Financial risk in health purchasing: risk pools
Part one of this series explored the financial risk associated with the size of a practice-based commissioning (PBC) group. A process for determining the point of minimum possible financial risk was illustrated by excluding high cost admissions from the core PBC budget (Jones, 2008). By implication, such exclusions will be gathered into a risk pool held on behalf of the PBC group.
The nature of healthcare costs and financial risk in commissioning
The health insurance industry in the USA has noted a cycle of underwriting gains and losses which appeared to commence in the early to mid 1960s. After adjusting for inflation, unexplained step-like increases in total cost of approximately 6% appear to have occurred somewhere around 1962, 1966, 1974, 1979, 1986, 1990, 1998 and 2002. A similar pattern relating to medical emergency admissions has operated in the UK for at least 20 years. The implications of this behaviour tothe financial risk inherent in commissioning in England are discussed in this article. Data fromthe USA and Canada is used to complement the previous studies from the UK to explore causes for this behaviour.
An overview of truck and bus safety: 1999 Knoxville symposium
This paper presents a summary of the topics and discussions from the Second International Truck and Bus Safety Symposium held in Knoxville, Tennessee, October 6-8, 1999. This paper is not a technical paper but is based on the symposium proceedings, which can be accessed for more technical information. The symposium provided an opportunity for the many stakeholders in truck and bus safety, such as carriers, shippers, inspectors, law enforcement officials, insurers, regulators, manufacturers and researchers, to network and discuss the key issues associated with truck and bus safety.