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  • External Review of Health Plan Decisions — Policy Brief

    Issue Brief

    An 8-page policy brief on the external review of health plan decisions to inform the policy debate in California and nationally. The policy brief covers external review systems in other states and the Medicare program, the current status of external review in California, and issues regarding the design and implementation of external review. Policy Brief: External Review of Health Plan Decisions Policy Brief: External Review of Health Plan Decisions

  • External Review of Health Plan Decisions: An Overview of Key Program Features in the States and Medicare

    Report

    In 1978, the state of Michigan established a system to call on independent medical experts to help resolve disputes between health plans and patients about the medical necessity and appropriateness of care. Since then, twelve other states and the Medicare program have established similar kinds of external review programs. In the first half of 1998, five more states enacted external review laws (and two states passed laws modifying or expanding existing programs). The term "external…

  • External Review of Health Plan Decisions in the States and Medicare

    Report

    An analysis of the external review process, the formal dispute resolution process established by state or federal agencies, independent of disputing parties, that has the capacity to evaluate and resolve at least those disputes involving medical issues. This paper identifies critical features of external review systems in thirteen states and in the Medicare program. Executive Summary Report

  • External Review of Health Plan Decisions in the States and Medicare – Report

    Report

    External Review of Health Plan Decisions:An Overview of Key Program Features in the States and Medicare External Review of Health Plan Decisions:An Overview of Key Program Features in the States and Medicare Prepared for the Kaiser Family Foundation by:Karen Pollitz, M.P.P., Geraldine Dallek, M.P.H., and Nicole Tapay, J.D.Institute for Health Care Research and Policy, Georgetown University Executive Summary In 1978, the state of Michigan established a system to call on independent medical experts to help…

  • Managed Care Consumer Protections Offered by Medium and Large Employers

    Fact Sheet

    A fact sheet summarizing data from a survey conducted between January and March of 1998 with 1,583 firms with 200 or more workers. The survey, which is conducted annually, focuses on the characteristics of the health benefit plans sponsored by employers.The supplemental questions discussed in this brief were developed jointly by staff from the Kaiser Family Foundation and KPMG and funded by the Foundation. Fact Sheet Fact Sheet

  • Managed Care Consumer Protections Offered by Medium and Large Employers – Fact Sheet

    Fact Sheet

    Managed Care Consumer Protections Offered by Medium and Large Employers November 1998 Background During the past year, Congress and the states considered a number of proposals that would have provided additional protections to consumers in health insurance plans, particularly managed care plans. Among the key issues raised in these debates was how much the protections would increase health insurance premiums, which depends in part on the extent to which these proposed protections are already in…

  • Kaiser/Harvard Survey of Americans on the Consumer Protection Debate

    Report

    The survey was designed and analyzed by researchers at the Kaiser Family Foundation and Harvard University; and was conducted by telephone by Princeton Survey Research Associates with 1,200 adults, 18 years or older, nationwide, between August 6 and August 20, 1998. TOPLINE Download CHARTPACK Download NEWS RELEASE Download

  • Summary of Findings: Privatization of Public Hospitals

    Poll Finding

    This Summary presents background, findings, and data from the Economic and Social Research Institute's (ESRI) full report, Privatization of Public Hospitals. Section I provides background about public hospital conversions, including the role of public hospitals, reasons for conversion, the mechanisms of conversion and new ownership entities, and analysis of national and regional public hospital data. Section II provides a discussion of the five case studies of public hospital conversions and the key findings from the…

  • Privatization of Public Hospitals

    Report

    This report examines the trends in the closure of public hospitals and their conversion to private ownership. It also provides case studies of communities where major privatizations have occurred. Report (.pdf) Summary of Findings (.pdf)

  • HIPAA Compliance Strategies In California:  Reforming the State’s Individual Health Insurance Market — Policy Brief

    Other Post

    HIPAA Compliance Strategies In California: Reforming the State's Individual Health Insurance Market -- Policy Brief A policy brief on reform of the individual insurance market and implementation of the Health Insurance Portability and Accountability Act (HIPAA) in California. The brief is based, in part, on discussion at a California Health Policy Roundtable held in Sacramento, California on March 12, 1998. Note: This publication is no longer in circulation. However, a copy may still exist in…