새로운 건강보험 보장성 강화 대책 2부: 복부 초음파 및 MRI 급여 확대 A New Health Care Policy in Korea Part 2: Expansion of Coverage by National Health Insurance on the Abdominal Ultrasound and MRI
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PROVIDER: S-EPMC9431876 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
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Project description:In accordance with the new healthcare policy of government (Moon Jae-In Care) to strengthen health insurance coverage, the National Health Insurance (NHI) coverage of brain magnetic resonance imaging (MRI), brain/neck MR angiography (MRA), and head and neck MRI have been expanded since 2018 in Korea. This article has been reviewed focusing on the "Detailed matter concerning criteria and method for providing reimbursed services in the NHI. Some revisions" regarding reimbursement for MRI, which was revised from October 2018 to April 2020 and is currently in effect. It included the MRI reimbursement system in Korea, recent adjustment of the reimbursement coverage for patients with headache or dizziness, and reimbursement coverage, standard imaging, and radiologic report of brain MRI, brain/neck MRA and head and neck MRI. This article could help radiologists gain knowledge on health insurance to protect the expertise of the radiologist and to play a leading role in the hospital. As the policy changes, detailed matter concerning criteria and method for providing reimbursed services in the NHI may be revised. Therefore, radiologists should update issues related to insurance reimbursement for MRI continuously.
| S-EPMC9431867 | biostudies-literature
Project description:Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.
| S-EPMC9431868 | biostudies-literature
Project description:ObjectiveTo test the impact of the dependent coverage expansion (DCE) on insurance disparities across race/ethnic groups.Data sources/study settingSurvey data from the National Survey of Drug Use and Health (NSDUH).Study designTriple-difference (DDD) models were applied to repeated cross-sectional surveys of the U.S. adult population.Data collection/extraction methodsData from 6 years (2008-2013) of the NSDUH were combined.Principal findingsFollowing the DCE, the relative odds of insurance increased 1.5 times (95 percent CI 1.1, 1.9) among whites compared to blacks and 1.4 times (95 percent CI 1.1, 1.8) among whites compared to Hispanics.ConclusionsHealth reform efforts, such as the DCE, can have negative effects on race/ethnic disparities, despite positive impacts in the general population.
| S-EPMC5867154 | biostudies-literature
Project description:ImportanceAlthough nearly 1 in 5 persons in the United States has a physical or mental disability, little is known about the association of the Patient Protection and Affordable Care Act (ACA) with health insurance coverage among persons with a disability.ObjectiveTo determine the association of Medicaid expansion with health insurance coverage among persons with a disability.Design, setting, and participantsCross-sectional analysis of adults eligible for Medicaid expansion (aged 26-64 years with incomes up to 138% of the federal poverty level), using a triple-differences (difference-in-difference-in-difference) approach to compare the pre-ACA with post-ACA trend in health insurance rates by disability status between expansion and nonexpansion states using nationally representative, repeated cross-sectional sample data obtained from the American Community Survey in the United States from January 1, 2010, to December 31, 2016. Time was defined as either pre-ACA (January 1, 2010, to December 31, 2013) or post-ACA (January 1, 2014, to December 31, 2016). Treatment status was defined as whether a state implemented Medicaid expansion after January 1, 2014. States that expanded Medicaid between January 1, 2014, to December 31, 2016, were classified as the treatment group, and states that did not expand Medicaid during the study period were classified as the control group. Data were analyzed from December 12, 2018, to May 21, 2019.Main outcomes and measuresSelf-reported health insurance coverage (uninsured, Medicaid, private) and self-reported disability status (≥1 condition limiting activity, including cognitive, ambulatory, self-care, independent living, and sensory difficulties).ResultsOf 2 549 376 Medicaid-eligible adults, 1 348 620 (52.9%) were female; 1 218 602 (47.8%) were non-Hispanic white, 497 128 (19.5%) were non-Hispanic black, 211 598 (8.3%) were Hispanic, and 206 499 (8.1%) were of other race/ethnicity; and 619 498 (24.3%) reported at least 1 disability. The percentage of persons without health insurance was greatest for persons without a disability who lived in a nonexpansion state before the ACA's Medicaid expansion provision went into effect (236 645 of 426 387 [55.5%]), and the smallest proportion of persons without health insurance was reported for persons with a disability living in an expansion state after the ACA went into effect (19 552 of 176 145 [11.1%]). Triple-differences analysis suggested that Medicaid expansion was associated with a decrease in the uninsured rate for both persons with a disability (7.1% - 16.2% = -9.1%) and without a disability (21.2% - 34.9% = -13.7%) and that Medicaid expansion was associated with a 4.6% decrease in the uninsurance rate for persons without a disability and a 2.6% decrease in persons with a disability (P < .001). Although Medicaid expansion was associated with an increase in Medicaid coverage for both persons with a disability (49.3% pre-ACA to 62.3% post-ACA; change, 13.0%) and persons without a disability (21.6% pre-ACA to 40.3% post-ACA; change, 17.7%), the triple difference-estimated Medicaid coverage was -4.7% for persons with a disability and 0.4% for persons without a disability, a difference of 5.1% (P < .001). Medicaid expansion was associated with a 3% higher private insurance rate for persons with a disability than for persons without a disability.Conclusions and relevanceMedicaid expansion appeared to be associated with lower uninsurance rates and higher Medicaid and private insurance coverage for persons with a disability. This study's findings suggest that the reduction in the uninsured rate and gains in Medicaid coverage were greater for persons without a disability than for persons with a disability.
| S-EPMC6647921 | biostudies-literature
Project description:Using data from the US Census Bureau's Household Pulse Survey, we analyzed the likelihood of loss of health insurance and enrollment into new health coverage during the early months of the COVID-19 pandemic. Loss of employment was associated with a significant increase in the likelihood of loss of health insurance and, specifically, an increase in the likelihood of employer-sponsored health insurance. However, individuals in Medicaid expansion states experienced a lower likelihood of loss of health insurance compared with individuals in nonexpansion states. At the same time, there was a statistically significant increase in Medicaid enrollment in expansion states, by 3.2 percentage points. Reemployment or acquiring employment was associated with a gain in health insurance coverage. During an economic downturn, eligibility, and coverage gaps leave many without affordable coverage options, and the pandemic will likely bring renewed attention to gaps in Medicaid coverage in nonexpansion states.
| S-EPMC9877596 | biostudies-literature
Project description:OBJECTIVE:To determine the association of Medicaid expansion with health insurance coverage by marital status and sex. METHODS:A population-based, quasi-experimental policy analysis was undertaken of the implementation of the Patient Protection and Affordable Care Act's (ACA) Medicaid expansion provision on or after January 1, 2014. The 2010-16 American Community Survey provided data on 3,874,432 Medicaid-eligible adults aged 19-64 with incomes up to 138% of the federal poverty level. The outcome measures were no health insurance coverage and Medicaid coverage. The predictor variables were marital status and sex, with controls for family size, poverty status, race/ethnicity, education, employment status, immigration status, and metropolitan residence. RESULTS:In 2016, the uninsured rate for married men and women in a Medicaid expansion state was 21.2% and 17.1%, respectively, compared to 37.4% for married men and 35.8% for married women in a non-expansion state. The Medicaid coverage rate grew between 14.8% to 19.3% in Medicaid expansion states, which contrasts with less than a 5% growth in non-expansion states. Triple differences analysis suggests that, for women of all age groups, Medicaid expansion resulted in a 1.6 percentage point lower uninsured rate for married women compared to unmarried women. For men, there was not a statistically significant difference in the uninsured rate for married compared to unmarried men. For women of all age groups, there was a 2.6 percentage point higher Medicaid coverage rate for married compared to unmarried women. For men, there was a 1.8 percentage point higher Medicaid coverage rate for married compared to unmarried men. CONCLUSION:Medicaid expansion under the ACA differentially lowered uninsurance and improved Medicaid coverage for married persons, especially married women, more than unmarried persons.
| S-EPMC6808332 | biostudies-literature
Project description:BackgroundIn 2009, the South Korean government expanded universal health insurance to include oral health services. In the present study, we sought to examine whether improved access resulted in a reduction in income-based self-reported oral health inequalities.MethodsWe analyzed repeated cross-sectional data from the Korea National Health and Nutrition Examination Survey (KNHANES) waves IV through VI (2007-2015). We analyzed self-reported oral health status among 68,431 subjects. Changes in oral health inequalities across four income levels (low, middle-low, middle-high, and high) were assessed with the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII).ResultsThe average oral health status of children and adolescents improved the most over the observation period. The absolute magnitude of oral health inequalities (measured by the SII) improved for most groups, with the notable exception of young male adults. By contrast, the ratio of poor oral health between high- and low-income groups (measured by the RII) changed little over time, indicating that relative inequalities remained resistant to change.ConclusionsThe expansion of dental health insurance may not be sufficient to move the needle on self-reported oral health inequalities among adults.
| S-EPMC7661332 | biostudies-literature
Project description:ObjectiveTo introduce the American Community Survey (ACS) and its measure of health insurance coverage to researchers and policy makers.Data sources/study settingWe compare the survey designs for the ACS and Current Population Survey (CPS) that measure insurance coverage.Study designWe describe the ACS and how it will be useful to health policy researchers.Principal findingsRelative to the CPS, the ACS will provide more precise state and substate estimates of health insurance coverage at a point-in-time. Yet the ACS lacks the historical data and detailed state-specific coverage categories seen in the CPS.ConclusionsThe ACS will be a critical new resource for researchers. To use the new data to the best advantage, careful research will be needed to understand its strengths and weaknesses.
| S-EPMC2677056 | biostudies-literature
Project description:Virginia expanded Medicaid under the Affordable Care Act beginning in January 2019, which substantially increased income eligibility up to 138% of the federal poverty level (FPL) for both childless adults and parents. In this study, we examined the effects of Virginia's Medicaid expansion in 2019 on health insurance coverage, access to care, and health status by employing a difference-in-differences and a synthetic control design. The study included data on health insurance from the 2016-2020 American Community Survey (ACS) and data on access to care and health status come from the 2016-2020 Behavioral Risk Factors Surveillance System (BRFSS). The samples from ACS and BRFSS were limited to non-elderly adults with income below 138% of the FPL. Separate models were estimated for individuals below 100% of FPL, and those within 100-138% of FPL. The Virginia Medicaid expansion was associated with a 9-11 percentage-point increase in Medicaid coverage rate and a 7-8 percentage-point increase in the insured rate among individuals below 100% FPL, in the first two years of expansion. There was a larger increase in Medicaid coverage among individuals within 100-138% of FPL which also led to a larger increase in the insured rate in 2020. Both income groups showed no changes in private coverage after the expansion in Virginia. We also found a decline in delaying necessary medical visits due to cost for individuals below 100% FPL in 2019 and for individuals within 100-138% FPL in 2020. There was overall no discernable change in health status outcomes. Virginia's 2019 Medicaid expansion substantially increased insurance coverage among poor adults with suggestive early evidence for improved access. The findings highlight the missed opportunity for other states that have not yet decided to expand their Medicaid programs to improve coverage and access among their low-income individuals.
| S-EPMC9134455 | biostudies-literature
Project description:ImportanceWhile various policies to support couples experiencing infertility have been introduced due to the fertility rate rapidly dropping in developed countries, few large-scale nationwide cohort studies have evaluated the outcomes of assisted reproductive technology (ART) health insurance coverage policies.ObjectiveTo evaluate ART health insurance coverage for multiple pregnancies and births in Korea.Design, setting, and participantsThis population-based cohort study used delivery cohort data from the Korean National Health Insurance Service database between July 1, 2015, and December 31, 2019. A total of 1 474 484 women were included after exclusion of those who gave birth at nonmedical institutions and those with missing data.ExposureTwo 27-month periods were examined before and after the Korean National Health Insurance Service had begun covering ART treatment (preintervention period, July 1, 2015, to September 30, 2017; postintervention period, October 1, 2017, to December 31, 2019).Main outcomes and measuresMultiple pregnancies and multiple births were identified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes. Total births were defined as the total number of babies born to each pregnant woman during the follow-up period. An interrupted time series with segmented regression was conducted to analyze the time trend and its change in outcomes. Data analysis was conducted between December 2, 2022, and February 15, 2023.ResultsOf the 1 474 484 women eligible for the analysis (mean [SD] age, 33.2 [4.6] years), approximately 1.60% had multiple pregnancies and 1.10% had multiple births. After covering ART treatment, the likelihood of multiple pregnancies and multiple births was estimated to increase by 0.7% (estimate, 1.007; 95% CI, 1.004-1.011; P < .001) and 1.2% (estimate, 1.012; 95% CI, 1.007-1.016; P < .001) compared with before coverage. The probability of an increase in the number of total births per pregnant woman after the intervention was estimated to be 0.5% (estimate, 1.005; 95% CI, 1.005-1.005; P < .001). The relatively high-income class above the median income showed a decreasing trend in multiple births and total births before the intervention, but after the intervention, a significant increase was observed.Conclusions and relevanceThis population-based cohort study found that the possibility of multiple pregnancies and births in Korea significantly increased after the implementation of an ART health insurance coverage policy. These findings suggest that the development and coverage of policies to support couples experiencing infertility may help address low fertility rates.
| S-EPMC10245192 | biostudies-literature