Does managed care affect the supply and use of ICU services?

Article Abstract:

Managed care plans have been found to be successful in limiting the use of expensive medical services such as hospital intensive care units (ICU). Several methods for lowering the overall cost of expensive health care service have been proposed including the recruitment of physicians who tend to be judicious in their use of costly services and medical equipment. Studies have shown that ICU length of stay tend to be shorter for those covered by managed care plans than privately insured patients.

Direct Health and Medical Insurance Carriers, Hospital and medical service plans, Medical Care Insurance, Laws, regulations and rules, Finance, Health insurance, Medical care, Cost of, Health care costs, Insurance, Intensive care units

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Defining and implementing medical necessity in Washington state and Oregon

Article Abstract:

Definition and implementation of medical necessity in Washington and Oregon remains vague and unstandardized. Definition of medical necessity in the two states varies, with some based on published scientific evidence of crucial care while others are based on physician's discretion. Implementation is either classified as a provider-based utilization management approach for managed care organizations or a claims-based utilization review for fee-for-service insurers.

Research, Health care industry, Insurance industry, Washington, Oregon

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