Health Insurers' Assessment of Medical Necessity

Regulating Medical Necessity Decision Making by Health Maintenance Organizations

Health technology assessment: A necessity in post-sanctions Iran while implementing the health transformation plan

Iran’s health system is in the serious need of reconstructing its infrastructures, a significant part of which is health technologies. An untapped market of 80 million people will be open to technologies of the world through Iran's entry to post-sanctions era. Health Technology Assessment projects date back to nearly eight years ago in Iran. However, given the current circumstances, its a...

The Futility of Medical Necessity

he past few years in health care have been a story of extraordinary turbulence. After decades of uncontrolled cost escalation, the businesses and governments that directly pay for most health care finally mandated a fiscal restraint that, in the early 1990s, launched in earnest the upheaval known as “managed care.” One major result has been the replacement of such values as, “If it might help a...

The necessity of professor’s assessment with emphasizing on Iran medical universities

Introduction: The promotion of teaching quality in the universities is an important issue that has been emphasized in recent years. Professors’ evaluation is one of the common methods to determine the professors teaching purposes achievement. Therefore this study presents the importance of medical universities’ professors in Iran. Methods: Documents in the libraries and internet were revi...

Impact of medical loss regulation on the financial performance of health insurers.

The Affordable Care Act's regulation of medical loss ratios requires health insurers to use at least 80-85 percent of the premiums they collect for direct medical expenses (care delivery) or for efforts to improve the quality of care. To gauge this rule's effect on insurers' financial performance, we measured changes between 2010 and 2011 in key financial ratios reflecting insurers' operating p...