Background Nepal has made remarkable efforts towards social health protection over the past several years. In 2016, the Government of Nepal introduced a National Health Insurance Program (NHIP) with an aim to ensure equitable and universal access to healthcare by all Nepalese citizens. Following the first year of operation, the scheme has covered 5 percent of its target population. There ...

In the conditions of market infrastructure for the transformation of medical services, there is an objective need to build effective insurance protection of the population against risks associated with loss of health. Using a systematic approach, the problem of combining compulsory and voluntary health insurance is investigated, a theoretical conceptualization of the concept of “financial mecha...

Experience in European health insurance exchanges indicates that even with the best risk-adjustment formulas, insurers have substantial incentives to engage in risk selection. The potentially most worrisome form of risk selection is skimping on the quality of care for underpriced high-cost patients--that is, patients for whom insurers are compensated at a rate lower than the predicted health ca...

Background: Health insurance literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of health insurance literacy in Iranian society. Methods: The study approach is qualitative. Data were collected using nine semi-structured interviews, ten focal group meetings with the presence o...

Health Insurance has come to the forefront of Public Policy with launch Ayushman Bharat. Government spending on health is dismal compared other countries, even within same income bracket, and insurance being proposed as way out. Although not a new concept, people are still unfamiliar it. Hence, present study was conducted assess utilization, awareness perception regarding policies in patients a...

BACKGROUND Approximately 29 million individuals are expected to enroll in health insurance using the Patient Protection and Affordable Care Act (ACA) Marketplace by 2022. Those seeking health insurance struggle to understand insurance options and choose a plan that best suits their needs. METHODS We interviewed stakeholders to identify the challenges associated with the ACA Marketplace health...

First-year insurer participation in the Health Insurance Marketplaces (HIMs) established by the Affordable Care Act is limited in many areas of the country. There are 3.9 participants, on (population-weighted) average, in the 395 ratings areas spanning the 34 states with federally facilitated marketplaces (FFMs). Using data on the plans offered in the FFMs, together with predicted market shares...