scholarly journals First steps towards price transparency: comparability of online out-of-pocket tools from Australian private health funds

2020 ◽  
Vol 44 (3) ◽  
pp. 347
Author(s):  
Kelsey Chalmers ◽  
Adam G. Elshaug ◽  
Shaun Larkin
Keyword(s):  
Claims Data ◽  
Private Insurance ◽  
Cost Information ◽  
Cost Estimates ◽  
Price Transparency ◽  
Online Tools ◽  
Procedure Cost ◽  
Insurance Funds ◽  
Health Insurance Funds ◽  
The Cost

Objective The aims of this study were to compare and contrast the information three Australian private health insurance funds (HCF, Bupa and Medibank) have provided on their online out-of-pocket cost tools and to consider the implications this has for price transparency in Australia. Methods Website data were downloaded from HCF, Bupa and Medibank on 18 February 2019. The information and statistics provided on these pages were reviewed, and the procedures compared across funds if their pages had referred to the same Medicare Benefits Schedule (MBS) item(s). Information was extracted regarding descriptions of the claims data used, the types of statistics provided, the out-of-pocket estimates, the total procedure cost, the MBS items referenced and the assumptions the funds described on their pages. Results HCF specified the MBS items used to select the claims data for their estimates, whereas Bupa and Medibank only referred to common MBS items associated with the procedures. On average, HCF had 1.44 more MBS items listed than Bupa and 2.08 more than Medibank. The funds organised procedures differently, such as HCF providing separate cost estimates for vaginal, abdominal and keyhole hysterectomy compared with Medibank’s single estimate for hysterectomy costs. Conclusions These funds have started to address the need for transparent out-of-pocket cost information, but the differences across these pages demonstrate complexities and the potential obfuscation of cost data. What is known about the topic? Out-of-pocket costs are highly variable and patient ‘bill shock’ is an increasing concern in Australia. Private insurance funds have created online tools to share procedure cost estimates based on their claims data. What does this paper add? This is the first review of Australian insurance funds’ price transparency tools. The cost information is difficult to interpret both within funds (for members) and across funds (for the system). What are the implications for practitioners? Policy makers will need to consider the complexities and presentation options for cost estimates within the health system if they move ahead with a public price transparency tool. There is still a requirement for cost information that can facilitate price shopping across providers and funders.

scholarly journals Using administrative and claims data in the GNC-study – how to overcome legal restrictions

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Janett Powietzka ◽  
Christoph Stallmann ◽  
Enno Swart
Keyword(s):  
Health Insurance ◽  
Informed Consent ◽  
Social Security ◽  
Data Protection ◽  
Claims Data ◽  
Legal Requirements ◽  
Data Owner ◽  
The Social ◽  
Insurance Funds ◽  
Health Insurance Funds

ABSTRACT ObjectivesThe German GNC-Health Study (GNC) will have duration of at least ten years and will compile medical examinations, biomaterials and computer assisted interviews of intended 200.000 participants (funding code: 01ER1301A). For the first time, this data collection will be supplemented with a multitude of administrative and claims data such as data of statutory health insurance funds, statutory pension funds as well as the Federal Employment Agency. The GNC extends this field of research to private health insurance funds, epidemiologic and clinical cancer and mortality registers. This supplementary use of claims data is strictly regulated by legal requirements. The challenges and solutions for scientific use of such data in Germany will be described. ApproachThe Social Security Code and data protection rules govern the scientific use of administrative data. These rules include requirements for the wording of important documents such as informed consent, release from confidentiality, participants’ information, data protection concept etc. and often an authorization process by the supervisory authority of the data owner. These complex tasks, which are time consuming costly and labour intensive, are tied into the GNC-Competence Network for secondary and registry data (CNSRD). ResultsThe GNC-CNSRD has helped to formulate legal informed consent for each data source, which describes the use of the information provided by the participants, as well as the period and limitation of its retro- and prospective use. Furthermore, only the GNC-trust agency is allowed to save the social security number but not the local study center. The modular consent process and the IT- and data protection concept of the GNC is a prototype to enable the large scale use of administrative and claims data of future epidemiologic studies in Germany. ConclusionUnfortunately, one of the biggest obstacles for the scientific use of administrative and claims data still remains unsolved. The application for data use at the local supervisory authority of the data owner requires the description and limitation of the research question and the period of use of this data. This is in conflict with the modern longitudinal design of GNC because it wants to establish a research structure and data base in order to answer a variety of future and unspecified research questions. Hence, current legal requirements in Germany prevent the full utilization of the potential of administrative and claims data. Therefore, the German Federal Commissioner for Data Protection and Freedom of Information recommended an amendment to the social law.

Information Requirements for Cost Estimating in the Automotive Industry

2003 ◽  
Author(s):  
Rajkumar Roy ◽  
Petros Souchoroukov ◽  
Harri S. Koponen
Keyword(s):  
Automotive Industry ◽  
Cost Estimation ◽  
Sources Of Information ◽  
Cost Estimating ◽  
Cost Information ◽  
Information Requirements ◽  
Cost Estimates ◽  
Market Competitiveness ◽  
The Cost ◽  
Product Costs

The automotive companies operate in a very competitive market. Competitiveness requires controlling product costs, and cost estimation is an important activity for this. Cost estimation requires quality information but the conducted research found several issues that hinder this activity, namely a lack of resources and information acquiring and validation difficulties. Data and Information requirements are a major issue in cost estimating. Research in cost estimating mainly focus on improving techniques and methodologies. There is a need to investigate the data and information requirements and corresponding sources of information for cost estimating. These issues have led to the extensive use of expert judgement. Experienced cost estimators use a variety of information resources and cost elements to create a cost estimate, and this causes communication issues. Better information is needed for both creating sound cost estimates and increasing understanding of these created cost estimates. This paper proposes a novel idea, an information infrastructure for automotive cost estimation to address the issue. The constructed Infrastructure provides relevant cost information needed to develop sound and robust cost estimates using a webportal design. It defines in depth the necessary cost information, explains why it is used and gives details where to find it and how to validate it. The research increases understanding of the cost estimation information requirements for the automotive industry.

scholarly journals Pharmacotherapy costs and medicines reimbursement policies of osteoporosis in the Republic of Bulgaria and Republic of North Macedonia

Pharmacia ◽  
2020 ◽  
Vol 67 (4) ◽  
pp. 199-207
Author(s):  
Lidija Chakuleska ◽  
Rumyana Simeonova ◽  
Nikolay Danchev
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
The Other ◽  
Reimbursement Policy ◽  
Ibandronic Acid ◽  
Number Of Patients ◽  
Insurance Funds ◽  
The Republic ◽  
Health Insurance Funds ◽  
The Cost

The aim of the present study was to analyze and compare the number of health insured persons suffering from osteoporosis and antiosteoporotic drugs reimbursed by the National Health Insurance Funds (NHIF) in the Republic of Bulgaria (RBG) and Republic of North Macedonia (RNM) for the period 2015–2018. The reimbursement cost paid by the NHIF for the same period in both countries was surveyed. The results show an increase in both the number of patients with osteoporosis and the cost of the treatment. The most prescribed drug in R. Bulgaria is denosumab and it has the highest costs respectively, while in R.N. Macedonia the most prescribed and respectively the most expensive treatment is the bisphosphonate ibandronic acid, tablets of 150 mg. The trend of rising costs in both countries is likely to continue due to the increasing number of patients with osteoporosis. The number of patients and cost of pharmacotherapy in RNM and RBG are increasing but the reimbursement policy in RNM is more restrictive in terms of reimbursed medicines. On the other side, the RNM is with a higher level of reimbursement that might positively affect the cost of pharmacotherapy.

scholarly journals A Review of Cost Estimates for Flood Adaptation

Water ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1646 ◽  
Author(s):  
Jeroen Aerts
Keyword(s):  
Unit Cost ◽  
Economic Assessment ◽  
Costs And Benefits ◽  
Construction Costs ◽  
Cost Information ◽  
Adaptation Measures ◽  
Cost Estimates ◽  
The Cost ◽  
Riverine Systems ◽  
Flood Adaptation

Floods are the most devastating of global natural disasters, and flood adaptation measures are needed to reduce future risk. Researchers have started to evaluate the costs and benefits of flood adaptation, but information regarding the cost of different flood adaptation measures is often not available or is hidden in non-peer-reviewed literature. Recent review studies have explored cost estimates for different aspects of flood adaptation, such as nature-based solutions. This study aims to contribute empirical data regarding the cost of flood adaptation by compiling peer-reviewed literature and research reports. The focus is on construction costs and expenses for operation and maintenance. This paper integrates the unit cost information of six main flood adaptation measure categories: (1) the flood-proofing of buildings, (2) flood protection, (3) beach nourishment and dunes, (4) nature-based solutions for coastal ecosystems, (5) channel management and nature-based solutions for riverine systems, and (6) urban drainage. Cost estimates are corrected for inflation and converted to U.S. dollars (2016). Measures are described, and cost figures for both developed and developing countries are provided. The results of this study can be used as input for economic-assessment studies on flood adaptation measures.

scholarly journals A cost analysis to address issues of budget constraints on the implementation of the indoor residual spray programme in two districts of Maputo Province, Mozambique

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Neide Canana
Keyword(s):  
Sensitivity Analysis ◽  
Cost Analysis ◽  
Financial Analysis ◽  
Indoor Residual Spraying ◽  
Economic Cost ◽  
Cost Information ◽  
Financial Cost ◽  
Provider Perspective ◽  
The Government ◽  
The Cost

Abstract Background It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions. Methods Cost information was collected retrospectively from the provider perspective, and both economic and financial costs were calculated. A “one-way” deterministic sensitivity analysis was performed. Results The average economic costs totaled US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. The average financial cost totaled US$69,174.83, with an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Vehicle, salary, and insecticide costs were the greatest contributors to overall cost in the economic and financial analysis, corresponding to 52%, 17%, and 13% in the economic analysis and 21%, 27%, and 22% in the financial analysis, respectively. The sensitivity analysis was adapted to a range of ± (above and under) 25% change. There was an approximate change of 14% in the average economic cost when vehicle costs were decreased by 25%. In the financial analysis, the average financial cost was lowered by 7% when salary costs were decreased by 25%. Conclusions Altogether, the current cost analysis provides an impetus for the consideration of targeted IRS operationalization within the available governmental budget, by using locally-available human resources as spray operators to decrease costs and having IRS rounds be correctly timed to coincide with the build-up of vector populations.

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

The Research and Development of Mechanical Product Turning Processing Cost Estimation System

2011 ◽  
Vol 121-126 ◽  
pp. 3612-3616
Author(s):  
Wen Quan Huang ◽  
Kai Shi Li ◽  
Hai Jun Liu
Keyword(s):  
Cost Estimation ◽  
Manufacturing Cost ◽  
Cost Information ◽  
Development Environment ◽  
Improve Design ◽  
Market Competitiveness ◽  
Processing Cost ◽  
Estimation System ◽  
The Cost ◽  
Time Standard

This paper adopts the method labor time standard, in the development environment of VC++, using Access database storage costs data, and the cost results output into Excel, developed mechanical product turning processing manufacturing cost estimation system. Using this system can realize turning processing cost estimation and feedback the cost information of mechanical product turning processing, make a design personnel to understand the cost information, to improve design, reduce the cost, improve the market competitiveness of products

scholarly journals Using Private Claims Data to Study the Cost of the Opioid Crisis

2018 ◽  
Vol 21 ◽  
pp. S183
Author(s):  
R Gelburd ◽  
A Russo
Keyword(s):  
Claims Data ◽  
Opioid Crisis ◽  
The Cost

Charter of the Kazan Society of Physicians for the provision of medical care to participants in the sickness funds established by law on June 3, 1912

1913 ◽  
Vol 13 (2) ◽  
pp. 91-110
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Medical Assistance ◽  
Medical Aid ◽  
Insurance Funds ◽  
The Law ◽  
Health Insurance Funds ◽  
The City

The Kazan Society of Physicians for the Provision of Medical Aid to the Participants of the Health Insurance Funds Established on the Basis of the Law of June 23, 1912 "has the goal of providing medical assistance to the participants of the Health Insurance Fund established on the basis of the Law of June 23, 1912 in the city of Kazan and its environs.

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