The cost of health insurance administration in California: estimates for insurers, physicians, and hospitals

Administrative costs account for 25 percent of health care spending, but little is known about the portion attributable to billing and insurance-related (BIR) functions. We estimated BIR for hospital and physician care in California. Data for physician practices came from a mail survey and interviews; for hospitals, from regulatory reporting; and for private insurers, from a consulting company. Private insurers spend 9.9 percent of revenue on administration and 8 percent on BIR. Physician offices spend 27 percent and 14 percent, and hospitals, 21 percent and 7-11 percent, respectively. Overall, BIR represents 20-22 percent of privately insured spending in California acute care settings.     

Comparative evaluation of the auditory responsiveness of normal infants and profoundly multihandicapped children

Responses to sound were observed in two groups of children. One was developmentally normal; the other was older but profoundly multihandicapped. The groups had developmental ages from 2 to 4 months, as assessed by the Kent Infant Developmental Scale (Katoff, Reuter, & Dunn, 1978). Stimuli were speech and random noise, both unfiltered and band-pass filtered at 2000 Hz, presented at 40, 60, and 80 dB HL. Responsiveness was determined from the confidence levels of observers' judgments of videotapes. Results showed that there were no significant differences between the subject groups. In both groups, however, responsiveness was dependent on hearing level and bandwidth but not on meaningfulness. The results support the practice of evaluating auditory responsiveness of multihandicapped children in relation to developmental age.