%0 Book %A Transportation Research Board %A National Academies of Sciences, Engineering, and Medicine %T Airport Insurance Coverage and Risk Management Practices %D 2011 %U https://nap.nationalacademies.org/catalog/14611/airport-insurance-coverage-and-risk-management-practices %> https://nap.nationalacademies.org/catalog/14611/airport-insurance-coverage-and-risk-management-practices %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 51 %X TRB’s Airport Cooperative Research Program (ACRP) Synthesis 30: Airport Insurance Coverage and Risk Management Practices identifies both the variables that affect insurance purchasing for airport operators and the range of risk management practices that exist among U.S. airports. The report is designed to help airport officials confronted with risk-financing and insurance-purchasing decisions. %0 Book %A Transportation Research Board %A National Academies of Sciences, Engineering, and Medicine %E Parker, Terri %E Stevenson, Laurel %T Due Diligence for Insurance Coverage in Transportation Construction Contracts %D 2015 %U https://nap.nationalacademies.org/catalog/22107/due-diligence-for-insurance-coverage-in-transportation-construction-contracts %> https://nap.nationalacademies.org/catalog/22107/due-diligence-for-insurance-coverage-in-transportation-construction-contracts %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 70 %X TRB's National Cooperative Highway Research Program (NCHRP) Legal Research Digest 66: Due Diligence for Insurance Coverage in Transportation Construction Contracts explores the process of "due diligence," in which a transportation agency acquires objective and accurate information about its insurance companies and contractors in order to evaluate the risks of entering into an agreement and a contractual relationship. The report addresses the common issues faced by the agencies such as: proof of coverage; difficulty of interpretation of specification and insurance language; coverage disputes; lapse in coverage; and qualifying contractors for the bidding process. %0 Book %A National Research Council %E Plewes, Thomas J. %T Databases for Estimating Health Insurance Coverage for Children: A Workshop Summary %@ 978-0-309-16240-1 %D 2010 %U https://nap.nationalacademies.org/catalog/13024/databases-for-estimating-health-insurance-coverage-for-children-a-workshop %> https://nap.nationalacademies.org/catalog/13024/databases-for-estimating-health-insurance-coverage-for-children-a-workshop %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Behavioral and Social Sciences %K Surveys and Statistics %P 204 %X This report summarizes the proceedings of a workshop convened in June 2010 to critically examine the various databases that could provide national and state-level estimates of low-income uninsured children and could be effectively used as criteria for monitoring children's health insurance coverage. %0 Book %A Institute of Medicine %T Coverage Matters: Insurance and Health Care %@ 978-0-309-07609-8 %D 2001 %U https://nap.nationalacademies.org/catalog/10188/coverage-matters-insurance-and-health-care %> https://nap.nationalacademies.org/catalog/10188/coverage-matters-insurance-and-health-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 203 %X Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers. %0 Book %A Transportation Research Board %A National Academies of Sciences, Engineering, and Medicine %E Wells, Catherine B. %E Raese, Olivia %T Airport Insurance Requirements %D 2023 %U https://nap.nationalacademies.org/catalog/26908/airport-insurance-requirements %> https://nap.nationalacademies.org/catalog/26908/airport-insurance-requirements %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 86 %X An airport’s insurance program is just one component of its overall risk management program. An insurance program can be quite complex, addressing types of coverage, limits, retention amounts, and legal and contractual issues, among other factors. The TRB Airport Cooperative Research Program's ACRP Research Report 248: Airport Insurance Requirements provides best practices for airports developing an insurance program, including requirements for contracts with third parties doing business at the airport. Supplemental to the report are a Brochure and Insurance Coverage Templates. %0 Book %T Shared-Risk Insurance Pools for Transit Agencies: A Guide %D 2023 %U https://nap.nationalacademies.org/catalog/27419/shared-risk-insurance-pools-for-transit-agencies-a-guide %> https://nap.nationalacademies.org/catalog/27419/shared-risk-insurance-pools-for-transit-agencies-a-guide %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 68 %X Transit agencies are finding it increasingly difficult to find, purchase, and maintain adequate and affordable insurance coverage for public transit vehicles. The number of smaller insurance providers is decreasing due to the volatile nature and demands of the insurance industry and insurance coverage requirements in general. NCHRP Research Report 1079: Shared-Risk Insurance Pools for Transit Agencies: A Guide, from TRB's National Cooperative Highway Research Program, explains how insurance pools function, how to evaluate the feasibility of a shared-risk insurance pool, and how to establish and manage this type of pool. Supplemental to report is a presentation and NCHRP Web-Only Document 374: Developing a Guide to Shared-Risk Insurance Pools for Transit Agencies: Conduct of Research Report. %0 Book %A Transportation Research Board %A National Academies of Sciences, Engineering, and Medicine %T Availability and Accessibility of Liability and Excess Insurance for Public Transit and Private Coach Operators %D 2005 %U https://nap.nationalacademies.org/catalog/23321/availability-and-accessibility-of-liability-and-excess-insurance-for-public-transit-and-private-coach-operators %> https://nap.nationalacademies.org/catalog/23321/availability-and-accessibility-of-liability-and-excess-insurance-for-public-transit-and-private-coach-operators %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 35 %X TRB’s National Cooperative Highway Research Program (NCHRP) Research Results Digest 295: Availability and Accessibility of Liability and Excess Insurance for Public Transit and Private Coach Operators examines alternatives to conventional liability insurance coverage for public transit agencies and private motorcoach (coach) operators in response to the insurance crisis of the early 2000s, which has had, and continues to have, a significant impact on the cost and availability of liability insurance coverage. %0 Book %A Institute of Medicine %T Care Without Coverage: Too Little, Too Late %@ 978-0-309-08343-0 %D 2002 %U https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late %> https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 212 %X Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital--based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million -- one in seven--working--age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash. %0 Book %A Institute of Medicine %T Health Insurance is a Family Matter %@ 978-0-309-08518-2 %D 2002 %U https://nap.nationalacademies.org/catalog/10503/health-insurance-is-a-family-matter %> https://nap.nationalacademies.org/catalog/10503/health-insurance-is-a-family-matter %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 296 %X Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well—being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects. %0 Book %A Institute of Medicine %T America's Uninsured Crisis: Consequences for Health and Health Care %@ 978-0-309-12789-9 %D 2009 %U https://nap.nationalacademies.org/catalog/12511/americas-uninsured-crisis-consequences-for-health-and-health-care %> https://nap.nationalacademies.org/catalog/12511/americas-uninsured-crisis-consequences-for-health-and-health-care %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 237 %X When policy makers and researchers consider potential solutions to the crisis of uninsurance in the United States, the question of whether health insurance matters to health is often an issue. This question is far more than an academic concern. It is crucial that U.S. health care policy be informed with current and valid evidence on the consequences of uninsurance for health care and health outcomes, especially for the 45.7 million individuals without health insurance. From 2001 to 2004, the Institute of Medicine (IOM) issued six reports, which concluded that being uninsured was hazardous to people's health and recommended that the nation move quickly to implement a strategy to achieve health insurance coverage for all. The goal of this book is to inform the health reform policy debate—in 2009—with an up-to-date assessment of the research evidence. This report addresses three key questions: What are the dynamics driving downward trends in health insurance coverage? Is being uninsured harmful to the health of children and adults? Are insured people affected by high rates of uninsurance in their communities? %0 Book %A National Research Council %E Leibowitz, Arleen %E Pollack, Earl S. %T Data Needs for the State Children's Health Insurance Program %@ 978-0-309-08463-5 %D 2002 %U https://nap.nationalacademies.org/catalog/10416/data-needs-for-the-state-childrens-health-insurance-program %> https://nap.nationalacademies.org/catalog/10416/data-needs-for-the-state-childrens-health-insurance-program %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Behavioral and Social Sciences %K Surveys and Statistics %P 72 %X The State Children's Health Insurance Program (SCHIP) was established by Congress to provide health insurance to uninsured children whose family income was too high for Medicaid coverage but too low to allow the family to obtain private health insurance coverage. The enabling legislation for SCHIP, included in the Balanced Budget Act of 1997, made available to states (and the District of Columbia) almost $40 billion over a 10-year period for this program. Like Medicaid, SCHIP is a joint federal-state program, with funding from both sources, but it is implemented by the states. Thus, there are SCHIP programs in all of the states and the District of Columbia. The National Research Council, through the Committee on National Statistics, was asked to explore some of the ways in which data analysis could be used to promote achievement of the SCHIP goal of expanding health insurance coverage for uninsured children from low-income families. To inform its work, the panel for this project held a workshop to bring together state SCHIP officials and researchers to share findings and methods that would inform the design, implementation, and evaluation of SCHIP at the state and national levels. In keeping with this charge, this report is limited to discussions at the workshop. It does not attempt to provide a summary of all the state programs nor a comprehensive review of the literature. Data Needs for the State Children's Health Insurance Program concludes that data are insufficient in the individual states to provide a clear picture of the impact of SCHIP on the number of children who are eligible for the program, the rate at which eligible children are enrolled in the program, and the rate at which they are retained in the program once enrolled. This situation is due, in part, to the fact that sample sizes in national surveys are too small to provide detailed data for individual states. In addition, the great amount of movement of children among health insurance categories—Medicaid, SCHIP, private insurance, or no insurance at all—makes it difficult for states to count the number of children in specific categories at a particular point in time. The panel specifies a number of practices that could be implemented to improve the overall functioning of SCHIP and the ability of policy makers to evaluate the program. Foremost among these are: (1) developing more uniform ways of estimating eligibility and health insurance coverage among the states; (2) sharing among the states effective methods for outreach; (3) taking qualitative information into account, in addition to quantitative information, in assessing variation among states in enrollment and disenrollment; and (4) implementing longitudinal studies to track the movement of children among the various insurance statuses. %0 Book %A Institute of Medicine %A National Research Council %E O'Grady, Michael J. %E Wunderlich, Gooloo S. %T Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care %@ 978-0-309-26604-8 %D 2012 %U https://nap.nationalacademies.org/catalog/13525/medical-care-economic-risk-measuring-financial-vulnerability-from-spending-on %> https://nap.nationalacademies.org/catalog/13525/medical-care-economic-risk-measuring-financial-vulnerability-from-spending-on %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %K Industry and Labor %K Behavioral and Social Sciences %K Surveys and Statistics %P 312 %X The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families' economic security or their income available for other basic needs. In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families' disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel's recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM. The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies - whether part of the ACA or other policies - are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report. %0 Book %A Transportation Research Board %A National Academies of Sciences, Engineering, and Medicine %E Kerness, Eric %E Dettman, Kurt %E Evans, James W., Jr. %E McDaniel, James %T Legal Issues with Obtaining Insurance for Large Transit Projects %D 2014 %U https://nap.nationalacademies.org/catalog/22301/legal-issues-with-obtaining-insurance-for-large-transit-projects %> https://nap.nationalacademies.org/catalog/22301/legal-issues-with-obtaining-insurance-for-large-transit-projects %I The National Academies Press %C Washington, DC %G English %K Transportation and Infrastructure %P 66 %X TRB’s Transit Cooperative Research Program (TCRP) Legal Research Digest 47: Legal Issues with Obtaining Insurance for Large Transit Projects identifies and discusses in detail the legal issues confronting transit agencies seeking to obtain insurance for large transit capital projects. The report covers different types of insurance coverage required for large projects and the types of programs available, including Owner Controlled Insurance Programs and owner’s protective professional indemnity insurance. In addition, the report considers the benefits, advantages, and disadvantages of such programs as compared to consultant- or contractor-provided insurance programs.The digest also examines how state law affects the ability to assign risk contractually; the current practices for drafting contract provisions to manage risk; competitive procurement and cost analysis issues; methods of obtaining comparative pricing for various insurance options; and the impacts of the various types of insurance programs on owner liability, project and contractor safety, and disadvantaged and small business enterprise project participation. %0 Book %A National Academies of Sciences, Engineering, and Medicine %E Augustine, Norman R. %E Madhavan, Guru %E Nass, Sharyl J. %T Making Medicines Affordable: A National Imperative %@ 978-0-309-46805-3 %D 2018 %U https://nap.nationalacademies.org/catalog/24946/making-medicines-affordable-a-national-imperative %> https://nap.nationalacademies.org/catalog/24946/making-medicines-affordable-a-national-imperative %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 234 %X Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicines—and health care at large—more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugs—coupled with the broader trends in overall health care costs—is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care. %0 Book %A Institute of Medicine %T Hidden Costs, Value Lost: Uninsurance in America %@ 978-0-309-08931-9 %D 2003 %U https://nap.nationalacademies.org/catalog/10719/hidden-costs-value-lost-uninsurance-in-america %> https://nap.nationalacademies.org/catalog/10719/hidden-costs-value-lost-uninsurance-in-america %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 212 %X Hidden Cost, Value Lost, the fifth of a series of six books on the consequences of uninsurance in the United States, illustrates some of the economic and social losses to the country of maintaining so many people without health insurance. The book explores the potential economic and societal benefits that could be realized if everyone had health insurance on a continuous basis, as people over age 65 currently do with Medicare. Hidden Costs, Value Lost concludes that the estimated benefits across society in health years of life gained by providing the uninsured with the kind and amount of health services that the insured use, are likely greater than the additional social costs of doing so. The potential economic value to be gained in better health outcomes from uninterrupted coverage for all Americans is estimated to be between $65 and $130 billion each year. %0 Book %A Institute of Medicine %E Corrigan, Janet M. %E Greiner, Ann %E Erickson, Shari M. %T Fostering Rapid Advances in Health Care: Learning from System Demonstrations %@ 978-0-309-08707-0 %D 2003 %U https://nap.nationalacademies.org/catalog/10565/fostering-rapid-advances-in-health-care-learning-from-system-demonstrations %> https://nap.nationalacademies.org/catalog/10565/fostering-rapid-advances-in-health-care-learning-from-system-demonstrations %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 107 %X In response to a request from the Secretary of the Department of Health and Human Services, the Institute of Medicine convened a committee to identify possible demonstration projects that might be implemented in 2003, with the hope of yielding models for broader health system reform within a few years. The committee is recommending a substantial portfolio of demonstration projects, including chronic care and primary care demonstrations, information and communications technology infrastructure demonstrations, health insurance coverage demonstrations, and liability demonstrations. As a set, the demonstrations address key aspects of the health care delivery system and the financing and legal environment in which health care is provided. The launching of a carefully crafted set of demonstrations is viewed as a way to initiate a "building block" approach to health system change. %0 Book %A Institute of Medicine %T Financing Vaccines in the 21st Century: Assuring Access and Availability %@ 978-0-309-08979-1 %D 2004 %U https://nap.nationalacademies.org/catalog/10782/financing-vaccines-in-the-21st-century-assuring-access-and-availability %> https://nap.nationalacademies.org/catalog/10782/financing-vaccines-in-the-21st-century-assuring-access-and-availability %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 264 %X The national immunization system has achieved high levels of immunization, particularly for children. However, this system faces difficult challenges for the future. Significant disparities remain in assuring access to recommended vaccines across geographic and demographic populations. These disparities result, in part, from fragmented public–private financing in which a large number of children and adults face limited access to immunization services. Access for adults lags well behind that of children, and rates of immunizations for those who are especially vulnerable because of chronic health conditions such as diabetes or heart and lung disease, remain low. Financing Vaccines in the 21st Century: Assuring Access and Availability addresses these challenges by proposing new strategies for assuring access to vaccines and sustaining the supply of current and future vaccines. The book recommends changes to the Advisory Committee on Immunization Practices (ACIP)-the entity that currently recommends vaccines-and calls for a series of public meetings, a post-implementation evaluation study, and development of a research agenda to facilitate implementation of the plan. %0 Book %A National Research Council %A Institute of Medicine %E Lawrence, Robert S. %E Gootman, Jennifer Appleton %E Sim, Leslie J. %T Adolescent Health Services: Missing Opportunities %@ 978-0-309-11467-7 %D 2009 %U https://nap.nationalacademies.org/catalog/12063/adolescent-health-services-missing-opportunities %> https://nap.nationalacademies.org/catalog/12063/adolescent-health-services-missing-opportunities %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 366 %X Adolescence is a time of major transition, however, health care services in the United States today are not designed to help young people develop healthy routines, behaviors, and relationships that they can carry into their adult lives. While most adolescents at this stage of life are thriving, many of them have difficulty gaining access to necessary services; other engage in risky behaviors that can jeopardize their health during these formative years and also contribute to poor health outcomes in adulthood. Missed opportunities for disease prevention and health promotion are two major problematic features of our nation's health services system for adolescents. Recognizing that health care providers play an important role in fostering healthy behaviors among adolescents, Adolescent Health Services examines the health status of adolescents and reviews the separate and uncoordinated programs and services delivered in multiple public and private health care settings. The book provides guidance to administrators in public and private health care agencies, health care workers, guidance counselors, parents, school administrators, and policy makers on investing in, strengthening, and improving an integrated health system for adolescents. %0 Book %A Institute of Medicine %T Complementary and Alternative Medicine in the United States %@ 978-0-309-09270-8 %D 2005 %U https://nap.nationalacademies.org/catalog/11182/complementary-and-alternative-medicine-in-the-united-states %> https://nap.nationalacademies.org/catalog/11182/complementary-and-alternative-medicine-in-the-united-states %I The National Academies Press %C Washington, DC %G English %K Health and Medicine %P 360 %X Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate. Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings. It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards. %0 Book %T %D %U %> %I The National Academies Press %C Washington, DC %G English %P