Financing mental health and substance use disorder care within physical health: a look to the future.

After sharing several case examples of health care for patients who have mental health/substance use disorders (MH/SUDs) in the current health care environment, this article describes the advantages that would occur if assessment and treatment of MH/SUDs became a clinical, administrative, and financial part of physical health with common provider networks, the ability to combine service locations (integrated clinics and inpatient units), similar coding and billing procedures, and a single funding pool. Because transition to such a system is complicated, the article then describes several process changes that would be required for integrated service delivery to take place.

Future trends in dental benefits.

Dentistry and dental payment systems as we know them today will continue to evolve. Dentistry as practiced today and the prepayment systems of dentistry are substantially different than they were fifty years ago when dental insurance as we know it was first developed. Dentistry has always changed with the development of our science and the expression of dentistry's diseases in the populations we serve. The changes that are likely to occur in the future will be focused on improving health outcomes across risk-analyzed populations with the goals of providing optimal health outcomes at reasonable costs. Dentists will increasingly become engaged in the whole health of their patients. Where sufficient correlations can be leveraged between dentistry and overall health, medical plans will play an increasing role in dentistry's future for two reasons. Given favorably altered therapeutic outcomes for medical systems that preserve scarce resources, it will be an economic imperative to engage the dental system. It will also be the right thing to do from a total health perspective. In the final analysis, this elevates the role of dentistry and empowers the dentist to participate in the total health of their patients.

Industry economics in the United States.

Demand for medical equipment in the United States (US) is projected to grow by 8% between 2001 and 2006, to reach 105 billion dollars. In 2001,the market was valued at 71.4 billion dollars, based on an annual growth of 7.5% between 1996 and 2001, according to The Freedonia Group. Product innovation and the growing ageing population is driving the industry, despite health-care cost containment measures. Medical and surgical instruments continue to be the largest sector, which is expected to grow to 30.5 billion dollars in 2006. However, electromedical/electrotherapeutic apparatus will remain the fastest growing sector, with annual gains of 10.8% predicted for this period.

How much do kids count in corporate board rooms? Results from the first survey of Fortune 1000 companies.

OBJECTIVE: The objective of this study was to characterize the extent of the business community's commitment to children, particularly with respect to understanding its role in assuring children's health and development, by conducting a survey of the largest US companies. METHODS: A survey of year 2001 Fortune 1000 companies was performed to determine whether their mission statements, vision statements, or guiding principles include a commitment to children; whether they employ people under the age of 18 years in the United States; whether they encourage their employees to mentor children under the age of 18 years; whether they have an affiliated philanthropic foundation; whether their company's philanthropy focuses specifically on children; and whether they participate in any activities that particularly help disadvantaged children. The survey consisted of 2 mailings followed by phone calls to companies to obtain answers to the questions listed above and answers to additional questions that asked specifically about the company's financial expenditures for parental leave, child care, and healthcare for children of employees and about the company's specific philanthropic giving aimed at helping children. Descriptive information about some of the ways that companies impact the lives of children was also obtained to provide context for the responses. RESULTS: Data were obtained from 333 year 2001 Fortune 1000 companies (33%) between March 20, 2002 and March 20, 2003, with a good representation of all industry sectors. These data suggest that approximately 33% of the companies that responded have mission statements, vision statements, or guiding principles that specifically include a commitment to children. Employment opportunities for children under the age of 18 years in the United States exist at approximately 41% of these companies. These companies clearly see mentoring as a major theme, with 77% of them encouraging their employees to mentor children under the age of 18 years. Approximately 60% of the companies that responded support affiliated, independent philanthropic foundations, and approximately 55% of companies indicated that they focus their philanthropy specifically (although not exclusively) on children. Approximately 80% of these companies indicated that they participate in at least one activity that helps disadvantaged children. Many companies faced challenges in estimating their overall investments in children, particularly given their large and decentralized nature, but they were able to provide an overall sense of their commitment and they indicated that they could provide quantitative data prospectively if they knew it would be requested. CONCLUSION: Many companies that responded play a major role in supporting children's health and development in the United States both directly and indirectly. Further efforts to better quantify the business community's aggregate commitments to improving children's health and development should be sought to allow better estimation of the amount of resources expended and the impact of these investments on children.

Medicaid and indigent care issue brief: Medicaid: benefits and services: year end report-2003.

Medicaid provides health care insurance for low-income children, some parents who meet income thresholds, pregnant women, the elderly and the disabled. In order to receive federal funds for Medicaid, each state must offer coverage for the following health care services: inpatient and outpatient hospital services; physician services; medical and surgical dental services; nursing facility services; home health care services; family planning services; rural health clinic services; laboratory and x-ray services; pediatric and family nurse practitioner services; federally qualified health center services; nurse-midwife services; and early and periodic screening, diagnosis and treatment (EPSDT) services for individuals under age 21. States can also choose to cover certain additional services under their Medicaid plans, and these often include prescription drugs, dental services (nonmedical or surgical), clinic services, and vision and hearing services. It is up to each state to decide what optional services to include with the mandated services to create their Medicaid benefit package.

Medicaid and indigent care issue brief: Medicaid: eligibility: year end report-2003.

Medicaid provides health insurance coverage to low-income children, parents meeting specific income thresholds, pregnant women, the elderly and people with disabilities. In 1999, Medicaid provided health care insurance to approximately 32 million low-income Americans. However, in that same year, 42 million Americans had no health insurance at all. In order to reduce the number of people without health insurance, states have expanded or clarified their eligibility standards to allow more people to enroll in Medicaid and other medical assistance programs.

Medicaid and indigent care issue brief: Medicaid: services covered: year end report-2002.

Medicaid provides health care insurance for low-income children, some parents who meet income thresholds, pregnant women, the elderly and the disabled. In order to receive federal funds for Medicaid, each state must offer coverage for the following health care services: inpatient and outpatient hospital services; physician services; medical and surgical dental services; nursing facility services; home health care services; family planning services; rural health clinic services; laboratory and x-ray services; pediatric and family nurse practitioner services; federally qualified health center services; nurse-midwife services; and early and periodic screening, diagnosis and treatment (EPSDT) services for individuals under age 21. States can also choose to cover certain additional services under their Medicaid plans, and these often include prescription drugs, dental services (nonmedical or surgical), clinic services, and vision and hearing services. It is up to each state to decide what optional services to include with the mandated services to create their Medicaid benefit package.

A regional survey of health insurance coverage for complementary and alternative medicine: current status and future ramifications.

OBJECTIVE: The purpose of this survey is to evaluate the extent of health insurance coverage for complementary and alternative medicine (CAM) within one region in the United States, a study prompted by the increased utilization of CAM. DESIGN: Prospective telephone interview of health insurance representatives. LOCATION: A contiguous three-state area (New York, New Jersey, and Connecticut) in the North-east. RESULTS: Almost all of the insurers surveyed cover chiropractic services. Less than half of the insurers reimburse acupuncture, usually for chronic pain management. Coverage for massage therapy is minimal and usually associated with physical therapy or chiropractic treatment. Other CAM services receive negligible coverage. CONCLUSIONS: Current health insurance coverage of CAM is limited essentially to chiropractic medicine, acupuncture and massage therapy. Coverage of CAM is made confusing by different policies, practitioner requirements, and health plans within each carrier.