Containing Health Benefit Costs

1. Front Matter

   Pages i-viii

   PDF

2. Context and Issues

   1. Front Matter

      Pages 1-1

      PDF

   2. Industry-Insurer Relationships—A Dynamic Interaction

      • Richard H. Egdahl, Diana Chapman Walsh

      Pages 2-11

   3. A Spectrum of Financing and Administrative Alternatives

      • Richard H. Egdahl, Diana Chapman Walsh

      Pages 12-18

   4. Shaving Percentage Points Off Administrative Costs

      • Richard H. Egdahl, Diana Chapman Walsh

      Pages 19-31

   5. Using Claims Data to Contain Health Care Costs

      • Richard H. Egdahl, Diana Chapman Walsh

      Pages 32-52

3. Purchaser Perspectives: Four Corporations

   1. Front Matter

      Pages 53-53

      PDF

   2. American Telephone and Telegraph Company

      • Richard W. Stone, Michael J. Gulotta, Donald P. Harrington

      Pages 55-59

   3. Mobil Oil Corporation

      • Robert B. Peters, Jack H. Bleuler, David H. Winkworth

      Pages 60-64

   4. Deere and Company

      • Kevin Stokeld

      Pages 65-68

   5. Polaroid Corporation

      • Galt Grant

      Pages 69-72

4. Administering the Benefit: Third-Party Views

   1. Front Matter

      Pages 73-73

      PDF

   2. Prudential Insurance Company of America

      • Lesley L. Ralson

      Pages 74-78

   3. Blue Cross-Blue Shield of Greater New York

      • Steven Sieverts

      Pages 79-88

   4. U. S. Administrators

      • Samuel X. Kaplan

      Pages 89-98

   5. United Mine Workers of America Health and Retirement Funds

      • Stephen C. Caulfield

      Pages 99-116

   6. United Storeworkers Security Plan

      • William Michelson, Eleanor J. Tilson

      Pages 117-120

5. An Action Plan

   1. Front Matter

      Pages 121-121

      PDF

   2. Industry and Insurer Interventions to Control the Costs of Health Benefits

      • William J. Bicknell, Brant Kelch

      Pages 122-161

   3. Legal Considerations

      • John D. Blum

      Pages 163-178

The springboard for this sixth volume in the Industry and Health Care series was a conference sponsored by the Center for Industry and Health Care of Boston University on June 9 and 10, 1978. That conference had a gradual genesis. Over a year ago we spent some time with Kevin Stokeld of Deere and Company and heard his views on self-insurance and self-administration as one device for a corporation to achieve better management control of its health benefit. More recent discussions with representatives of American Telephone and Telegraph Company and other corporations made it increasingly clear to us that management's need for data to monitor the use of employee health benefits was emerging as a critical policy issue. Subsequent meetings with executives at John Hancock Mutual Life Insurance Company in Boston and Mobil Oil Corporation in New York, among others, convinced us that simple answers would be elusive or inadequate and that there was a need for an objective and careful look at the evolving relationships between employee health benefits, claims administration, health services utilization, and corpo­ rate health care cost containment programs. Since self-funding and particularly self-administration represent a fun­ damental change in the traditional insurance relationship, the conference was convened to explore the advantages and disadvantages of self-insurance for employee health benefits, with some attention to claims production but with special emphasis on the originating question of data for effective management of an employee health benefit.

• Finanzierung
• Gesundheitswesen
• Health
• Krankenversicherung
• Vereinigte Staaten /Finanzwirtschaft, Finanzpolitik
• Vereinigte Staaten /Sozialpolitik, Sozialarbeit
• Vereinigte Staaten /Versicherungen
• attention
• care
• health care
• health services
• intervention
• management
• production
• relationships

• Center for Industry and Health Care, Boston University Health Policy Institute, Boston, USA

  Richard H. Egdahl, Diana Chapman Walsh

Policies and ethics