ABSTRACT
Based on data from a 1999 national survey of 1,939 randomly selected employers, this paper examines the policies that affect the percentage of workers eligible for and enrolled in a firm's health plan. In 1994, 14 percent of employees worked for a firm offering cash-back payments, but fewer than 1 percent worked for a firm with income-related premiums or deductibles. The strongest determinants of eligibility rates are the waiting time for new employees before they are deemed eligible, and eligibility standards for part-time workers. The primary determinants of the take-up rate are lowest monthly employee contribution for single coverage, and the percentage of the workforce earning less than $20,000 per year.
Subject(s)
Community Participation , Health Benefit Plans, Employee/statistics & numerical data , Data Collection , Deductibles and Coinsurance , Eligibility Determination , Employee Incentive Plans , Health Benefit Plans, Employee/organization & administration , Insurance Coverage , Multivariate Analysis , Organizational Policy , United StatesABSTRACT
This paper examines trends in out-of-pocket spending for insured workers from 1990 to 1997. Data are from the Consumer Expenditure Survey conducted by the U.S. Bureau of Labor Statistics. The survey collects detailed quarterly data on all consumer spending from logs kept each year by more than 10,000 households with job-based health insurance. During the study period, total out-of-pocket spending in constant dollars remained unchanged. Spending for medical expenses, drugs, and supplies declined by 23 percent, but this decline was offset by rising employee contributions for health insurance premiums. The shift to managed care, whose benefit structure requires less cost sharing, may have played a role in reducing out-of-pocket spending.
Subject(s)
Financing, Personal/statistics & numerical data , Health Benefit Plans, Employee , Health Expenditures/statistics & numerical data , Health Expenditures/trends , Fees and Charges/trends , Financing, Personal/trends , Health Benefit Plans, Employee/statistics & numerical data , Health Benefit Plans, Employee/trends , Health Care Surveys , Health Maintenance Organizations/economics , Health Maintenance Organizations/statistics & numerical data , Humans , Income/classification , Insurance, Health/statistics & numerical data , Prospective Payment System/economics , United StatesSubject(s)
Fee-for-Service Plans/trends , Health Benefit Plans, Employee/trends , Insurance Coverage/trends , Choice Behavior , Fee-for-Service Plans/economics , Fees and Charges/trends , Health Benefit Plans, Employee/economics , Health Services Research , Humans , Insurance Coverage/economics , Managed Care Programs/economics , Managed Care Programs/trends , Surveys and Questionnaires , United StatesABSTRACT
In recent years, the health care industry has experienced considerable growth in organizations that are national in focus-organizations that operate in multiple markets not all clustered in one geographic region. This study summarizes information on trends in ownership of various types of health care organizations (i.e., HMOs, PPOs, hospitals, physician practices) for purposes of assessing the growth rate of national companies and the overall significance of this phenomenon. This is followed by a synthesis of factors that encourage or impede the growth of national managed care companies, the sector that has exhibited the most pronounced growth of national companies. We discuss likely future directions and the degree to which national companies may enjoy long-term competitive advantages.
