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The financial professional's guide to healthcare reform /
"A comprehensive reference guide interpreting and applying healthcare reform law for consultants, appraisers, accountants, and attorneysThe Financial Consultants'Guide to Healthcare Reform provides an historical backdrop on how the healthcare system got to its present state including the M...
| Clasificación: | Libro Electrónico |
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| Autor principal: | |
| Otros Autores: | |
| Formato: | Electrónico eBook |
| Idioma: | Inglés |
| Publicado: |
Hoboken, N.J. :
John Wiley & Sons,
©2012.
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| Temas: | |
| Acceso en línea: | Texto completo Texto completo |
Tabla de Contenidos:
- The Financial Professional's Guide to Healthcare Reform; Contents; Foreword; Preface; Acknowledgments; CHAPTER 1: Introduction; A Brief Recap of the History of Reform; Early Reform Efforts; Tax Deductibility of Health Insurance; The Great Society: Medicare and Medicaid; The 1970s: Medicare HMOs and ERISA; Regulation: The Anti-Kickback Statute; Prospective Payment Systems; The 1990s; Rise of Managed Care; The Stark Law: Anti-Referral Statute; Balanced Budget Act of 1997; Balanced Budget Revision Act and Benefits Improvement and Protection Act; Failure of Managed Care.
- Provider Integration and ConsolidationSummary of the Healthcare Market in 2000; The New Century; One Size Fits All? Geographic Disparities in the U.S. Healthcare System; Profit and Nonprofit Hospitals and Health Insurers; History of Blue Plans; Medicare: The Other White Meat; Other Market-Based Studies; Geo-Clinical Differences; Summary; Notes; CHAPTER 2: Massachusetts; The Time Line of Massachusetts Reform; Early Reform Legislation in Massachusetts; Acts of 1996; Targeting the Small Group Market; Targeting the Trade Associations Offering Health Insurance to their Members.
- The Intervening YearsComponents of the 2006 Massachusetts Legislation; Merging the Small Group and Individual Markets; Commonwealth Care Subsidies; Key Features of Massachusetts Reform; Recounting the Results of Reform in Massachusetts; Universal Coverage; Response of the Healthcare Provider Community; Differing Views of Massachusetts Reform; Special Commission on the Health Care Payment System; The Alternative Quality Contract; State Government Reports Tracking the Results of Reform; The Small Group and Individual Market versus Self-Insured Market; Massachusetts Quarterly Reports.
- Massachusetts Attorney General's ReportSimilar Experience in Other Markets; Specific Comparisons; Take from the Poor and Give to the Rich?; Impact on Market Share of Financially Weaker Providers; Most Favored Nation Clauses; Tiered Pricing; Recent Legislative Changes through August 2010; Open Hearings in December 2009; August 2010 Changes in Massachusetts; Open Enrollment; Review of Premium Increases; Tiered Network Requirement; What Can We Learn from the Massachusetts Experience?; Notes; CHAPTER 3: Insurance Reforms; What is Insurance?
- Components of Health Insurance and Healthcare EntitlementSources of Coverage; Medicare; Medicaid; Self-Insured Employers; Small Group (Small Business) Insureds; Individual Insureds; Large Group--Business Not Self-Insuring; Uninsured; Health Insurers; How Do Health Insurers Provide Health Insurance?; Understanding Acturial Risk; How Does Self-Insurance Work?; Regional and Industry Factors in Health Insurance; The Reform of Health Insurance; Minimum Essential Coverage; Preventive Medicine Services; The Precious Metals of Health Insurance Policies; Defining Actuarial Value; Deductibles.