Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Patient protection laws don’t favor health providers

27.12.2004


Despite critics who say patients’ bills of rights laws are actually designed to protect health care providers, new research published in the current issue of the American Journal of Medicine found just the opposite.



"There is little evidence these laws have much impact on providers’ economic concerns," said Mark Hall, J.D., professor of law and public health at Wake Forest University Baptist Medical Center.

Hall reviewed managed care patient protection laws in the 48 states that have enacted them and also surveyed state regulators about law content. Commonly known as patients’ bills of rights, these laws are aimed at restraining the perceived excesses of managed care, including "gate-keeping," or denying insurance payment for medically necessary treatment and restricting patients’ choice of physicians Critics of the laws, however, say they actually provide protection to providers. Hall’s research was designed to assess the validity of these claims by evaluating the laws’ impacts.


After completing a review of state laws, Hall conducted in-depth case studies of six states – Iowa, Louisiana, Michigan, New Jersey, Texas and Virginia. The states were selected to ensure variety in location and size, the extent of patient protection laws and the market share of health maintenance organizations.

In each state, Hall conducted 16 to 24 confidential interviews with health plan managers, physician practices, regulators, patient advocates, industry observers and others. He also conducted a focus group with nine health care lawyers from across the country and conducted interviews at four of the largest national health plans.

Hall found that most of the patient protection laws are dominated by provisions that are directed primarily at patients’ rights. Laws that are directed primarily to providers’ interests are less frequent and are not very strong.

"The laws targeted most directly to protecting providers are not especially prominent in the overall package of state patient protection laws," writes Hall in the article.

One goal of the interviews was to determine whether provider interests were the main impetus for enacting the laws. Interviewees gave three primary reasons for the laws: media attention to managed care "horror stories," reaction to routine complaints about managed care, and a desire to prevent problems from arising.

"Provider advocacy and provider interests didn’t stand out as the dominant forces leading to enactment in most states, or nationally," said Hall.

When it comes to the effects of the laws, Hall found much the same thing: there is little evidence that they help providers economically. He reviewed the laws’ provisions that address whether insurance companies can exclude certain providers from their panels, how providers can be terminated from panels and other aspects of providers’ relationships with health plans.

He found that the laws do not deter health plans from being selective about which providers they include, do not create significant barriers to terminating providers and do not greatly improve the economic situation of providers.

"We found that managed care patient protection laws do not advance the agendas of providers more than they protect consumers," said Hall. "Instead, they appear to embody a convenient alignment of interests among providers, patients and lawmakers."

Hall said the findings are consistent with findings from similar studies, including one that found that these laws are a "curious mix of consumers’ rights, provider protection and patient protections."

Karen Richardson | EurekAlert!
Further information:
http://www.wfubmc.edu

More articles from Studies and Analyses:

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

nachricht Pan-European study on “Smart Engineering”
30.03.2017 | IPH - Institut für Integrierte Produktion Hannover gGmbH

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

'On-off switch' brings researchers a step closer to potential HIV vaccine

30.03.2017 | Health and Medicine

Penn studies find promise for innovations in liquid biopsies

30.03.2017 | Health and Medicine

An LED-based device for imaging radiation induced skin damage

30.03.2017 | Medical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>