Results No significant differences in the variables (total nucleated cell count, cell viability, CD34+ cell count) were observed between samples cryopreserved for one and two years. Upon comparing the variables before cryopreservation and post thawing with the capillaries of one year of storage, cell viability and CD34+ cell counts decreased significantly. The use of cord blood samples in capillaries, which can be easily stored for a long period, was similar to the methods used for testing segments attached to the cord blood unit. Conclusions The results of this study may be useful for determining the period during which the quality of cryopreserved cord blood units used for transplantation is maintained. PMID:28028998

  3. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

    PubMed

    Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

    2004-05-12

    Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

  4. An Insurance Planner. Teaching Low-Income Consumers about Insurance.

    ERIC Educational Resources Information Center

    Shurtz, Mary Ann; LeFlore, Ann Becker

    This module, one of six on teaching consumer matters to low-income groups, focuses on buying insurance. Topics include life insurance (language, types, settlement options), auto insurance, health insurance (standard, health maintenance organizations, medicaid, medicare), tenant's insurance (property damage, liability), what to do in case of loss,…

  5. Case conferences between general practitioners and specialist teams to plan end of life care of people with end stage heart failure and lung disease: an exploratory pilot study.

    PubMed

    Mitchell, Geoffrey; Zhang, Jianzhen; Burridge, Letitia; Senior, Hugh; Miller, Elizabeth; Young, Sharleen; Donald, Maria; Jackson, Claire

    2014-01-01

    Most people die of non-malignant disease, but most patients of specialist palliative care services have cancer. Adequate end of life care for people with non-malignant disease requires acknowledgement of their limited prognosis and appropriate care planning. Case conferences between specialist palliative care services and GPs improve outcomes in cancer-based populations. We report a pilot study of case conferences between the patient's GP and specialist staff to facilitate care planning for people with end stage heart failure or non-malignant lung disease in a regional health service in Queensland Australia. Single face to face case conferences about patients with a primary diagnosis of advanced heart failure or respiratory failure from non-malignant disease were conducted between a palliative care consultant, a case management nurse and the patient's GP. Annualised rates of service utilisation (emergency department [ED] presentations, ED discharges back to home, hospital admissions, and admission length of stay) before and after case conference were calculated. Content and counts of case conference recommendations, and the rate of adherence to recommendations were also assessed. A process evaluation of case conferences was undertaken. Twenty-three case conferences involving 21 GPs were conducted between November 2011 and November 2012. One GP refused to participate. Ten patients died, three at home. Of 82 management recommendations made, 55 (67%) were enacted. ED admissions fell from 13.9 per annum (pa) to 2.1 (difference 11.8, 95% CI 2.2-21.3, p = 0.001); ED admissions leading to discharge home from 3.9 to 0.4 pa (difference 3.5, 95% CI -0.4-7.5, p = 0.05); hospital admissions from 11.4 to 3.5 pa (difference 7.9, 95% CI 2.2-13.7, p = 0.002); and length of stay from 7.0 to 3.7 days (difference 3.4, 95% CI 0.9-5.8, p = 0.007). Participating health professionals were enthusiastic about the process. This pilot is the initial step in the development and testing of a

  6. Nonlife Insurance Pricing:

    NASA Astrophysics Data System (ADS)

    Darooneh, Amir H.

    We consider the insurance company as a physical system which is immersed in its environment (the financial market). The insurer company interacts with the market by exchanging the money through the payments for loss claims and receiving the premium. Here, in the equilibrium state, we obtain the premium by using the canonical ensemble theory, and compare it with the Esscher principle, the well-known formula in actuary for premium calculation. We simulate the case of car insurance for quantitative comparison.

  7. Employer-sponsored, personal, and portable health insurance.

    PubMed

    Goodman, John C

    2006-01-01

    Personal and portable health insurance is an idea whose time has come. Despite its stated intent, however, the Health Insurance Portability and Accountability Act (HIPAA) strongly discourages individually owned, portable insurance. Federal tax laws do the same. Some examples of portable benefits exist, such as the TIAA-CREF system. This paper considers three reform models for moving toward personal, portable coverage: the National Center for Policy Analysis-Texas Blue Cross Blue Shield proposal, the Massachusetts health care plan, and a health reimbursement arrangement (HRA) approach. Congress could make the transition smoother by clarifying when and if individually owned insurance can be purchased with pretax dollars.

  8. Insurance and indemnification implications of future space projects

    NASA Technical Reports Server (NTRS)

    O'Brien, John E.

    1987-01-01

    NASA options regarding insurance and indemnification policies as they relate to NASA customers and contractors are described. The foundation for the discussion is the way in which NASA is planning to return the Space Shuttle fleet to safe flight as well as current U.S. policy concerning future uses of the Shuttle fleet. Issues discussed include: the nature of the Shuttle manifest; the policy regarding property damage or destruction; insurance against liability to third parties; the reduction of the scope of the risk to be insured; NASA as the insurer; a sharing arrangement between the user and NASA; and contractors and subcontractors involved in Shuttle operations.

  9. Insurance and indemnification implications of future space projects

    NASA Technical Reports Server (NTRS)

    O'Brien, John E.

    1987-01-01

    NASA options regarding insurance and indemnification policies as they relate to NASA customers and contractors are described. The foundation for the discussion is the way in which NASA is planning to return the Space Shuttle fleet to safe flight as well as current U.S. policy concerning future uses of the Shuttle fleet. Issues discussed include: the nature of the Shuttle manifest; the policy regarding property damage or destruction; insurance against liability to third parties; the reduction of the scope of the risk to be insured; NASA as the insurer; a sharing arrangement between the user and NASA; and contractors and subcontractors involved in Shuttle operations.

  10. From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil.

    PubMed

    Bahia, Ligia; Scheffer, Mario; Tavares, Leandro Reis; Braga, Iale Falleiros

    2016-11-03

    The concentration and internationalization of health plan companies in Brazil gave them a clearly financial face. Based on the need to understand the health care industry's capital accumulation patterns, the current study examines health plan companies' expansion strategies through the classification of their supply and demand characteristics by recent historical periods and an analysis of recent shareholding trends in one of the leading corporations in the Brazilian health care industry. The 1960s to 2000s witnessed changes in the scale of demands for health plans and adherence by companies to long-term accumulation strategies. Beginning in the early 21st century, changes in the shareholding structures of the largest Brazilian company, consistent with the financialization of its accumulation regime, resulted in the rapid multiplication of its capital. Deepening segmentation of the health care system in a context marked by the downturn in the national economy challenges the preservation of public subsidies for private health plans. Resumo: A concentração e internacionalização de empresas de planos de saúde no Brasil conferiram-lhes feição financeira. Considerando a necessidade de compreender os padrões de acumulação desse setor, o trabalho examina estratégias de expansão das empresas de planos de saúde por meio da periodização de atributos da oferta e demanda e exame da trajetória patrimonial recente de um dos grandes grupos do setor. Entre os anos 1960 e 2000, ocorreram alterações na escala das demandas por planos de saúde e adesão das empresas a estratégias de acumulação de longo prazo. A partir do século XXI, as alterações nas estruturas societárias da maior empresa brasileira, compatíveis com o regime de acumulação financeirizada, resultaram na multiplicação de seu capital em um curto intervalo de tempo. O aprofundamento da segmentação do sistema de saúde, em um contexto marcado pela desaceleração da economia, questiona a

  11. Personal Financial Planning: Failure to Plan Properly May Have Dire Consequences.

    ERIC Educational Resources Information Center

    Rosenbloom, Jerry

    1988-01-01

    Effective personal financial planning results in sound decisions in the areas of insurance, accumulating capital, retirement planning, and tax planning. Appropriate financial planning concerns everyone--regardless of his or her stage in life. (MLW)

  12. Empowering survivors after colorectal and lung cancer treatment: Pilot study of a Self-Management Survivorship Care Planning intervention.

    PubMed

    Reb, Anne; Ruel, Nora; Fakih, Marwan; Lai, Lily; Salgia, Ravi; Ferrell, Betty; Sampath, Sagus; Kim, Jae Y; Raz, Dan J; Sun, Virginia

    2017-08-01

    This study evaluates the feasibility and acceptability of a Self-Management Survivorship Care Planning (SM-SCP) intervention in colorectal and lung cancer survivors. This is a single-group, pre- and post-mixed methods study of an advance practice nurse-driven survivorship care intervention that integrates a survivorship care plan with self-management skills coaching. Colorectal and lung cancer survivors with stage I-III disease were enrolled at 3-6 months after completing treatments, and the intervention was administered in one in-person or telephone session. Survivor outcome measures included depression, anxiety, self-efficacy, QOL, and satisfaction. Paired t-tests were used for exploratory evaluations of pre-to post-intervention score changes. Content analysis was conducted to analyze the qualitative data to describe survivors' experience with the intervention. Thirty participants (15 colorectal, 15 lung) enrolled and completed the study (73% retention). It took an average of 40 min to complete the TS/CP and 34.2 min to deliver the intervention. Exploratory analysis revealed significant differences from baseline to post-intervention in depression, anxiety, self-efficacy, physical functioning, role limitations-physical, pain, general health, health transition, physical health summary, and total QOL. Three qualitative themes emerged: 1) Feeling empowered about having a plan; 2) Struggling with psychosocial concerns; and 3) Suggestions for intervention content and delivery. The SM-SCP intervention was feasible and acceptable for colorectal and lung cancer survivors after treatment completion. Survivorship care interventions have potential to fulfill the unmet needs of colorectal and lung cancer survivors. Their effectiveness might be greater by integrating conceptually-based models of care, such as self-management skills building. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. 78 FR 71558 - Insurance Cost Information Regulation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ... TRANSPORTATION National Highway Traffic Safety Administration 49 CFR Part 582 Insurance Cost Information... vehicle damage susceptibility information to consumers. NHTSA plans to use this information to meet a... susceptibility information to consumers. DATES: You should submit your comments early enough to ensure that...

  14. Student Health Insurance: Problems and Solutions

    ERIC Educational Resources Information Center

    Wagner, Robin

    2006-01-01

    Student health insurance experiences the same inflationary trends as employee benefits, but is rarely viewed as a significant direct cost to an institution, nor is the bill as high as the costs associated with employee health plans. Several long-term solutions and strategies that could help colleges to contain the ever-escalating cost of providing…

  15. Student Health Insurance: Problems and Solutions

    ERIC Educational Resources Information Center

    Wagner, Robin

    2006-01-01

    Student health insurance experiences the same inflationary trends as employee benefits, but is rarely viewed as a significant direct cost to an institution, nor is the bill as high as the costs associated with employee health plans. Several long-term solutions and strategies that could help colleges to contain the ever-escalating cost of providing…

  16. Hazardous substance liability insurance

    SciTech Connect

    Not Available

    1982-03-01

    The study was carried out to meet requirements of the Comprehensive Environmental Response, Compensation and Liability Act of 1980. It considers the adequacy and feasibility of private insurance to protect owners and operators of ships covered by the Act and for post-closure financial responsibility for hazardous waste disposal facilities. The report is in three parts: Pt. 1 is an introduction to the hazardous substance insurance problem; Pt. 2 considers the adequacy of private insurance for owners and operators of vessels and facilities; Pt. 3 focuses on the problem of a private insurance alternative to the Post-Closure Liability Fund for 'inactive' hazardous waste disposal facilities.

  17. Insuring against environmental risks

    SciTech Connect

    Anspach, K.G.

    1993-06-01

    As the chemical process industries now know all too well, environmental damages represent a significant risk to the firms and individuals in it. Whether the cause of the damage is a sudden spill or the gradual contamination of a site through underground leakage, major financial losses are a constant threat. U.S. insurance companies are also aware of these risks. During the late 1970s and early 1980s, many limited environmental coverage in the policies that they sold; later, such coverage was dropped entirely. Recently, many new types of coverage have become available, but often at high expense. To get adequate insurance coverage at a reasonable price, CPI firms can pursue several options: general liability insurance, self-insurance, specialized environmental insurance--or no insurance at all. Each of these options raise certain risks and costs. At the same time, individual engineers or consulting engineering groups that service the CPI have their own set of insurance options. Most independent engineering consultants carry some type of liability insurance; now, as the potential consequences of their work on the environment become clearer, some have invested in various types of professional insurance.

  18. 42 CFR 457.50 - State plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies § 457.50 State plan. The State plan is a... 42 Public Health 4 2010-10-01 2010-10-01 false State plan. 457.50 Section 457.50 Public...

  19. 42 CFR 457.50 - State plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies § 457.50 State plan. The State plan is a... 42 Public Health 4 2012-10-01 2012-10-01 false State plan. 457.50 Section 457.50 Public...

  20. 42 CFR 457.50 - State plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies § 457.50 State plan. The State plan is a... 42 Public Health 4 2011-10-01 2011-10-01 false State plan. 457.50 Section 457.50 Public...

  1. 42 CFR 457.50 - State plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies § 457.50 State plan. The State plan is a... 42 Public Health 4 2013-10-01 2013-10-01 false State plan. 457.50 Section 457.50 Public...

  2. 42 CFR 457.50 - State plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies § 457.50 State plan. The State plan is a... 42 Public Health 4 2014-10-01 2014-10-01 false State plan. 457.50 Section 457.50 Public...

  3. Genetic information and insurance: some ethical issues.

    PubMed Central

    O'Neill, O

    1997-01-01

    Life is risky, and insurance provides one of the best developed ways of controlling risks. By pooling, and so transferring risks, those who turn out to suffer antecedently uncertain harms can be assured in advance that they will be helped if those harms arise; they can then plan their lives and activities with confidence that they are less at the mercy of ill fortune. Both publicly organized and commercial insurance can organize the pooling of risk in ways that are beneficial for all concerned. They provide standard ways of securing fundamental ethical values such as solidarity and mutuality. Although policy holders do not know or contract with one another, each benefits from the contribution of others to a shared scheme for pooling and so controlling risk. Although there is a limit to the degree to which commercially-based insurance, where premiums depend on risk level, can go beyond mutuality towards solidarity, in practice it too often achieves a measure of solidarity by taking a broad brush approach to pooling risk. However, the ordinary practices of insurance, and in particular of commercial insurance, also raise ethical questions. These may be put in simple terms by contrasting the way in which an insurance market discriminates between different people, on the basis of characteristics that (supposedly) determine their risk level, and our frequent abhorrence of discrimination, in particular on the basis on religious, racial and gender characteristics. Are the discriminations on which insurance practice relies upon as standard acceptable or not? The increasing availability of genetic information, which testing (of individuals) and screening (of populations) may provide, could lend urgency to these questions. Genetic information may provide a way of obtaining more accurate assessment of individual risks to health and life. This information could be used to discriminate more finely between the risk levels of different individuals, and then to alter the

  4. 24 CFR 965.205 - Qualified PHA-owned insurance entity.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... organizational documentation, as evidenced by copies of the articles of incorporation, by-laws, business plans... insurance company is licensed or authorized to do business in the State by the State Insurance Commissioner... suspended from providing insurance coverage in the State or been suspended or debarred from doing business...

  5. 36 CFR 1211.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Health and insurance...

  6. 7 CFR 15a.39 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 1 2011-01-01 2011-01-01 false Health and insurance benefits and services. 15a.39... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students,...

  7. 45 CFR 618.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...

  8. 32 CFR 196.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of...

  9. 45 CFR 2555.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of...

  10. 34 CFR 106.39 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall...

  11. 13 CFR 113.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits...

  12. 7 CFR 15a.39 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 15a.39... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students,...

  13. 34 CFR 106.39 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall...

  14. 32 CFR 196.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of...

  15. 45 CFR 2555.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of...

  16. 45 CFR 618.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Health and insurance benefits and services. 618....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...

  17. 36 CFR 1211.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance...

  18. 24 CFR 3.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Health and insurance benefits...

  19. 24 CFR 3.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits...

  20. 13 CFR 113.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Health and insurance benefits...

  1. 36 CFR 1211.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  2. 45 CFR 2555.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  3. 45 CFR 2555.440 - Health and insurance benefits and services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

  4. Small firm self-insurance under the Affordable Care Act.

    PubMed

    Buettgens, Matthew; Blumberg, Linda J

    2012-11-01

    The Affordable Care Act changes the small-group insurance market substan­tially beginning in 2014, but most changes do not apply to self-insured plans. This exemp­tion provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employ­ers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stabil­ity in small-group insurance coverage.

  5. Insurance: An Evaluation Report for the Occupational Exploration Program.

    ERIC Educational Resources Information Center

    Altschuld, James W.; And Others

    The evaluation report is one of seven produced for the Occupational Exploration Program (OEP), a series of simulated occupational experiences designed for junior high school students. Describing the pilot testing of the simulation dealing with the insurance field, the report contains sections describing the simulation context, evaluation…

  6. Problematic healthcare insurance: a comparison with successful models.

    PubMed

    Matusitz, Jonathan

    2014-01-01

    This article analyzes the experiences of problematic health insurance models in Canada, France, Germany, and Spain, based on news reports, facts, and data. Those nations were selected because they represent typical socialist economies with nationalized health insurance systems. Major findings are that (a) these health insurance systems are not cheap, (b) they sometimes contribute to governments' own financial deficits, (c) there are significant restrictions for access to private health care, (d) many services are not covered, and (e) the insurance plans create conflict as to what treatment options are offered. The author also provides a description of the current U.S. health care insurance model and compares it with the European socialist model. What comes subsequently is an examination of two ideal models of efficient health care insurance: the ones of Switzerland and the Netherlands. This analysis ends with a discussion section that provides implications for U.S. health care and offers suggestions for future research.

  7. Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

    PubMed

    Korenman, Sanders D; Remler, Dahlia K

    2016-12-01

    We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the health inclusive poverty rate.

  8. Insurance Needs for Adventure Programs.

    ERIC Educational Resources Information Center

    Wolff, Robert M.; Washburn, Nancy

    1984-01-01

    lines insurance needs for adventure education programs. Gives results of a survey (65 percent response rate) of 68 adventure education programs and their insurance coverage or reasons why they had no insurance. Discusses risk management for adventure education programs. (MH)

  9. Basic insurance concepts for dentists.

    PubMed

    Hagglund, C E; Weimer, B D; Weeding, W C

    1997-06-01

    Dentists cannot afford to be ignorant about insurance. Insurance is an important risk-management tool, minimizing the exposure for catastrophic claims and losses. Patient insurance is also a major source of revenue for most dental practices.

  10. Insurance Needs for Adventure Programs.

    ERIC Educational Resources Information Center

    Wolff, Robert M.; Washburn, Nancy

    1984-01-01

    lines insurance needs for adventure education programs. Gives results of a survey (65 percent response rate) of 68 adventure education programs and their insurance coverage or reasons why they had no insurance. Discusses risk management for adventure education programs. (MH)

  11. Comparing Types of Health Insurance for Children

    PubMed Central

    DeVoe, Jennifer E.; Tillotson, Carrie J.; Wallace, Lorraine S.; Selph, Shelley; Graham, Alan; Angier, Heather

    2015-01-01

    Background Many states have expanded public health insurance programs for children, and further expansions were proposed in recent national reform initiatives; yet the expansion of public insurance plans and the inclusion of a public option in state insurance exchange programs sparked controversies and raised new questions with regard to the quality and adequacy of various insurance types. Objectives We aimed to examine the comparative effectiveness of public versus private coverage on parental-reported children’s access to health care in low-income and middle-income families. Methods/Participants/Measures We conducted secondary data analyses of the nationally representative Medical Expenditure Panel Survey, pooling years 2002 to 2006. We assessed univariate and multivariate associations between child’s full-year insurance type and parental-reported unmet health care and preventive counseling needs among children in low-income (n =28,338) and middle-income families (n = 13,160). Results Among children in families earning <200% of the federal poverty level, those with public insurance were significantly less likely to have no usual source of care compared with privately insured children (adjusted relative risk, 0.79; 95% confidence interval, 0.63–0.99). This was the only significant difference in 50 logistic regression models comparing unmet health care and preventive counseling needs among low-income and middle-income children with public versus private coverage. Conclusions The striking similarities in reported rates of unmet needs among children with public versus private coverage in both low-income and middle-income groups suggest that a public children’s insurance option may be equivalent to a private option in guaranteeing access to necessary health care services for all children. PMID:21478781

  12. Forest insurance number.

    Treesearch

    Thornton T. Munger; H.B. Shepard

    1934-01-01

    This inquiry, originally conceived as an effort to determine definitely whether the existing lack of adequate and practical forest fire insurance facilities is in truth unavoidable and, if possible, to suggest means whereby the condition might be remedied, finds no apparent reason why successful forest fire insurance should not be possible as far as the loss situation...

  13. The Insurance Educator. 1994.

    ERIC Educational Resources Information Center

    Insurance Educator, 1994

    1994-01-01

    These two issues of a semiannual newsletter are intended to provide secondary educators with a greater knowledge of insurance and access to teaching materials, new ideas, and insurance career information for students. Each newsletter contains the following: lessons for the teacher, special features (learning activities), teen drivers/automobile…

  14. Insuring Interlibrary Loans.

    ERIC Educational Resources Information Center

    Moran, Michael L.

    1982-01-01

    Argues that current library policy and practice of insuring interlibrary loan transactions are inconsistent and confusing. Responsibility for loss in various situations is defined, methods of valuation for loaned materials are discussed, and the need for insuring theses and dissertations is questioned. (Author/JL)

  15. 48 CFR 212.7002 - Pilot program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Pilot program. 212.7002... OF DEFENSE ACQUISITION PLANNING ACQUISITION OF COMMERCIAL ITEMS Pilot Program for Transition to Follow-On Contracting After Use of Other Transaction Authority 212.7002 Pilot program. ...

  16. 48 CFR 212.7002 - Pilot program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Pilot program. 212.7002... OF DEFENSE ACQUISITION PLANNING ACQUISITION OF COMMERCIAL ITEMS Pilot Program for Transition to Follow-On Contracting After Use of Other Transaction Authority 212.7002 Pilot program. ...

  17. 48 CFR 212.7102 - Pilot program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Pilot program. 212.7102... OF DEFENSE ACQUISITION PLANNING ACQUISITION OF COMMERCIAL ITEMS Pilot Program for Acquisition of Military-Purpose Nondevelopmental Items 212.7102 Pilot program. ...

  18. 33 CFR 385.12 - Pilot projects.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated with certain components such as aquifer storage and recovery, in-ground reservoir technology, seepage management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary...

  19. 33 CFR 385.12 - Pilot projects.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated with certain components such as aquifer storage and recovery, in-ground reservoir technology, seepage management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary...

  20. 33 CFR 385.12 - Pilot projects.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated with certain components such as aquifer storage and recovery, in-ground reservoir technology, seepage management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary...