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Related Concept Videos

Introduction To Health Care Delivery System01:18

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Methods Of Healthcare Delivery System01:26

Methods 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...
Preventive Healthcare Services01:30

Preventive Healthcare Services

Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Health Information Technology and Healthcare Information System01:30

Health 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:
Standards of Care I01:22

Standards of Care I

Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:

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Related Experiment Video

Updated: Jul 11, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
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

State-sponsored programs for the uninsured: is there adverse selection?

E H Kilbreth1, A F Coburn, C McGuire

  • 1Institute for Health Policy, Edmund S. Muskie School of Public Service, University of Southern Maine, Portland 04104-9300, USA.

Inquiry : a Journal of Medical Care Organization, Provision and Financing
|November 11, 1998
PubMed
Summary
This summary is machine-generated.

States offering subsidized health coverage to previously uninsured individuals found similar service use compared to employer plans. This suggests manageable risk for state programs aiming to expand insurance access.

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Area of Science:

  • Health Services Research
  • Health Economics
  • Public Health Policy

Background:

  • State programs face challenges in predicting healthcare costs for newly insured populations.
  • Understanding service utilization is crucial for effective risk contracting and program design.

Purpose of the Study:

  • To evaluate the healthcare service utilization patterns of previously uninsured individuals enrolled in state-subsidized managed care plans.
  • To assess the feasibility and potential risks associated with expanding coverage to low-income, uninsured populations.

Main Methods:

  • Analysis of utilization data from two state programs providing subsidized coverage.
  • Comparison of service use between program participants and individuals covered by large employer plans.
  • Examination of factors influencing service access and satisfaction.

Main Results:

  • Program participants exhibited service utilization comparable to those in large employer health plans.
  • No significant evidence of pent-up demand or excessive chronic illness was observed.
  • While underutilization was minimal, nonwhite enrollees reported higher dissatisfaction and service barriers.

Conclusions:

  • State-subsidized managed care programs can effectively cover previously uninsured populations with predictable utilization patterns.
  • Addressing service barriers and ensuring equitable access for all enrollees is essential for program success.
  • Findings support the viability of state-led initiatives to expand health insurance coverage.