External Review of Health Plan Decisions — Policy Brief December 30, 1998 Issue Brief An 8-page policy brief on the external review of health plan decisions to inform the policy debate in California and nationally. The policy brief covers external review systems in other states and the Medicare program, the current status of external review in California, and issues regarding the design and implementation…
Setting Capitation Rates for HIV/AIDS Care: A Primer for Ryan White CARE Act Title IV Project January 30, 1998 Report Setting Capitation Rates for HIV/AIDS Care: A Primer for Ryan White CARE Act Title IV ProjectReport: Setting Capitation Rates for HIV/AIDS Care: A Primer for Ryan White CARE Act Title IV Projects
Managed Care Plan Liability: An Analysis of Texas and Missouri Legislation October 30, 1997 Report This report analyzes recently enacted laws in Texas and Missouri that expand consumers' ability to sue their HMOs or other managed care plans for inappropriately denied care or similar problems.Report Report
The Impact of Managed Care Legislation: An Analysis of Five Legislative Proposals from California October 30, 1997 Report This study analyzed five 1997 managed care consumer protection proposals currently or recently under consideration by the California state legislature: allowing consumers to sue their HMO (health maintenance organization) or managed care plan; expanding access to prescription drugs not approved by the health plan; expanded coverage of mental health services;…
Protection in Managed Care Plans: A Side-by-Side Comparison of Proposal Federal Legislation June 29, 1997 Report Protection in Managed Care Plans: A Side-by-Side Comparison of Proposed Federal Legislation. A side-by-side comparison of the provisions for consumer protection in managed care plans contained in the House and Senate budget reconciliation bills and in eight other consumer protection bills currently under consideration by Congress. These bills, which would…
The New Dominance of Managed Care: Insurance Trends in the 1990s December 30, 1996 Report Report: Managed Care and the Small Group Market Report: Small Group Reform and Insurance Provision by Small Firms, 1989-1995
Kaiser/HRET Survey: 2002 State Employee Health Plans July 1, 2003 Report Kaiser/HRET Survey: 2002 State Employee Health PlansState employee health plans provided coverage for 3.4 million state government employees in 2002. The Kaiser/HRET Survey: 2002 State Employee Health Plans finds that premiums for state employee health plans increased 12.8% in 2002, similar to national averages. It also finds that state employee…
Medicare Prescription Drugs Through Private Drug-Only Plans: A Discussion with Actuaries May 31, 2003 Report Central to the current debate over Medicare prescription drug coverage is the role of private insurance plans in providing drug benefits to Medicare beneficiaries. This report offers views from health actuaries knowledgeable about the Medicare program and the prescription drug debate on key issues that emerge for potential plan sponsors,…
Paying for Choice: The Cost Implications of Health Plan Options For People on Medicare January 1, 2003 Report This report illustrates the financial stakes for Medicare beneficiaries when making choices about supplemental insurance coverage, by examining how much people on Medicare could spend out-of-pocket including premiums and other cost-sharing requirements under different supplemental insurance options. To assess the cost implications of choosing between different Medigap and Medicare+Choice insurance…