Setting priorities in medical care through benefit design and medical management

Health Affairs

Volumn 23, Issue SUPPL., 2004, Pages

  Yegian, Jill Mathews ^a  

^a California HealthCare Foundation   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONFERENCE PAPER; COST BENEFIT ANALYSIS; COST EFFECTIVENESS ANALYSIS; EVIDENCE BASED MEDICINE; GOVERNMENT; HEALTH CARE COST; HEALTH CARE MANAGEMENT; HEALTH ECONOMICS; LAW; MEDICAL CARE;

EID: 4644267453     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.W4.300     Document Type: Conference Paper

References (11)

1. Participants included the following: Wade Aubry, University of California at San Francisco (UCSF); Elaine Batchlor, LA Care; Michael Belman, Blue Cross of California; Sophia Chang, California HealthCare Foundation (CHCF); Lesley Cummings, Managed Risk Medical Insurance Board; Marion Danis, National Institutes of Health; Cindy Ehnes, California Department of Managed Health Care; Lynn Etheredge, Health Insurance Reform Project; Susan Foote, University of Minnesota; Alan Garber, Stanford University; Mark Gibson, Milbank Memorial Fund; Marjorie Ginsburg, Sacramento Healthcare Decisions; Emma Hoo, Pacific Business Group on Health; Sandra Hunt, PricewaterhouseCoopers LLP; John Iglehart, Health Affairs; Harold Luft, UCSF; Don Metz, Health Affairs; Christine Paige, Kaiser Foundation Health Plan; David Pockell, CHCF; Robert Rebitzer, United Behavioral Health; Lonny Reisman, Active Health Management; Jeffrey Rideout, Blue Shield of California Foundation; James Robinson, University of California, Berkeley; Debra Roth, independent consultant; David Studdert, Harvard School of Public Health; Joyce Vermeersch, California Public Employees Retirement System; Victor Villagra, Health and Technology Vector Inc.; Paul Wallace, Care Management Institute; Stanley Wallack, Brandeis University; and Jill Yegian, CHCF.
2. Centers for Medicare and Medicaid Services, Office of the Actuary.
3. Blue Shield of California Foundation, Essential Health Benefits (San Francisco: Blue Shield of California Foundation, June 2003).
4. Of note, the Oregon approach incorporated extensive input from the public and explicitly considers cost, while the Blue Shield effort was based primarily on providers' assessment of scientific evidence and clinical importance.
5. More information is about this program is available at www.chbrp.org.
6. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, "Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker versus Diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)," Journal of the American Medical Association 288, no. 23 (2002): 2981-2997.
7. M. Mello and T. Brennan, "The Controversy over High-Dose Chemotherapy with Autologous Bone Marrow Transplant for Breast Cancer," Health Affairs 20, no. 5 (2001): 101-117.
8. J. Robinson and J. Yegian, "Medical Management after Managed Care," Health Affairs, 19 May 2004, content.healthaffairs.org/cgi/content/ abstract/hlthaff.w4.269 (19 May 2004).
9. S. Singer et al., "Regulating Medical Necessity Decision-Making by Health Maintenance Organizations" (Unpublished manuscript), www.hcfo.net/pdf/singer.pdf (15 March 2004).
10. Sacramento Healthcare Decisions, When Options Exceed Resources: Making Trade-Offs in Healthcare Benefits (Sacramento: SHD, October 2003).
11. SHD, Cost Effectiveness as a Criterion for Medical and Coverage Decisions (Sacramento: SHD, October 2001), 3.