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The Commission's approach to the problems described in this chapter has been to focus on strengthening and balancing the relationship between the individual insurance applicant, policyholder, or claimant and the insurance institution with whom he deals. As indicated at the outset, the Commission's recommendations have three objectives: (1) to c

The Commission's approach to the problems described in this chapter has been to focus on strengthening and balancing the relationship between the individual insurance applicant, policyholder, or claimant and the insurance institution with whom he deals. As indicated at the outset, the Commission's recommendations have three objectives: (1) to c

Every member of a modern society acts out the major events and transitions of his life with organizations as attentive partners. Each of his countless transactions with them leaves its mark in the records they maintain about him. The uniqueness of this record-generating pressure cannot be overemphasized. Never before the Twentieth Century have org

The imbalance in the relationship between individuals and record-keeping institutions today is pointedly illustrated by the experiences of Catherine Tarver, a "welfare mother" from the State of Washington, and Mitchell Miller, a businessman from Kathleen, Georgia.

This report is about records and people. It looks toward a national policy to guide the way public and private organizations treat the records they keep about individuals. Its findings reflect the fact that in American society today records mediate relationships between individuals and organizations and thus affect an individual more easily, more

Site Visits to FEHB Health Plans Conducted through a contract between the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services and in conjunction with the U.S. Office of Personnel Management; and subcontracts between ROW Sciences and the University of Maryland School of Medicine, RAND Health, Harvar

Descriptive findings on FEHB plans’ parity implementation were obtained using data for two time periods (pre- and post-parity) from the Parity Reporting Requirement (PRR), which was completed by all FEHB plans that remained in the FEHB Program continuously from 1999 to 2002. 37 Findings on FEHB plans’ benefit design changes in response to the

The PERT studied the effect of parity on quality of care for adults by using established standards of care for treating specific disorders, i.e., depression and substance abuse, to create indicators of quality following the methods developed by several investigators (c.f. Berndt et. al 1997; Lehman and Steinwachs, 1998). The methods described in t

Implementing parity required changing the nominal benefits for coverage of treating mental health and substance abuse (MH/SA) disorders. The dimensions of the nominal benefit that are most often affected when parity policies are implemented are:

This chapter addresses the intermediate and long-term impacts of the parity policy on access to care, service use, cost, and quality of care, as illustrated in the evaluation logic model in Figure II-I. The research questions, data sources and collection methods, and analysis methods relating to cost, access, utilization, and quality that we summa

PERT researchers acquired nominal plan benefits information on the 304 FEHB plans with available benefit design information and participating in the FEHB in 1999, the baseline year of the evaluation. This information was obtained from the OPM website for all four years of the evaluation (1999-2002). To compile information on benefits in each of

As part of the Office of Personnel Management’s (OPM’s) contract with the FEHB plans, each health plan was required to submit to the OPM a report on implementing mental health and substance abuse (MH/SA) parity in the first quarter of 2002 and in the first quarter of 2003. 12 The report, The Parity Reporting Requirement (PRR), designed by P

The Federal Employees Health Benefits (FEHB) Program evaluation addressed changes in cost, access, utilization, and quality as a result of the parity policy. Additionally, the evaluation focused on adverse selection arising from the managed competition that exists in the FEHB Program. Adverse selection refers to the tendency for individuals to c

How was the FEHB Parity Policy Implemented? All of the FEHB plans complied with the parity policy, most incurred no added administrative costs, and none reported major problems with implementation. The policy change enhanced MH/SA benefits for FEHB Program enrollees. Table 1 shows the key research questions regarding how the parity policy was im

Edwards, W.S., & Edwards, B. (1989). National Medical Expenditure Survey questionnaire and date collection methods for the Institutional Population Component: Methods 1 . Hyattsville, MD: National Center for Health Services Research. Hauber, F.A., Bruininks, R.H., Wieck, C.A., Sigford , B.B., & Hill, B.K. (1981). 1978-1979 in-depth nat

The sample size and broad coverage of mental retardation facilities and residents in the Institutional Population Component of NMES will yield much information of value regarding the residential living arrangements of persons with mental retardation and related conditions. At the same time the study's sample frame limitations, and thereby its samp

Table 7 and Table 8 present basic resident movement statistics for calendar year 1986 for ICF-MR and noncertified facilities by type of operation and size. Movement is expressed as a percentage of the "current residents." Movement data were based on Facility Questionnaire responses, but included only facilities open for all of 1986.

Table 5 and Table 6 present basic administrative statistics for ICF-MR and noncertified facilities by type of operation and facility size. The statistics presented on facility capacity, current residents and certified capacity have the limitations discussed above. Proportion of Capacity Occupied

1. Inclusion of statutory rape in reporting requirements Mandated reporters are required to notify the appropriate authorities of all cases of suspected abuse. [599] The definition of abuse makes specific reference to children who are victims of sexual activity that constitutes a crime listed in the “Sexual Offenses” chapter of the statut

1. Inclusion of statutory rape in reporting requirements Mandated reporters are required to report all cases where they know or have reasonable cause to suspect that a child has been a victim of abuse. [582] The definition of an abused child includes the sexual offenses listed in the previous section. It does not include any provisions indica