INQUIRY journal's Fall 2010 issue released

Topics include paying for health insurance and care, hospital mergers, integrated delivery of care, not-for-profit hospital CEO performance and pay in Connecticut, and more

ROCHESTER, NY (11/24/2010)(readMedia)-- The Fall 2010 issue of INQUIRY journal has been released, and includes a variety of timely articles on health insurance and care, hospital mergers, integrated delivery of care, not-for-profit hospital CEO performance and pay, nonprofit enterprises, and an editorial exploring whether health care reform's wellness incentives can save health care dollars - details and links to abstracts follow.

"CHIP Premiums, Health Status, and the Insurance Coverage of Children," by James Marton and Jeffery C. Talbert - This study found that introducing premiums into Kentucky's Children's Health Insurance Program (CHIP) reduced the duration of CHIP coverage for the average child, but children with chronic health conditions were less likely to drop the coverage than those without one of these conditions. Results indicated that 56 percent of families who lost CHIP found some type of alternative health coverage.

"Reforming Beneficiary Cost Sharing to Improve Medicare Performance," by Stephen Zuckerman, Baoping Shang, and Timothy Waidmann – This analysis shows that adding an out-of-pocket spending limit, and slightly raising deductibles and coinsurance would provide better safeguards for Medicare beneficiaries with high costs than Medicare's current benefit structure. Estimates suggest that policies to protect these Medicare beneficiaries with the greatest needs could be implemented in a way that would add little to overall program costs.

"Paying for Individual Health Insurance Through Tax-Sheltered Cafeteria Plans," by Mark A. Hall and Amy B. Monahan - Employees who buy individual health insurance outside the workplace use after-tax income, costing them from 20 to 50 percent more than others who buy equivalent group coverage. This paper explores some of the legal issues involved in paying for individual health insurance on a pre-tax basis through a "cafeteria plan," and how the new Patient Protection and Affordable Care Act will impact this area of the law.

"Hospital Mergers and Referrals in the United States: Patient Steering or Integrated Delivery of Care?" by Sayaka Nakamura - Results of this study show that low- or average-quality tertiary care hospitals exploit the monopoly power of non-tertiary care hospitals that they acquire to boost patient referrals to the acquiring facility. Hospital acquisitions by more distinguished tertiary care hospitals, however, appear to be motivated by objectives other than increasing referrals, such as better integrated delivery of care.

"Not-for-Profit Hospital CEO Performance and Pay: Some Evidence from Connecticut," by Jeffrey Kramer and Rexford E. Santerre - This study found that not-for-profit CEOs, at least in Connecticut, are motivated by pay incentives to increase the occupancy of privately insured patients at the expense of uncompensated care and public-pay patients. Thus, economic performance takes precedence over charitable performance at the margin.

Also featured in INQUIRY's fall issue:

"Meeting Community Needs," by Howard Berman - This McNerney Forum piece examines society's nonprofit sector. It is an excerpt from Berman's new book, Making a Difference: The Management and Governance of Nonprofit Enterprises, published by CCE Publications (see www.ccepublications.org for details).

"The View from Here: Can Reform's Prevention Incentives Help to Bend the Cost Curve?" by Alan C. Monheit – In this column, INQUIRY's editor examines the preventive care measures in the Patient Protection and Affordable Care Act, the potential behavioral responses to these recommendations, and the implications for possible cost reductions.

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INQUIRY, the journal of health care organization, provision, and financing, is in its 47th year. The nonprofit Excellus Health Plan, Inc., publishes INQUIRY; the journal maintains a freelance editorial staff and is run as an independent, peer-reviewed, quarterly academic journal. Press releases and article abstracts are available on the INQUIRY website at www.inquiryjournal.org under "Current Issue Table of Contents."