Related Experiment Video
Updated: Aug 8, 2026
14:43
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Risk-rated health insurance programs: a review of designs and important issues
M A Kaelin1, J K Barr, T Golaszewski
1Department of Health Professions, Montclair State College, New Jersey.
American Journal of Health Promotion : AJHP
|October 5, 1992
Summary
Individually risk-rated health insurance plans are increasing, requiring careful consideration of implementation, verification, and social responsibility. Health promotion professionals must ensure these plans are socially acceptable and cost-beneficial.
Area of Science:
- Health Promotion
- Preventive Medicine
- Employee Benefits
Background:
- Individually risk-rated health insurance plans are becoming more common.
- These plans use various administrative procedures, verification strategies, and economic incentives/disincentives.
- Implementation raises significant questions about verification, cost-effectiveness, employee control, and social responsibility.
Purpose of the Study:
- To assist health promotion professionals in implementing individually risk-rated health insurance plans.
- To introduce the concept of individually risk-rated health insurance.
- To review selected plans and explore implementation, administration, and appropriateness issues.
Main Methods:
- Review based on authors' knowledge of preventive medicine, health promotion, and employee benefits literature.
- Selection of six risk-rated health insurance programs demonstrating National Association of Insurance Commissioners' Model implementation.
- Focus on administrative procedures, verification strategies, and economic incentives/disincentives.
Main Results:
- Individually risk-rated health insurance programs utilize diverse administrative approaches and verification methods.
- The adoption of these programs is on the rise.
- Key implementation challenges include lifestyle behavior verification, cost savings, employee control over risk factors, and social responsibility.
Conclusions:
- Widespread adoption necessitates addressing business, medical, ethical, and legal issues.
- Refinement of risk-rating programs is crucial.
- The health promotion community must ensure socially acceptable implementation and cost-beneficial outcomes.
Related Concept Videos
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
01:15Bioequivalence Experimental Study Designs: Repeated Measures, Cross-Over, Carry-Over, and Latin Square Designs
Bioequivalence experimental study designs play a pivotal role in testing the effectiveness of various treatments. Key among these are the repeated measures, cross-over, carry-over, and Latin square designs. In the repeated measures design, each subject receives all treatments, allowing for temporal comparisons. This type of design is useful in reducing variability but requires careful planning to avoid bias.The cross-over design, an economical method, involves sequential administration of...
01:11Hazard Rate
The hazard rate, also known as the hazard function or failure rate, is a statistical measure used to describe the instantaneous rate at which an event occurs, given that the event has not yet happened. From a probabilistic perspective, it represents the likelihood that a subject will experience the event in a very small time interval, conditional on surviving up to the beginning of that interval. In terms of frequency, the hazard rate can be viewed as the ratio of the number of events to the...
01:12Hazard Ratio
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial evaluating a...
For example, in a clinical trial evaluating a...