Managed care: Strengthening the consumer voice in managed care: VI. Initial lessons from independent external review

Psychiatric Services

Volumn 54, Issue 1, 2003, Pages 24-25+28

  Sabin, James E ^a,d   Granoff, Karen ^b   Daniels, Norman ^c  

^a HARVARD MEDICAL SCHOOL   (United States)

^b MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH   (United States)

^c HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^d Department of Ambulatory Care ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONSUMER; CRISIS INTERVENTION; HEALTH CARE; HEALTH CARE PLANNING; HEALTH MAINTENANCE ORGANIZATION; HOSPITAL; HUMAN; MENTAL HEALTH SERVICE; PSYCHIATRIST; REVIEW; TREATMENT PLANNING; ARTICLE; CONSUMER ADVOCACY; ECONOMICS; HEALTH CARE DELIVERY; MENTAL DISEASE; PROFESSIONAL STANDARDS REVIEW ORGANIZATION; STANDARD; UNITED STATES;

CONSUMER ADVOCACY; CONSUMER PARTICIPATION; HEALTH MAINTENANCE ORGANIZATIONS; HEALTH SERVICES ACCESSIBILITY; HUMANS; MENTAL DISORDERS; MENTAL HEALTH SERVICES; PROFESSIONAL REVIEW ORGANIZATIONS; UNITED STATES;

EID: 0037270842     PISSN: 10752730     EISSN: None     Source Type: Journal    
DOI: 10.1176/appi.ps.54.1.24     Document Type: Review

References (17)

1. Gresenz CR, Studdert DM, Campbell N, et al: Patients in conflict with managed care: A profile of appeals in two HMOs. Health Affairs 21(4):189-196, 2002
2. Morgan RB, Levy DR: 2002 State by State Guide to Managed Care Law. New York, Aspen, 2002
3. Pollitz K, Crowley J, Lucia K, et al: Assessing State External Review Programs and the Effects of Pending Federal Patient's Rights Legislation. Washington, DC, Georgetown University, Institute for Health Care Research and Policy, May 2002. Available at www.kff.org/content/2002/3221/externalreviewpart2rev.pdf
4. National Association of Independent Review Organizations: Preserving the Integrity and Viability of Independent Medical Review. Available at www.nairo.org/nairo.pdf
5. American Association of Health Plans: Independent Medical Review of Health Plan Coverage Decisions: Empowering Consumers With Solutions. Available at www.aahp.org/template.cfm?section=external_review
6. National Mental Health Association: The Consumer's Right to Health Care: How to Overturn Managed Care Treatment Denials. Available at www.nmha.org/shcr/articles/denial.cfm
7. Daniels N, Sabin JE: Setting Limits Fairly. New York, Oxford University Press, 2002
8. Sabin JE, Daniels N: Strengthening the consumer voice in managed care: I. Can the private sector meet the public-sector standard? Psychiatric Services 52:461-462,464, 2001
9. Sabin JE, O'Brien MF, Daniels N: Strengthening the consumer voice in managed care: II. Moving NCQA standards from rights to empowerment. Psychiatric Services 52:1303-1305, 2001
10. Sabin JE, Daniels N: Strengthening the consumer voice in managed care: III. The Philadelphia Consumer Satisfaction Team. Psychiatric Services 53:23-24,29, 2002
11. Sabin JE, Daniels N: Strengthening the consumer voice in managed care: IV. The leadership academy program. Psychiatric Services 53:405-406,411, 2002
12. Sabin JE, Daniels N. Strengthening the consumer voice in managed care: V. helping professionals listen. Psychiatric Services 53:805-806,811, 2002
13. Chapter 141 of the Acts of 2000: An Act Relative to Managed Care Practices in the Insurance Industry. Available at www.state. ma.us/legis/laws/seslaw00/sl000141.htm
14. 105 CMR 128.000 Health Insurance Consumer Protection Regulations. Available at www.state.ma.us/dph/opp/128.pdf
15. Kaysen S: Girl, Interrupted. New York, Random House, 1995
16. Sabin JE: A credo for ethical managed care in mental health practice. Hospital and Community Psychiatry 45:859-860,869, 1994
17. Sabin JE: Caring about patients and caring about money: The American Psychiatric Association code of ethics meets managed care. Behavioral Sciences and the Law 12:317-330, 1994