Abstract The way a country finances its health care system is a key determinant of the health of its citizenry. Selection of an adequate and efficient method s of financing in addition to organizational delivery structure for health services is essential if a country is set to achieve its national health objective of providing health for all. Health care in Nigeria is financed by tax revenue, out-of-pocket payments, donor funding, and health insurance social and community. However, achieving successful health care financing system continues to be a challenge in Nigeria.
It also helps to improve health care quality and affordability for all Americans. Here is where your health care dollar really goes. Specifically, the analysis shows the inflation-adjusted average annual amounts paid by commercial health insurance plans in for the medical care of plan members; the average annual amounts paid for general operating expenses of the health plan in ; and the average annual reported profit or loss in AHIP randomly selected a total sample of 30 health plans: Plans were selected from a list of all health plans that had the majority of their business i.
The not-for-profit plans sample was further reduced by excluding three plans that had just started operations inone plan that ceased operations as an independent entity during the study period, and four plans that lacked publicly available statutory information.
To estimate operating costs and profitability, for the five publicly-traded insurance companies, their 10K filings with the Securities and Exchange Commission were examined; while operating expense and profitability data for private, not-for-profit organizations were extracted from their Form s, filed with the Internal Revenue Service.
We were unable to obtain a Form for one plan in and two plans inthus, their operating expenses and profits are the average of two-years of data.
Since the analysis used multiple years of data, all expenditure data from and were adjusted for inflation and expressed in dollars. Bureau of Labor Statistics www. Only those patients under the age of 65 on the date of service who had evidence of continuous health plan enrollment for the entire period in each study year, or and had prescription drug coverage were included.
Claims having missing payment information; missing dates of service; and in the case of the inpatient and outpatient services claims, missing data on whether the claim was submitted by the facility or the physician were excluded from the study. The net payment amounts of all included claims for each study year were summed Only those revenues attributable to premium payments from health plan members were recorded for each plan for each year Revenues from sources other than premium payments, such as from other business segments or investment income, for example, were excluded.
For each plan, the average revenue across the three years was calculated. Amounts paid for taxes were also recorded. For each plan, an average total operating cost and an average net profit were calculated across the three years and recorded.
These calculations were performed for each plan for each year and recorded. These two averages were then weighted by the share of commercial enrollment for the publicly-traded, for-profit plans and the not-for-profit plans in based on AIS data and combined.
The average total operating expense calculated across all plans was further subcategorized into the key functional areas summarized in Table 2. The proportions of the average total operating costs attributable to each of these core administrative functions was determined by the consulting firm, Milliman, Inc.
This proprietary benchmarking model is based on data collected from more than health plans and third-party administrators. For this study, the model was adjusted to reflect the study-specific health plans sampled with respect to plan size, enrollment, and business mix.In any field, improving performance and accountability depends on having a shared goal that unites the interests and activities of all stakeholders.
In health care, however, stakeholders have. 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 leslutinsduphoenix.com broad terms, health economists study the functioning of healthcare systems and health-affecting behaviors such as smoking.
A seminal article by Kenneth Arrow, often credited with giving rise to health. The way a country finances its health care system is a key determinant of the health of its citizenry. Selection of an adequate and efficient method(s) of financing in addition to organizational delivery structure for health services is essential if a country is set to achieve its national health objective of providing health for all.
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Its aim is to guide alcohol policy and the medical treatment of alcohol problems with facts, data and information. Jun 29, · For several years during the s, health care costs were rising rapidly, causing concern among patients and insurance companies.
According to the November issue of the Journal of the.
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Your premium—how much you pay for your health insurance coverage each month—helps cover the costs of the medications and care you receive.