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Insurance, Health. --- Germany.

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Les tickets modérateurs existent en Belgique depuis près de 50 ans, et ils sont fort différenciés et complexes. À la demande de l'INAMI, le Centre Fédéral d'Expertise des Soins de Santé (KCE) a étudié un nombre de points sensibles importants. Le système gagnerait à être simplifié. Ainsi, les différences de tickets modérateurs en fonction du nombre de patients examinés pour les visites à domicile du médecin généraliste ou le lieu de la visite pourraient être supprimées. Plus la plus-value sociétale d'une intervention médicale est élevée, plus le ticket modérateur associé devrait être faible. Ceci devrait contribuer à des soins de santé efficaces et de meilleure qualité. Le KCE recommande donc de ne plus comptabiliser le ticket modérateur comme un pourcentage des honoraires médicaux ou du cout d'un médicament. Il importe d'élaborer une vision globale, dans laquelle les objectifs des tickets modérateurs seraient pris en compte.

2010-19 --- Cost-sharing --- Cost-sharing --- Cost-sharing --- Deductibles and Coinsurance --- Health Care Reform --- Health Care Reform --- Health Care Reform --- Health Services Accessibility --- Health Services Accessibility --- Health Services Accessibility --- Insurance, Health --- Insurance, Health --- Insurance, Health --- R186 --- W 74 Medical economics. Health care costs (General) --- W 74 Medical economics. Health care costs (General) --- W 74 Medical economics. Health care costs (General)

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Quatrième de couverture : "Virus du SIDA, grippe aviaire (H5N1), grippe A (H1N1) la menace d'une pandémie appartient désormais à notre quotidien. Drame humain majeur, ce risque sanitaire entraînerait de lourdes conséquences financières pour les assureurs. À l'exception de la grippe espagnole de 1918, nous ne disposons que de peu de repères pour modéliser, appréhender et calculer l'impact d'une pandémie. Les nouvelles normes européennes Solvabilité II qui entrent en vigueur en 2013 donnent obligation aux assureurs de cartographier l'ensemble des risques. Dès lors, comment modéliser une pandémie ? Comment évaluer son coût ? Comment transférer tout ou partie de ce risque à un tiers (réassureur, marchés financiers via la titrisation) ? Quelle stratégie de couverture choisir ? Cet ouvrage modélise, pour la première fois, le risque de pandémie et apporte ainsi des réponses claires à l'ensemble de ces questions. Il constitue un guide essentiel pour les compagnies d'assurance."

Stochastic Processes --- Insurance, Health --- Pandemics --- prevention and control --- AA / International- internationaal --- 368.00 --- Theorieën over verzekeringen. Actuariële wetenschappen --- Pandemics - prevention and control

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Professional Practice Location - economics - United States. --- Medicare --- Legislation as Topic --- Health Services Administration --- Social Sciences --- Fees and Charges --- Professional Practice --- North America --- Reimbursement Mechanisms --- Private Practice --- Medical Assistance --- Americas --- Health Care --- Social Control, Formal --- Anthropology, Education, Sociology and Social Phenomena --- Insurance, Health, Reimbursement --- Insurance, Health --- Health Care Economics and Organizations --- Financing, Organized --- Public Assistance --- Insurance --- Geographic Locations --- Financing, Government --- Geographicals --- Medicare Part B --- Medicare Part A --- United States --- Fee-for-Service Plans --- Organization and Administration --- Professional Practice Location --- Economics --- Medical care --- Medical policy

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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.

Medical policy. --- Health insurance. --- Health plans, Prepaid --- Insurance, Health --- Medical care, Prepaid --- Medical insurance --- Prepaid health plans --- Prepaid medical care --- Sickness insurance --- Health care policy --- Health policy --- Medical care --- Medicine and state --- Policy, Medical --- Public health --- Public health policy --- State and medicine --- Government policy --- Insurance --- Ambulance service --- Health care reform --- Home care services --- Hospitals --- Medically uninsured persons --- Surgical clinics --- Science and state --- Social policy --- Prospective payment --- Emergency services --- Outpatient services --- Rehabilitation services --- United States.