Planning health

Health Planning and Administration U.S. National Library of Medicine BRS, Data-Star, Dialog, Medlars health care delivery... 

The information that follows summarizes the findings of audits and site safety and health plan (SSAHP) reviews performed for eleven... 

OSHA found multiple defieieneies in the design, management, and implementation of safety and health plans at all the sites that it visited and in all of the plans reviewed. These defieieneies fell into twelve fune-tional areas and were often eommon to all the sites. A diseussion of the findings speeifie to eaeh funetional area follows. Note, for the remainder of this report, that the identities of the sites are masked and are referred to by a randomly assigned letter designation (Site A-K). 

The site-specific safety and health plan (SSAHP) mnst inclnde pro-cednres for implementing and enforcing safety and health rnles for all persons on site, inclnding employers, employees, ontside contractors, and visitors. 

The audit team found that at Sites B and H, safety and health personnel had suflfieient authority in most eases to thoroughly implement the safety and health plans. To faeilitate safety and health eom-plianee, anyone who entered Site H, ineluding delivery personnel, was required to view a brief video that summarized the site history and remediation operations, identified the hazardous substanees monitored on site, and deseribed site evaeuation proeedures. Site B s SSAHP did not mention speeifie subeontraetors and their roles and responsibilities however, it did indieate that the prime eontraetor had oversight responsibility for all safety and health aetivities and the authority to diseontinue or modify site operations when unsafe eonditions were deteeted. 

Review of the Site s Safety and Health Plan (SAHP)... 

Does the employer have an up-to-date written safety and health plan (SAHP) [OSHA Referenee. 120(b)(l)(i)]... 

Does the site-speeifie safety and health plan inelude at least the following elements ... 

Another external response to concerns about MCOs has been an increased interest in measuring the quality of care they deliver [35]. This interest has resulted in the development of numerous quality indicators. One example, HEDIS (Health Plan Employer Data and Information Set), is a standardized set of performance indicators used to compare health plans. Developed by the National Committee for Quality Assurance, HEDIS measures allow employers and employees to evaluate different plans. Only a small number of HEDIS indicators are related to medication use, but more drug-related indicators are likely to be added in the future. The use of quality indicators likely will increase as the measures become more refined and tested. 

A minimum coverage health plan could be established that would guaran-... 

Baumgartner J, Leeb T, Gruber T and Tiefenbacher R (2002), Pig health and health planning organic herds in Austria , Proceedings of the 5thNAHOWA Workshop, Rpdding, Denmark, 11-13 November 126-131. 

The work concerning farm-specific health plans and on-farm measures was funded by the European Commission in the framework of the Integrated project QualityLowInputFood (QLIF) and the Naturaplan Fund of the COOP supermarket group (Switzerland). 

Brown JS, Marcy SA. (1991) The use of botanicals for health purposes by members of a prepaid health plan. Res Nurs Health 14 339-350. 

At the same time, expenditures on pharmaceutical products continue to grow and often outpace expenditures for other consumer products. Pharmaceutical expenditures concern not only consumers, but government payers, private health plans, and employers as well. Generic drugs offer opportimities for significant cost savings over brand-name drug products. 

Gianfresco FD, Grogg AL, Mahmoud RA, et al. Differential effects of risperidone, olanzapine, clozapine, and conventional antipsychotics on type 2 diabetes findings from a large health plan database. / Clin Psychiatry 2002 63 920-30. 

Scheme negotiated prices with pharmaceutical companies, just as health plans do in the United States. Mr Vaile stated that such negotiations were fundamental policy of our government and consecutive governments in Australia. ... 

All health plans would receive a fixed-dollar subsidy for vaccine purchase and vaccine administration. The committee specified that the fixed-dollar subsidy be made a function of the social benefit of the vaccine for the groups for which the vaccine was mandated, but the subsidy would not necessarily equal the full social value. The subsidy would not reflect R D or on production costs. Although insurance coverage for particular vaccines... 

While the funded mandate would cover all insured persons, the voucher provision would cover uninsured children and adults, who would receive immunizations from health care providers oftheir choice, conditional onthe provider s being willing to accept the vouchers as payment in full. The value of the voucher would equal the fixed-dollar subsidy paid to health plans. Participating providers would collect the voucher at the time of service and submit it to the government for payment. The committee considered alternative approaches to the voucher system - from an electronic card system to simply reimbursing providers who submit a bill for each vaccination administered. The committee did not endorse any particular approach, although the hxed-dollar subsidy appears to have been preferred. 

Mandates have several justifications. Absent mandates, health plans may have an insufficient incentive to cover vaccines. Such coverage may not be demanded because individuals do not take account of the health and financial externalities in their purchase decisions (Summers 1989). Also, people may underestimate the probability of contracting various diseases (Jensen and Morrisey 1999). Vaccines are more likely to interfere with the spread of the disease than are drug treatments. As the probability of contracting a disease falls, fewer persons maybe expected to demand to be vaccinated for the disease. Also, market power of sellers of vaccines may be lower than for drug treatments. With drugs, persons who may benefit from the treatment are identifiable to sellers, thus allowing firms to extract consumer surplus... 

Huff-Rousselle, M. and F. Burnett. 1996. Cost Containment Through Pharmaceutical Procurement a Caribbean Case Study. International fournal Health Planning and Management 11 135-157. 

Health Planning and Administration ICC International Business Research International Pharmaceutical... 

Nanosys offers its employees a comprehensive health plan, basic life insurance, AD D, flexible time off, an employee referral program and stock options. 

The Health Plan Employer Data and Information Set (HED IS) is a health care report card created by NCQA. HEDIS standardizes health plan performance data and disseminates this information so that plans can be compared (O Malley, 1997). This allows health care purchasers and consumers to make informed choices (O Malley, 1997). HEDIS s performance domains include effectiveness of care, access and availability of care, health plan stability, use of services, cost of care, informed health care choices, satisfaction with the experience of care, and health plan descriptive information. 

Ovretveit J. 2001. Quality evaluation and indicator comparison in health care. Lnt J Health Plan Manag. HS. 

Smith J. 1992. EAPs evolve into health plan gatekeeper. Employee Benefit Plan Rev 46 18. 

As of 2008, pharmacies and pharmacists need to use a National Provider Identifier (NPI). This number will be used by all covered providers and health plans in transactions related to administration and financial transactions under the Health Insurance Portability and Accountability Act (HIPAA). Specifically, pharmacists will need to use their NPIs when billing PDPs for MTM services. The NPI is a numeric 10-digit unique identifier for providers (CMS, 2007b). It is available to any health care professional simply by completing an online form available at https //nppes. cms.hhs.gov/NPPES/Welcome.do. 

The type of education or management service offered may also influence compensation. For example, not all third-party payers cover preventive health education services such as weight-loss counseling or smoking cessation. If the service is not covered, the patient is personally responsible for the fees associated with the program. If it is not already known if the insurance carrier will or will not consider these services under the health plan, it would be prudent to contact the carrier before providing the service to a specific patient. In this way, the patient is aware of whether the services will be covered or if the patient will be responsible for the charges. 

Who is covered by the privacy rule The privacy rule considers health plans, health care providers, and health care clearinghouses as covered entities. Every health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity (DHHS, 2003b). This definition includes pharmacies. 

Medical record number, health plan number, account number, and/or prescription number... 

---