The Managed Care Backlash and the Task Force in California

Health Affairs

Volumn 17, Issue 4, 1998, Pages 95-110

  Enthoven, Alain C ^a   Singer, Sara J ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONSUMER; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; LEGAL ASPECT; PATIENT ATTITUDE; POLITICS; PUBLIC OPINION; STANDARD; UNITED STATES;

CALIFORNIA; CONSUMER SATISFACTION; HEALTH CARE REFORM; HEALTH EXPENDITURES; HUMANS; MANAGED CARE PROGRAMS; PATIENT ACCEPTANCE OF HEALTH CARE; POLITICS; PUBLIC OPINION;

EID: 0342409390     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.17.4.95     Document Type: Article

References (53)

1. Task force recommendations do not carry the force of law, nor is their implementation by either the public or private sector assured. However, the recommendations have been influential in framing both public and private debate. As of the writing of this paper, three laws based on task force recommendations have been passed in California. A fourth recommendation has been directed by the governor to the Little Hoover Commission, the state's standing body for evaluation of reorganization plans, and if not rejected by the legislature, will become law 1 August 1998. Many bills proposing task force recommendations are under consideration.
2. K. Levit et al., "National Health Expenditures, 1994," Health Care Financing Review (Spring 1996): 205-242.
3. K.R. Levit et al., "National Health Spending Trends in 1996," Health Affairs (January/February 1998): 35-51.
4. Ibid.
5. InterStudy Competitive Edge (Bloomington, Minn.: InterStudy Publications, 1996).
6. Ibid.; and InterStudy Competitive Edge (1985).
7. Ibid.; and InterStudy Competitive Edge (1985).
8. Information provided by Thomas Rice; based on KPMG Peat Marwick data collected for H. Schauffler, R. Brown, and T. Rice, The State of Health Insurance in California, 1996 (Berkeley and Los Angeles: University of California, Berkeley, School of Public Health, and UCLA Center for Health Policy Research, January 1997).
9. M. Freudenheim, "Health Insurers Seek Big Increases," New York Times, 24 April 1998, A1.
10. V. Fuchs, "It's Not Employers Who Bear the Costs," Los Angeles Times, 21 September 1993, B7.
11. Managed Health Care Improvement Task Force, "Public Perceptions and Experiences with Managed Care: Background Paper" (5 January 1998).
12. S. Greenfield et al., "Variations in Resource Utilization among Medical Specialties and Systems of Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 267, no. 12 (1992): 1624-1630; and B. Starfield, Primary Care (New York: Oxford University Press, 1992).
13. S. Greenfield et al., "Variations in Resource Utilization among Medical Specialties and Systems of Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 267, no. 12 (1992): 1624-1630; and B. Starfield, Primary Care (New York: Oxford University Press, 1992).
14. California Cooperative Healthcare Reporting Initiative, "1997 Report of Quality: California Health Plan Performance Results," (San Francisco: Pacific Business Group on Health, 1997); and Los Angeles Times poll, "Health Care in California," Study no. 361 (17-25 June 1995).
15. California Cooperative Healthcare Reporting Initiative, "1997 Report of Quality: California Health Plan Performance Results," (San Francisco: Pacific Business Group on Health, 1997); and Los Angeles Times poll, "Health Care in California," Study no. 361 (17-25 June 1995).
16. Task Force, "Public Perceptions and Experiences with Managed Care."
17. L. Weiss and J. Blustein, "Faithful Patients: The Effect of Long-Term Physician-Patient Relationships on Costs and Use of Health Care by Older Americans," American Journal of Public Health (December 1996): 1742-1747.
18. S. Singer et al., "New Research Shows How to Save Money on Employee Health Benefits," Managing Employee Health Benefits (Summer 1997): 1-9.
19. Public testimony, presented to the California Managed Health Care Improvement Task Force, 20 June 1997.
20. J. Newhouse et al., "Some Interim Results from a Controlled Trial of Cost Sharing in Health Insurance," New England Journal of Medicine (17 December 1981): 1501-1507.
21. Task Force, "Improving the Delivery of Care and the Practice of Medicine: Findings and Recommendations" (5 January 1998).
22. Task Force, "Standardizing Health Insurance Contracts: Findings and Recommendations" (5 January 1998). On 16 April 1998 the governor signed into law A.B. 607 (Assemblyman Jack Scott [D] and others), requiring health plans to include a benefits and coverage matrix in their disclosure materials to ease product comparisons for consumers.
23. Task Force, "Consumer Information, Communication, and Involvement: Findings and Recommendations" (5 January 1998).
24. Task Force, "Improving the Dispute Resolution Process: Findings and Recommendations" (5 January 1998).
25. Ibid.
26. K. Davis and C. Schoen, "Managed Care, Choice, and Patient Satisfaction," Kaiser/Commonwealth National Health Insurance Survey (New York: Commonwealth Fund, August 1997).
27. Task Force, "Expanding Consumer Choice of Health Plans."
28. Ibid.
29. Ibid.
30. Ibid.
31. Task Force, "Financial Incentives for Providers in Managed Care Plans: Findings and Recommendations" (5 January 1998).
32. Task Force, "Physician-Patient Relationship: Findings and Recommendations" (5 January 1998). 30. Task Force, "Improving the Delivery of Care and the Practice of Medicine."
33. Task Force, "Physician-Patient Relationship: Findings and Recommendations" (5 January 1998). 30. Task Force, "Improving the Delivery of Care and the Practice of Medicine."
34. Task Force, "Physician-Patient Relationship." On 30 April 1998, the governor signed into law A.B. 1181 (Assemblywoman Martha M. Escutia [D] and others) requiring health plans to provide for ongoing specialty referrals and specialists as primary care physicians for patients with certain chronic and acute conditions.
35. Task Force, "Integration and Coordination of Care: Case Study on Women's Health" (5 January 1998). On 16 April 1998 the governor signed into law A.B. 12 (Assemblywoman Susan Davis [D] and others), enabling direct access to obstetrical and gynecological services.
36. Recent indications suggest that doctors nationwide have not suffered an actual loss of income but rather fear a loss of income and perceive that they must work harder to earn the same amount. See P. Kilborn, "Doctors' Pay Regains Ground Despite Effects of HMOs," New York Times, 22 April 1998, A1.
37. American Medical Association, "Number of Managed Care Contracts per Practice, 1996," Physician Marketplace Statistics, 1996 (Chicago: AMA, 1996). Nationwide, physicians have an average of 11.2 managed care contracts.
38. D. Berwick, B. Godfrey, and J. Roessner, Curing Health Care: New Strategies for Quality Improvement (San Francisco: Jossey-Bass, 1991); P. Ellwood, "Outcomes Management: A Technology of Patient Experience," New England Journal of Medicine (9 June 1988): 1549-1556; and W. Roper et al., "Effectiveness in Health Care," New England Journal of Medicine (3 November 1988): 1197-1222.
39. D. Berwick, B. Godfrey, and J. Roessner, Curing Health Care: New Strategies for Quality Improvement (San Francisco: Jossey-Bass, 1991); P. Ellwood, "Outcomes Management: A Technology of Patient Experience," New England Journal of Medicine (9 June 1988): 1549-1556; and W. Roper et al., "Effectiveness in Health Care," New England Journal of Medicine (3 November 1988): 1197-1222.
40. D. Berwick, B. Godfrey, and J. Roessner, Curing Health Care: New Strategies for Quality Improvement (San Francisco: Jossey-Bass, 1991); P. Ellwood, "Outcomes Management: A Technology of Patient Experience," New England Journal of Medicine (9 June 1988): 1549-1556; and W. Roper et al., "Effectiveness in Health Care," New England Journal of Medicine (3 November 1988): 1197-1222.
41. Task Force, "Government Regulation and Oversight of Managed Health Care: Findings and Recommendations" (5 January 1998).
42. A.B. 434 (Assemblyman Martin Gallegos [D]), 1997; and S.B. 984 (Sen. Herschel Rosenthal [D]), 1997.
43. Task Force, "Executive Summary" (5 January 1998).
44. D. Griffith, "Hospital Crisis Diagnosis: Cutback, Shortage of Nurses," Sacramento Bee, 17 January 1998, A1.
45. Task Force, "Public Perceptions and Experiences with Managed Care."
46. Task Force, "Government Regulation and Oversight of Managed Health Care." On 1 May 1998 the governor proposed to the Little Hoover Commission to form a new Department of Managed Health Care, which was established 1 July 1998.
47. Task Force, "Expanding Consumer Choice of Health Plans."
48. Task Force, "Consumer Information, Communication, and Involvement: Findings and Recommendations" (5 January 1998).
49. Task Force, "Minimizing Risk Avoidance Strategies: Findings and Recommendations" (5 January 1998).
50. Task Force, "Physician-Patient Relationship;" "Consumer Information, Communication, and Involvement;" and "Improving the Delivery of Care and the Practice of Medicine."
51. Task Force, "Physician-Patient Relationship;" "Consumer Information, Communication, and Involvement;" and "Improving the Delivery of Care and the Practice of Medicine."
52. Task Force, "Physician-Patient Relationship;" "Consumer Information, Communication, and Involvement;" and "Improving the Delivery of Care and the Practice of Medicine."
53. Task Force, "Improving the Delivery of Care and the Practice of Medicine."