In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and healthcare. Health economics is important in determining how to improve health outcomes and lifestyle patterns through interactions between individuals, healthcare providers and clinical settings. In broad terms, health economists study the functioning of healthcare systems and health-affecting behaviors such as smoking, diabetes, and obesity.
Mark Barr McClellan is the director of the Robert J Margolis Center for Health Policy and the Margolis Professor of Business, Medicine and Health Policy at Duke University. Formerly, he was a senior fellow and director of the Health Care Innovation and Value Initiative at the Engelberg Center for Health Care Reform at The Brookings Institution, in Washington, D.C. McClellan served as commissioner of the United States Food and Drug Administration under President George W. Bush from 2002 through 2004, and subsequently as administrator of the Centers for Medicare and Medicaid Services from 2004 through 2006.
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing for-profit health care and providing American health insurance while improving the quality of that care. It has become the essentially exclusive system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
In health insurance in the United States, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the top insurer's or administrator's clients.
Maccabi Health Services, known as Kupat Holim Maccabi, is one of the four Health Maintenance Organizations (HMOs) currently active in Israel. It was founded in September 1940 and began operating in August 1941. Since 1995 Maccabi has been operating under the National Health Insurance Law. Membership fees for HMOs in Israel are legally determined and are collected from those entitled to membership by the Institute for National Insurance.
Sir Angus Stewart Deaton is a British-American economist and academic. Deaton is currently a Senior Scholar and the Dwight D. Eisenhower Professor of Economics and International Affairs Emeritus at the Princeton School of Public and International Affairs and the Economics Department at Princeton University. His research focuses primarily on poverty, inequality, health, wellbeing, and economic development.
Healthcare in the Netherlands can be divided in several ways: firstly in three different echelons; secondly in somatic versus mental healthcare; and thirdly in "cure" versus "care". Home doctors form the largest part of the first echelon. Being referred by a first echelon professional is frequently required for access to treatment by the second and third echelons, or at least to qualify for insurance coverage for that treatment. The Dutch health care system is quite effective in comparison to other western countries but is not the most cost-effective. Costs are said to be high because of over-use of in-patient care, institutionalised psychiatric care and elderly care.
Health insurance in the United States is any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
An integrated delivery system (IDS), also known as integrated delivery network (IDN), is a health system with a goal of logical integration of the delivery (provision) of health care as opposed to a fragmented system or a disorganized lack of system.
Anne Osborn Krueger is an American economist. She was the World Bank Chief Economist from 1982 to 1986, and the first deputy managing director of the International Monetary Fund (IMF) from 2001 to 2006. She is currently the senior research professor of international economics at the Johns Hopkins School of Advanced International Studies in Washington, D.C. She also is a senior fellow of Center for International Development and the Herald L. and Caroline Ritch Emeritus Professor of Sciences and Humanities' Economics Department at Stanford University.
Nyman's model was developed by John A. Nyman beginning in 1999 and presents an alternative view of moral hazard in the context of private health insurance in the United States. Nyman is a professor of Economics at the University of Minnesota.
Amy Nadya Finkelstein is a professor of economics at the Massachusetts Institute of Technology (MIT), the co-director and research associate of the Public Economics Program at the National Bureau of Economic Research, and the co-Scientific Director of J-PAL North America. She was awarded the 2012 John Bates Clark Medal for her contributions to economics. She was elected to the National Academy of Sciences and won a MacArthur "Genius" fellowship in 2018.
Janet Currie is a Canadian-American economist and the Henry Putnam Professor of Economics and Public Affairs at Princeton University's School of Public and International Affairs, where she is Co-Director of the Center for Health and Wellbeing. She served as the Chair of the Department of Economics at Princeton from 2014–2018. She also served as the first female Chair of the Department of Economics at Columbia University from 2006–2009. Before Columbia, she taught at the University of California, Los Angeles and at the Massachusetts Institute of Technology. She was named one of the top 10 women in economics by the World Economic Forum in July 2015. She was recognized for her mentorship of younger economists with the Carolyn Shaw Bell award from the American Economics Association in 2015.
Ariél Stanley Pakes is the Thomas Professor of Economics at Harvard University. He specializes in econometrics and industrial organization.
Trevon D'Marcus Logan is the Hazel C. Youngberg Trustees Distinguished Professor in the Department of Economics and Associate Dean of the College of Arts and Sciences at The Ohio State University, where he was awarded the 2014 Alumni Award for Distinguished Teaching. He is also a Research Associate at the National Bureau of Economic Research. In 2014, he was the youngest-ever president of the National Economic Association. In 2019, he was the inaugural North Hall Economics Professor at the University of California, Santa Barbara. In 2020, he was named the inaugural director of the National Bureau of Economic Research Working Group on Race and Stratification in the Economy. His research mainly focuses on economic history, including studies of African American migration, economic analysis of illegal markets, the economics of marriage transfers, and measures of historical living standards, with an emphasis on racial disparities in the United States.
Tufts Health Plan is a Massachusetts-based health insurance company under Tufts Associated Health Plans, Inc. with headquarters in Watertown, Massachusetts.
Robert A. Pollak is an economist. Pollak has made contributions to the specification and estimation of consumer demand systems, social choice theory, the theory of the cost of living index, and since the early 1980s, to the economics of the family and to demography. He is currently the Hernreich Distinguished Professor of Economics at Washington University in St Louis, holding joint appointments in the Faculty of Arts & Sciences and in the Olin Business School.
Kathleen M. McGarry is a Professor of Economics at the University of California, Los Angeles and a Research Associate of the National Bureau of Economic Research. She is also a co-investigator of the Health and Retirement Survey. From 2007 to 2009, she was Joel Z. and Susan Hyatt ‘72 Professor in the Department of Economics at Dartmouth College. She has served on the Editorial Boards of the American Economic Journal: Public Policy, the American Journal of Health Economics, and the Journal of Pension Economics.
Petra Persson is a Swedish economist and Assistant Professor in Economics at Stanford University. Persson is best known for her work in Public and Labour Economics where her research focuses on the interactions between family decisions and the policy environment. Specifically, Persson's research agenda is centered on studying government policy, family wellbeing, and informal institutions.
