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One byproduct of the patchwork system of public and private health insurance coverage in the United States is that individuals can gain or lose health insurance as they gain or lose jobs, or gain or lose eligibility for public programs. This phenomenon, known as “churning,” can lead to gaps in health insurance coverage and unnecessary […]

The Medicare Savings Programs provide assistance with premiums — and in some instances, cost sharing requirements — to Medicare beneficiaries of limited income and resources who do not qualify for full Medicaid benefits. Medicare Part B premiums currently amount to over $1,000 annually — which can be a large sum for some beneficiaries. The savings […]

Although it’s best known for introducing the Medicare prescription drug program, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 also made a number of changes to the Medicare managed care program – Medicare Advantage. Among the aims: Keep managed care plans from leaving the program by offering higher payments, and give beneficiaries […]

In today’s health care system it is clear that there needs to be a multidisciplinary approach toward improving quality. Nurses are on the front lines of implementing this quality improvement. By using the highest quality measurements and optimizing the delivery of care, those outside the nursing community would understand the importance of their role in quality performance. As […]

On April 4, the Massachusetts legislature approved a plan that requires all adults to purchase health insurance by July 2007, or face a fine. The plan is projected to expand coverage to 95 percent of the state’s uninsured residents over the next three years. Like many other states, Massachusetts has struggled during the last decade […]

Congress has actively considered whether and how to reorganize the health insurance market for small businesses. In Spring 2006, the Senate debated a legislative proposal, offered by Senators Michael Enzi and Benjamin Nelson, which centers on Small Business Health Plans (SBHPs). SBHPs are a new category of group health plans sponsored by bona-fide professional and other […]

The enactment of the Patient Safety and Quality Improvement Act last year sets the stage for health care providers to be able to report medical errors confidentially to designated entities known as “Patient Safety Organizations” (PSOs). How will these PSOs operate? What information will be reported to them, and how will policymakers use the data […]

Health savings accounts (HSAs) offered in conjunction with high-deductible health plans are on an upswing nationally. Simply stated, HSAs require an individual to use his or her own money (or money set aside by an employer for the individual’s use) to pay for medical expenses up to a fairly substantial deductible, at which point traditional […]

As health care tabs rise, every American feels the impact – on personal finances, company budgets, state coffers and federal entitlement programs. Rising demands for services from an aging population, medical advances, and quality imperatives all impact health care costs. Within this context, it is important to understand how various sectors of our health care […]

Disparities in health care have been well documented: Nonwhites have higher rates of infant mortality, death from heart disease, incidence of diabetes and HIV/AIDS and are less likely to receive appropriate immunization than are whites. A recent study in the Journal of Racial and Ethnic Disparities indicates that between 1991 and 2000, five times as […]

Medicare now covers nearly 42 million beneficiaries who are elderly, or who have a severe disability or end stage renal disease. The Medicare Modernization Act of 2003 made many changes to the program – including the addition of an outpatient prescription drug benefit (“Part D”), which will become effective in January 2006. Understanding this new […]

The U.S. isn’t alone in efforts to improve the quality of health care. Other countries as well are coming up with new ways to measure quality, working to improve patient safety, and experimenting with financial incentives to encourage physicians to meet or exceed quality targets. What are some other nations learning that would enhance quality […]