Perspectives on essential health benefits :: workshop report /
The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverag...
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| Sprache: | English |
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Washington, D.C. :
National Academies Press,
©2012.
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| Online-Zugang: | Volltext |
| Zusammenfassung: | The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children). Other provisions will go into effect during 2014, including the requirement for all individuals to purchase health insurance. In 2014, insurance purchasers will be allowed, but not obliged, to buy their coverage through newly established health insurance exchanges (HIEs)--marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance. The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits (EHBs). The Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend criteria and methods for determining and updating the EHBs. In response, the IOM convened two workshops in 2011 where experts from federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices. Essential health benefits summarizes the presentations in this workshop. The committee's recommendations will be released in a subsequent report. |
| Beschreibung: | 1 online resource (xvii, 164 pages) : illustrations |
| Bibliographie: | Includes bibliographical references. |
| ISBN: | 9780309215435 0309215439 9780309215442 0309215447 0309215463 9780309215466 |
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| 245 | 0 | 0 | |a Perspectives on essential health benefits : |b workshop report / |c Cheryl Ulmer, Bernadette McFadden, and Cassandra Cacace, rapporteurs ; Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans, Board on Health Care Services, National Research Council of the National Academies. |
| 246 | 3 | 0 | |a Essential health benefits |
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| 520 | |a The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children). Other provisions will go into effect during 2014, including the requirement for all individuals to purchase health insurance. In 2014, insurance purchasers will be allowed, but not obliged, to buy their coverage through newly established health insurance exchanges (HIEs)--marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance. The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits (EHBs). The Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend criteria and methods for determining and updating the EHBs. In response, the IOM convened two workshops in 2011 where experts from federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices. Essential health benefits summarizes the presentations in this workshop. The committee's recommendations will be released in a subsequent report. | ||
| 504 | |a Includes bibliographical references. | ||
| 505 | 0 | |a Introduction -- The policy context for essential health benefits -- Purchaser perspectives on the EHB -- State experiences with defining a minimum benefit standard -- Medical necessity and use of evidence -- Insurer decisions of benefit coverage and medical necessity -- Examining two categories of care in section 1302 -- Non-discrimination in the required elements for consideration -- Additional stakeholder perspectives -- Two private-sector approaches to benefit coverage and design -- Deciding what is essential and evidence-based in two states for public insurance programs -- Lessons from California's benefit review process -- Priority setting and value-based insurance design -- Assessing affordability and the potential for underinsurance. | |
| 588 | 0 | |a Print version record. | |
| 546 | |a English. | ||
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| 650 | 0 | |a Right to health |z United States |x States |v Congresses. | |
| 650 | 0 | |a Health insurance |z United States |x States |v Congresses. | |
| 650 | 0 | |a Health insurance |z United States |x Costs |x Forecasting |v Congresses. | |
| 650 | 0 | |a Medical care, Cost of |z United States |x Forecasting |v Congresses. | |
| 650 | 0 | |a Health services accessibility |z United States |v Congresses. | |
| 650 | 0 | |a Health care reform |z United States |v Congresses. | |
| 650 | 0 | |a Welfare economics |v Congresses. | |
| 650 | 0 | |a Fairness |v Congresses. | |
| 650 | 2 | |a Insurance Benefits |x economics |0 https://id.nlm.nih.gov/mesh/D007342Q000191 | |
| 650 | 2 | |a Insurance Benefits |x standards |0 https://id.nlm.nih.gov/mesh/D007342Q000592 | |
| 650 | 2 | |a Insurance, Health |x economics |0 https://id.nlm.nih.gov/mesh/D007348Q000191 | |
| 650 | 2 | |a State Health Plans |x economics |0 https://id.nlm.nih.gov/mesh/D013221Q000191 | |
| 651 | 2 | |a United States |0 https://id.nlm.nih.gov/mesh/D014481 | |
| 650 | 6 | |a Politique sanitaire |z États-Unis |x États |v Congrès. | |
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| 700 | 1 | |a Ulmer, Cheryl. |0 http://id.loc.gov/authorities/names/n2009180354 | |
| 700 | 1 | |a McFadden, Bernadette. |0 http://id.loc.gov/authorities/names/no2009191963 | |
| 700 | 1 | |a Cacace, Cassandra. |0 http://id.loc.gov/authorities/names/no2012014312 | |
| 710 | 2 | |a Institute of Medicine (U.S.). |b Board on Health Care Services. |0 http://id.loc.gov/authorities/names/no99064513 | |
| 710 | 2 | |a Institute of Medicine (U.S.). |b Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans. |0 http://id.loc.gov/authorities/names/no2012014691 | |
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| author2 | Ulmer, Cheryl McFadden, Bernadette Cacace, Cassandra |
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| author_GND | http://id.loc.gov/authorities/names/n2009180354 http://id.loc.gov/authorities/names/no2009191963 http://id.loc.gov/authorities/names/no2012014312 |
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| contents | Introduction -- The policy context for essential health benefits -- Purchaser perspectives on the EHB -- State experiences with defining a minimum benefit standard -- Medical necessity and use of evidence -- Insurer decisions of benefit coverage and medical necessity -- Examining two categories of care in section 1302 -- Non-discrimination in the required elements for consideration -- Additional stakeholder perspectives -- Two private-sector approaches to benefit coverage and design -- Deciding what is essential and evidence-based in two states for public insurance programs -- Lessons from California's benefit review process -- Priority setting and value-based insurance design -- Assessing affordability and the potential for underinsurance. |
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| id | ZDB-4-EBA-ocn777959279 |
| illustrated | Illustrated |
| indexdate | 2024-11-27T13:18:16Z |
| institution | BVB |
| institution_GND | http://id.loc.gov/authorities/names/no99064513 http://id.loc.gov/authorities/names/no2012014691 |
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| physical | 1 online resource (xvii, 164 pages) : illustrations |
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| spelling | Perspectives on essential health benefits : workshop report / Cheryl Ulmer, Bernadette McFadden, and Cassandra Cacace, rapporteurs ; Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans, Board on Health Care Services, National Research Council of the National Academies. Essential health benefits Washington, D.C. : National Academies Press, ©2012. 1 online resource (xvii, 164 pages) : illustrations text txt rdacontent computer c rdamedia online resource cr rdacarrier data file The Patient Protection and Affordable Care Act (herein known as the Affordable Care Act [ACA]) was signed into law on March 23, 2010. Several provisions of the law went into effect in 2010 (including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children). Other provisions will go into effect during 2014, including the requirement for all individuals to purchase health insurance. In 2014, insurance purchasers will be allowed, but not obliged, to buy their coverage through newly established health insurance exchanges (HIEs)--marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance. The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits (EHBs). The Department of Health and Human Services requested that the Institute of Medicine (IOM) recommend criteria and methods for determining and updating the EHBs. In response, the IOM convened two workshops in 2011 where experts from federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices. Essential health benefits summarizes the presentations in this workshop. The committee's recommendations will be released in a subsequent report. Includes bibliographical references. Introduction -- The policy context for essential health benefits -- Purchaser perspectives on the EHB -- State experiences with defining a minimum benefit standard -- Medical necessity and use of evidence -- Insurer decisions of benefit coverage and medical necessity -- Examining two categories of care in section 1302 -- Non-discrimination in the required elements for consideration -- Additional stakeholder perspectives -- Two private-sector approaches to benefit coverage and design -- Deciding what is essential and evidence-based in two states for public insurance programs -- Lessons from California's benefit review process -- Priority setting and value-based insurance design -- Assessing affordability and the potential for underinsurance. Print version record. English. United States. Patient Protection and Affordable Care Act Congresses. Patient Protection and Affordable Care Act (United States) fast Medical policy United States States Congresses. Right to health United States States Congresses. Health insurance United States States Congresses. Health insurance United States Costs Forecasting Congresses. Medical care, Cost of United States Forecasting Congresses. Health services accessibility United States Congresses. Health care reform United States Congresses. Welfare economics Congresses. Fairness Congresses. Insurance Benefits economics https://id.nlm.nih.gov/mesh/D007342Q000191 Insurance Benefits standards https://id.nlm.nih.gov/mesh/D007342Q000592 Insurance, Health economics https://id.nlm.nih.gov/mesh/D007348Q000191 State Health Plans economics https://id.nlm.nih.gov/mesh/D013221Q000191 United States https://id.nlm.nih.gov/mesh/D014481 Politique sanitaire États-Unis États Congrès. Droit à la santé États-Unis États Congrès. Assurance-maladie États-Unis États Congrès. Assurance-maladie États-Unis Coût Prévision Congrès. Soins médicaux Coût États-Unis Prévision Congrès. Services de santé Accessibilité États-Unis Congrès. Services de santé Réforme États-Unis Congrès. Économie du bien-être Congrès. Impartialité Congrès. MEDICAL Administration. bisacsh MEDICAL Practice Management & Reimbursement. bisacsh Fairness fast Health care reform fast Health insurance Costs Forecasting fast Health insurance U.S. states fast Health services accessibility fast Medical care, Cost of Forecasting fast Medical policy U.S. states fast Right to health U.S. states fast Welfare economics fast United States fast https://id.oclc.org/worldcat/entity/E39PBJtxgQXMWqmjMjjwXRHgrq Conference papers and proceedings fast Ulmer, Cheryl. http://id.loc.gov/authorities/names/n2009180354 McFadden, Bernadette. http://id.loc.gov/authorities/names/no2009191963 Cacace, Cassandra. http://id.loc.gov/authorities/names/no2012014312 Institute of Medicine (U.S.). Board on Health Care Services. http://id.loc.gov/authorities/names/no99064513 Institute of Medicine (U.S.). Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans. http://id.loc.gov/authorities/names/no2012014691 has work: Perspectives on essential health benefits (Text) https://id.oclc.org/worldcat/entity/E39PCH3CvXjRjQBbjDxCRTFWKq https://id.oclc.org/worldcat/ontology/hasWork Print version: Perspectives on essential health benefits. Washington, D.C. : National Academies Press, ©2012 9780309215442 (OCoLC)754743035 FWS01 ZDB-4-EBA FWS_PDA_EBA https://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&AN=433032 Volltext |
| spellingShingle | Perspectives on essential health benefits : workshop report / Introduction -- The policy context for essential health benefits -- Purchaser perspectives on the EHB -- State experiences with defining a minimum benefit standard -- Medical necessity and use of evidence -- Insurer decisions of benefit coverage and medical necessity -- Examining two categories of care in section 1302 -- Non-discrimination in the required elements for consideration -- Additional stakeholder perspectives -- Two private-sector approaches to benefit coverage and design -- Deciding what is essential and evidence-based in two states for public insurance programs -- Lessons from California's benefit review process -- Priority setting and value-based insurance design -- Assessing affordability and the potential for underinsurance. United States. Patient Protection and Affordable Care Act Congresses. Patient Protection and Affordable Care Act (United States) fast Medical policy United States States Congresses. Right to health United States States Congresses. Health insurance United States States Congresses. Health insurance United States Costs Forecasting Congresses. Medical care, Cost of United States Forecasting Congresses. Health services accessibility United States Congresses. Health care reform United States Congresses. Welfare economics Congresses. Fairness Congresses. Insurance Benefits economics https://id.nlm.nih.gov/mesh/D007342Q000191 Insurance Benefits standards https://id.nlm.nih.gov/mesh/D007342Q000592 Insurance, Health economics https://id.nlm.nih.gov/mesh/D007348Q000191 State Health Plans economics https://id.nlm.nih.gov/mesh/D013221Q000191 Politique sanitaire États-Unis États Congrès. Droit à la santé États-Unis États Congrès. Assurance-maladie États-Unis États Congrès. Assurance-maladie États-Unis Coût Prévision Congrès. Soins médicaux Coût États-Unis Prévision Congrès. Services de santé Accessibilité États-Unis Congrès. Services de santé Réforme États-Unis Congrès. Économie du bien-être Congrès. Impartialité Congrès. MEDICAL Administration. bisacsh MEDICAL Practice Management & Reimbursement. bisacsh Fairness fast Health care reform fast Health insurance Costs Forecasting fast Health insurance U.S. states fast Health services accessibility fast Medical care, Cost of Forecasting fast Medical policy U.S. states fast Right to health U.S. states fast Welfare economics fast |
| subject_GND | https://id.nlm.nih.gov/mesh/D007342Q000191 https://id.nlm.nih.gov/mesh/D007342Q000592 https://id.nlm.nih.gov/mesh/D007348Q000191 https://id.nlm.nih.gov/mesh/D013221Q000191 https://id.nlm.nih.gov/mesh/D014481 |
| title | Perspectives on essential health benefits : workshop report / |
| title_alt | Essential health benefits |
| title_auth | Perspectives on essential health benefits : workshop report / |
| title_exact_search | Perspectives on essential health benefits : workshop report / |
| title_full | Perspectives on essential health benefits : workshop report / Cheryl Ulmer, Bernadette McFadden, and Cassandra Cacace, rapporteurs ; Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans, Board on Health Care Services, National Research Council of the National Academies. |
| title_fullStr | Perspectives on essential health benefits : workshop report / Cheryl Ulmer, Bernadette McFadden, and Cassandra Cacace, rapporteurs ; Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans, Board on Health Care Services, National Research Council of the National Academies. |
| title_full_unstemmed | Perspectives on essential health benefits : workshop report / Cheryl Ulmer, Bernadette McFadden, and Cassandra Cacace, rapporteurs ; Committee on Defining and Revising an Essential Health Benefits Package for Qualified Health Plans, Board on Health Care Services, National Research Council of the National Academies. |
| title_short | Perspectives on essential health benefits : |
| title_sort | perspectives on essential health benefits workshop report |
| title_sub | workshop report / |
| topic | United States. Patient Protection and Affordable Care Act Congresses. Patient Protection and Affordable Care Act (United States) fast Medical policy United States States Congresses. Right to health United States States Congresses. Health insurance United States States Congresses. Health insurance United States Costs Forecasting Congresses. Medical care, Cost of United States Forecasting Congresses. Health services accessibility United States Congresses. Health care reform United States Congresses. Welfare economics Congresses. Fairness Congresses. Insurance Benefits economics https://id.nlm.nih.gov/mesh/D007342Q000191 Insurance Benefits standards https://id.nlm.nih.gov/mesh/D007342Q000592 Insurance, Health economics https://id.nlm.nih.gov/mesh/D007348Q000191 State Health Plans economics https://id.nlm.nih.gov/mesh/D013221Q000191 Politique sanitaire États-Unis États Congrès. Droit à la santé États-Unis États Congrès. Assurance-maladie États-Unis États Congrès. Assurance-maladie États-Unis Coût Prévision Congrès. Soins médicaux Coût États-Unis Prévision Congrès. Services de santé Accessibilité États-Unis Congrès. Services de santé Réforme États-Unis Congrès. Économie du bien-être Congrès. Impartialité Congrès. MEDICAL Administration. bisacsh MEDICAL Practice Management & Reimbursement. bisacsh Fairness fast Health care reform fast Health insurance Costs Forecasting fast Health insurance U.S. states fast Health services accessibility fast Medical care, Cost of Forecasting fast Medical policy U.S. states fast Right to health U.S. states fast Welfare economics fast |
| topic_facet | United States. Patient Protection and Affordable Care Act Congresses. Patient Protection and Affordable Care Act (United States) Medical policy United States States Congresses. Right to health United States States Congresses. Health insurance United States States Congresses. Health insurance United States Costs Forecasting Congresses. Medical care, Cost of United States Forecasting Congresses. Health services accessibility United States Congresses. Health care reform United States Congresses. Welfare economics Congresses. Fairness Congresses. Insurance Benefits economics Insurance Benefits standards Insurance, Health economics State Health Plans economics United States Politique sanitaire États-Unis États Congrès. Droit à la santé États-Unis États Congrès. Assurance-maladie États-Unis États Congrès. Assurance-maladie États-Unis Coût Prévision Congrès. Soins médicaux Coût États-Unis Prévision Congrès. Services de santé Accessibilité États-Unis Congrès. Services de santé Réforme États-Unis Congrès. Économie du bien-être Congrès. Impartialité Congrès. MEDICAL Administration. MEDICAL Practice Management & Reimbursement. Fairness Health care reform Health insurance Costs Forecasting Health insurance U.S. states Health services accessibility Medical care, Cost of Forecasting Medical policy U.S. states Right to health U.S. states Welfare economics Conference papers and proceedings |
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