Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Second opinions on coverage.

L B Benko

    Modern Healthcare
    |November 7, 2000
    PubMed
    Summary

    Managed care disputes between doctors, patients, and health maintenance organizations (HMOs) can now be resolved through external review boards. These independent expert panels offer a fair and cost-effective alternative to lengthy lawsuits.

    Related Experiment Videos

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Main event: HMOs vs. regulators. California scuffle reflects national battle over record fines, more oversight.

    Modern healthcare·2002
    Same author

    Doing the math. New NCQA Web-based program aims to quantify quality's financial dividends.

    Modern healthcare·2002
    Same author

    Members only. These doctors and their affluent patients find themselves in exclusive company.

    Modern healthcare·2002
    Same author

    True-blue motives? Study questions CareFirst's decision to convert Maryland blues to for-profit.

    Modern healthcare·2002
    Same author

    Sizing up the top health insurers. Big-time buyer WellPoint, smart seller Aetna a study in contrasts.

    Modern healthcare·2002
    Same author

    HMOs thriving but still cautious.

    Modern healthcare·2002

    Area of Science:

    • Healthcare policy
    • Medical dispute resolution

    Background:

    • Managed care organizations (HMOs) often deny coverage for treatments recommended by physicians.
    • Traditional legal recourse for patients involves lengthy and expensive lawsuits.

    Purpose of the Study:

    • To introduce external review boards as a novel dispute resolution mechanism.
    • To highlight the benefits of external review for patients and health plans.

    Main Methods:

    • External review boards comprise independent expert panels.
    • These panels adjudicate treatment disputes between patients and healthcare providers.

    Main Results:

    • External review offers an inexpensive and fair resolution process.
    • This method provides an alternative to traditional litigation.

    Conclusions:

    • External review boards are an effective solution for managed care disputes.
    • This approach benefits both patients seeking treatment and health plans managing costs.