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| http://dx.doi.org/10.1080/17571472.2008.11493200 | DOI Listing |
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Unpacking Performance Factors of Innovation Systems and Studying Germany's Attempt to Foster the Role of the Patient Through a Market Access Pathway for Digital Health Applications (DiGAs): Exploratory Mixed Methods Study.
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Working Group for Data-Driven Innovation, Hamburg University of Technology, Hamburg, Germany.
Background: Health care innovation faces significant challenges, including system inertia and diverse stakeholders, making regulated market access pathways essential for facilitating the adoption of new technologies. The German Digital Healthcare Act, introduced in 2019, offers a model by enabling digital health applications (DiGAs) to be reimbursed by statutory health insurance, improving market access and patient empowerment. However, the factors influencing the success of these pathways in driving innovation remain unclear.
View Article and Find Full Text PDFTubal Sterilization And Vasectomy Increased Among US Young Adults After The Supreme Court Decision In 2022.
Health Aff (Millwood)
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Julie Maslowsky, University of Michigan, Ann Arbor, Michigan.
Young adults' access to contraception is shifting after the June 2022 United States Supreme Court decision. This concurrent mixed-methods study measured young adults' use of and perceptions about tubal sterilization and vasectomy after the leaked opinion in May 2022. Using national-level medical claims data from IQVIA, we conducted difference-in-differences analyses of tubal sterilizations and vasectomies by age and state policy; using open-text survey responses from national MyVoice surveys in 2022 and 2023, we thematically analyzed young adults' perspectives.
View Article and Find Full Text PDFMedicare Risk Adjustment: Goals, Reform Proposals, And New Frontiers.
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Aaron L. Schwartz University of Pennsylvania and Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
Risk adjustment modifies payments to health insurers based on enrollee characteristics that are predictive of higher or lower medical spending. Risk-adjustment policy is a key ingredient for the success of regulated individual insurance markets in Medicare and beyond. Researchers have identified shortcomings of Medicare's current risk-adjustment system, illustrated the limits of coarse fixes, and proposed new strategies that improve the data and calculations used to generate beneficiary risk scores.
View Article and Find Full Text PDFResearch on quantitative evaluation of medical insurance fraud supervision policy based on 'Antecedents-Process-Outcomes' framework.
PLoS One
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School of Management, Wuhan University of Technology, Wuhan, Hubei Province, China.
Fraud in medical insurance is a serious problem that threatens the safety and sustainability of medical insurance funds. The process of reducing or even eliminating the impact of fraud is related to maintaining the balance of payments for medical insurance funds and reforming the payment system based on total amount control. As a result of reviewing the policy background of medical insurance fraud in China, combined with the policy evaluation model in the area of public management, this paper develops a conceptual framework of 'Antecedents-Process-Outcomes' that emphasizes the fraud and governance of medical insurance funds.
View Article and Find Full Text PDFCost-effectiveness of the SMILE intervention compared with usual care for people with severe mental illness: A randomized clinical trial.
PLoS One
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Department of Health Sciences, Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Objectives: Only studying effectiveness of lifestyle interventions for people with severe mental illness (SMI) is insufficient for policy making. As budgets for healthcare are limited, policy makers face the problem of allocating scarce healthcare resources. Cost-effectiveness studies are needed, but currently cost-effectiveness studies of lifestyle interventions for people with SMI delivered in ambulatory care are limited.
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