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In a previous paper (1990), we estimated the distribution of durations of uninsured spells for which the beginning could be observed. We raised the concern that uninsured spells that were in progress when the Survey of Income and Program Participation began might not be proportionally represented in a sample of uninsured spells restricted to spells with observed beginnings. This paper includes spells in progress when SIPP began. Including left-censored spells, and correcting for length bias inherent in such spells, does not fundamentally change our previous estimate of the distribution.

The evolution of provider compensation arrangements including health maintenance organizations and capitated payment plans and reasons for the growing disinterest in such plans is discussed. Government's possible role in insuring health care providers against the financial risks they face is another topic.

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Objective. To determine the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. Data Source/Study Setting. Twelve months of claims before and 12 months following a 2003 policy change, which included the elimination of the behavioral health benefit for selected Oregon Medicaid enrollees. Study Design.

We used a series of case studies of first-generation consumer-directed health plans to investigate their early experience and the suitability of their design for reducing the growth in health benefit spending and improving the value of that spending.We found three fundamental but correctible weaknesses: Most plans do not make available comparative measures of quality and longitudinal cost-efficiency in enough detail to help consumers discern higher-value health care options; financial incentives for consumers are weak and insensitive to differences in value among the selections that consume

BACKGROUND: TennCare expanded Medicaid coverage, substituting managed care for fee-for-service reimbursement in Tennessee. METHODS: To study effects of TennCare on utilization of obstetric care (office visits, prenatal tests, care at labor/delivery), we used a before (1993) and after (1995) design with North Carolina as a control state. Data came from interviews with women with various forms of insurance, delivering in 1993 or 1995 in both states. Multivariate logistic analysis was used to control for other utilization determinants (eg, demographic factors).

Objective. Tort reform may affect health insurance premiums both by reducing medical malpractice premiums and by reducing the extent of defensive medicine. The objective of this study is to estimate the effects of noneconomic damage caps on the premiums for employer-sponsored health insurance. Data Sources/Study Setting. Employer premium data and plan/establishment characteristics were obtained from the 1999 through 2004 Kaiser/HRET Employer Health Insurance Surveys. Damage caps were obtained and dated based on state annotated codes, statutes, and judicial decisions. Study Design.

Objective. To examine the effect of premiums and benefits on the health plan choices of older enrollees who choose Federal Employees Health Benefits Program (FEHBP) health plans as their primary payer.

Data Sources. Administrative enrollment data from the Office of Personnel Management (OPM) and plan premiums and benefits data taken from the Checkbook Guide to health plans.

A comparative study was conducted in two neighboring states, Tennessee and North Carolina, to determine whether Medicaid managed care (implemented in Tennessee as TennCare) affected prenatal care, care patterns at labor-delivery, and birth outcomes. A pre- and post-design coupled with a difference-in-difference approach--using North Carolina as a control--was used to assess TennCare's effects for all births and for three categories of high-risk mothers (under age eighteen, unwed, or living in high poverty areas).

OBJECTIVE: To conduct the first national study that assesses whether the Medicaid expansions for pregnant women, legislated by Congress over a decade ago, met the policy objectives of improved access to care and birth outcomes for poor and near-poor women. DATA SOURCES/STUDY SETTING: Data on 8.1 million births using the 1980, 1986, and 1993 National Natality Files. We use births from all areas of the United States except California, Texas, Washington, and upstate New York.

To what extent do health benefits obtained in the employment-based setting reflect individual preferences?  We examine this question by comparing the relationship between person-level characteristics and the plans they obtain in a group setting to the relationship observed in the individual insurance market, using data from the 1996-1997 and 1998-1999 Community Tracking Study's Household Surveys.  We also examine the effect of unions on group choice.  Our structural models of the demand for insurance indicate that plans obtained in the group setting often reflect underlying i