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Volumn , Issue , 2011, Pages 177-191

Patient appeals as policy disputes: Individual and collective action in managed care

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Indexed keywords


EID: 84873735880     PISSN: None     EISSN: None     Source Type: Book    
DOI: None     Document Type: Chapter
Times cited : (4)

References (51)
  • 3
    • 8844281600 scopus 로고    scopus 로고
    • Consolidation and the transformation of competition in health insurance
    • James C. Robinson, "Consolidation and the Transformation of Competition in Health Insurance, " Health Affairs 23, 6 (2004): 11-23.
    • (2004) Health Affairs , vol.23 , Issue.6 , pp. 11-23
    • Robinson, J.C.1
  • 6
    • 0030637698 scopus 로고    scopus 로고
    • Countervailing agency: A strategy of principled regulation under managed competition
    • Mark Schlesinger, "Countervailing Agency: A Strategy of Principled Regulation under Managed Competition, " Milbank Quarterly 75, 1 (1997): 35-87.
    • (1997) Milbank Quarterly , vol.75 , Issue.1 , pp. 35-87
    • Schlesinger, M.1
  • 9
    • 0005837777 scopus 로고    scopus 로고
    • Consumer protection and managed care: Issues, reform proposals, and trade-offs
    • Marc A. Rodwin, "Consumer Protection and Managed Care: Issues, Reform Proposals, and Trade-Offs, " Houston Law Review 32, 5 (1996): 1319-1381.
    • (1996) Houston Law Review , vol.32 , Issue.5 , pp. 1319-1381
    • Rodwin, M.A.1
  • 10
    • 0345908345 scopus 로고    scopus 로고
    • Ten ways HMOs have changed during the 1990s
    • Jon Gabel, "Ten Ways HMOs Have Changed during the 1990s, " Health Affairs 16, 3 (1997): 134-145.
    • (1997) Health Affairs , vol.16 , Issue.3 , pp. 134-145
    • Gabel, J.1
  • 11
    • 0008103779 scopus 로고    scopus 로고
    • Exit and voice in American health care
    • Marc A. Rodwin, "Exit and Voice in American Health Care, " Michigan Journal of Law Reform 34, 4 (1999): 1041-1067.
    • (1999) Michigan Journal of Law Reform , vol.34 , Issue.4 , pp. 1041-1067
    • Rodwin, M.A.1
  • 12
    • 0037621551 scopus 로고    scopus 로고
    • Consumers versus managed care: The new class actions
    • Clark C. Havighurst, "Consumers versus Managed Care: The New Class Actions, " Health Affairs 20, 4 (2001): 8-27.
    • (2001) Health Affairs , vol.20 , Issue.4 , pp. 8-27
    • Havighurst, C.C.1
  • 13
    • 0344322190 scopus 로고    scopus 로고
    • Consumer protection and managed care: The need for organized consumers
    • Marc A. Rodwin, "Consumer Protection and Managed Care: The Need for Organized Consumers, " Health Affairs 15, 3 (1996): 110-123.
    • (1996) Health Affairs , vol.15 , Issue.3 , pp. 110-123
    • Rodwin, M.A.1
  • 14
    • 0027936753 scopus 로고
    • Patient accountability and quality of care: Lessons from medical consumerism and the patients' rights, women's health, and disability rights movements
    • Marc A. Rodwin, "Patient Accountability and Quality of Care: Lessons from Medical Consumerism and the Patients' Rights, Women's Health, and Disability Rights Movements, " American Journal of Law and Medicine 20, 1 and 2 (1994): 147-167.
    • (1994) American Journal of Law and Medicine , vol.20 , Issue.1-2 , pp. 147-167
    • Rodwin, M.A.1
  • 16
    • 12144274474 scopus 로고    scopus 로고
    • The paradoxical politics of provider re-empowerment
    • Lawrence Brown and Elizabeth Eagan, "The Paradoxical Politics of Provider Re-empowerment." Journal of Health Politics, Policy, and Law 29, 6 (2004): 1045-71.
    • (2004) Journal of Health Politics, Policy, and Law , vol.29 , Issue.6 , pp. 1045-1071
    • Brown, L.1    Eagan, E.2
  • 17
    • 0032717988 scopus 로고    scopus 로고
    • Backlash: Prelude to managing managed care
    • Marc A. Rodwin, "Backlash: Prelude to Managing Managed Care, " Journal of Health Politics, Policy, and Law 24, 5 (1999): 1115-1126.
    • (1999) Journal of Health Politics, Policy, and Law , vol.24 , Issue.5 , pp. 1115-1126
    • Rodwin, M.A.1
  • 18
    • 1642586859 scopus 로고    scopus 로고
    • Independent medical review: Expanding legal remedies to achieve managed care accountability
    • Leatrice Berman-Sandler, "Independent Medical Review: Expanding Legal Remedies to Achieve Managed Care Accountability, " Annals of Health Law 13, 1 (2004): 233-302.
    • (2004) Annals of Health Law , vol.13 , Issue.1 , pp. 233-302
    • Berman-Sandler, L.1
  • 22
    • 0345818472 scopus 로고    scopus 로고
    • What's the appeal? Trying to control managed care medical necessity decisionmaking through a system of external appeals
    • Aaron Seth Kesselheim, "What's the Appeal? Trying to Control Managed Care Medical Necessity Decisionmaking through a System of External Appeals, " University of Pennsylvania Law Review 149 (2001): 873-920.
    • (2001) University of Pennsylvania Law Review , vol.149 , pp. 873-920
    • Kesselheim, A.S.1
  • 24
    • 33645087159 scopus 로고    scopus 로고
    • Managed process, due care: Structures of accountability in health care
    • Nan Hunter, "Managed Process, Due Care: Structures of Accountability in Health Care, " Yale Journal of Health Policy and Ethics 6, 1 (2006): 93-162.
    • (2006) Yale Journal of Health Policy and Ethics , vol.6 , Issue.1 , pp. 93-162
    • Hunter, N.1
  • 25
    • 84937301738 scopus 로고
    • Securing access to care in health maintenance organizations: Toward a uniform model of grievance and appeal procedures
    • Susan J. Stayn, "Securing Access to Care in Health Maintenance Organizations: Toward a Uniform Model of Grievance and Appeal Procedures, " Columbia Law Review 94, 5 (1994): 1674-1720.
    • (1994) Columbia Law Review , vol.94 , Issue.5 , pp. 1674-1720
    • Stayn, S.J.1
  • 26
    • 0037180785 scopus 로고    scopus 로고
    • Independent external review of health maintenance organizations' medical-necessity decisions
    • Wendy K. Mariner, "Independent External Review of Health Maintenance Organizations' Medical-Necessity Decisions, " New England Journal of Medicine 347, 26 (2002): 2178-2182.
    • (2002) New England Journal of Medicine , vol.347 , Issue.26 , pp. 2178-2182
    • Mariner, W.K.1
  • 27
    • 0034485755 scopus 로고    scopus 로고
    • Tapping and resolving consumer concerns about health care
    • Eleanor Kinney, "Tapping and Resolving Consumer Concerns about Health Care, " American Journal of Law and Medicine 26, 4 (2000): 335-399.
    • (2000) American Journal of Law and Medicine , vol.26 , Issue.4 , pp. 335-399
    • Kinney, E.1
  • 28
    • 84905140184 scopus 로고    scopus 로고
    • www.gao.gov/archive/1998/he98119.pdf.
  • 30
    • 0036366763 scopus 로고    scopus 로고
    • Not afraid to blame: The neglected role of blame attribution in medical consumerism and some implications for health policy
    • Marsha Rosenthal and Mark Schlesinger, "Not Afraid to Blame: The Neglected Role of Blame Attribution in Medical Consumerism and Some Implications for Health Policy, " Milbank Quarterly 80, 1 (2002): 41-95.
    • (2002) Milbank Quarterly , vol.80 , Issue.1 , pp. 41-95
    • Rosenthal, M.1    Schlesinger, M.2
  • 31
    • 0041914416 scopus 로고    scopus 로고
    • Voices unheard: Barriers to the expression of dissatisfaction with health plans
    • Mark Schlesinger, Shannon Mitchell, and Brian Elbel, "Voices Unheard: Barriers to the Expression of Dissatisfaction with Health Plans, " Milbank Quarterly 80, 4 (2002): 709-755.
    • (2002) Milbank Quarterly , vol.80 , Issue.4 , pp. 709-755
    • Schlesinger, M.1    Mitchell, S.2    Elbel, B.3
  • 32
    • 0030098065 scopus 로고    scopus 로고
    • What type of quality information do consumers want in a health care report card?
    • Judith H. Hibbard and Jacquelyn J. Jewett, "What Type of Quality Information Do Consumers Want in a Health Care Report Card?" Medical Care Research and Review 53, 1 (1996): 28-47.
    • (1996) Medical Care Research and Review , vol.53 , Issue.1 , pp. 28-47
    • Hibbard, J.H.1    Jewett, J.J.2
  • 33
    • 0030625058 scopus 로고    scopus 로고
    • Informing consumer decisions in health care: Implications from decision-making research
    • Judith H. Hibbard, Paul Slovic, and Jacquelyn J. Jewett, "Informing Consumer Decisions in Health Care: Implications from Decision-Making Research, " Milbank Quarterly 75, 3 (1997): 395-415.
    • (1997) Milbank Quarterly , vol.75 , Issue.3 , pp. 395-415
    • Hibbard, J.H.1    Slovic, P.2    Jewett, J.J.3
  • 34
    • 0037916111 scopus 로고
    • Complaints, redress, and subsequent purchases of medical service by dissatisfied consumers
    • Jane Kolodinsky, "Complaints, Redress, and Subsequent Purchases of Medical Service by Dissatisfied Consumers, " Journal of Consumer Policy 16, 2 (1993): 193-214.
    • (1993) Journal of Consumer Policy , vol.16 , Issue.2 , pp. 193-214
    • Kolodinsky, J.1
  • 35
    • 0042320866 scopus 로고
    • New York: Columbia University Press
    • Arthur Best, When Consumers Complain (New York: Columbia University Press, 1981).
    • (1981) When Consumers Complain
    • Best, A.1
  • 36
    • 84915363546 scopus 로고
    • Consumer response to unsatisfactory purchases: A survey of perceiving defects, voicing complaints, and obtaining redress
    • Arthur Best and Alan R. Andreasen, "Consumer Response to Unsatisfactory Purchases: A Survey of Perceiving Defects, Voicing Complaints, and Obtaining Redress, " Law and Society Review 11, 4 (1977): 701-742.
    • (1977) Law and Society Review , vol.11 , Issue.4 , pp. 701-742
    • Best, A.1    Andreasen, A.R.2
  • 37
    • 84857930593 scopus 로고    scopus 로고
    • External review of coverage denials by managed care organizations in California
    • Carole Roan Gresenz and David M. Studdert, "External Review of Coverage Denials by Managed Care Organizations in California, " Journal of Empirical Legal Studies 2, 3 (2005): 449-468.
    • (2005) Journal of Empirical Legal Studies , vol.2 , Issue.3 , pp. 449-468
    • Gresenz, C.R.1    Studdert, D.M.2
  • 38
    • 0036634461 scopus 로고    scopus 로고
    • Patients in conflict with managed care: A profile of appeals in two HMOs
    • Carol Roan Gresenz, David M. Studdert, Nancy Campbell, and Deborah R. Hensler, "Patients in Conflict with Managed Care: A Profile of Appeals in Two HMOs, " Health Affairs 21, 4 (2002): 189-196.
    • (2002) Health Affairs , vol.21 , Issue.4 , pp. 189-196
    • Gresenz, C.R.1    Studdert, D.M.2    Campbell, N.3    Hensler, D.R.4
  • 39
    • 0037453948 scopus 로고    scopus 로고
    • Enrollee appeals of preservice coverage denials at two health maintenance organizations
    • David M. Studdert and Carol Roan Gresenz, "Enrollee Appeals of Preservice Coverage Denials at Two Health Maintenance Organizations, " JAMA 289, 7 (2003): 864-870.
    • (2003) JAMA , vol.289 , Issue.7 , pp. 864-870
    • Studdert, D.M.1    Gresenz, C.R.2
  • 40
    • 84905140185 scopus 로고    scopus 로고
    • http://www.hmohelp.ca.gov/.
  • 41
    • 84905140186 scopus 로고    scopus 로고
    • http://wp.dmhc.ca.gov/imr/search.asp.
  • 42
    • 84905140179 scopus 로고    scopus 로고
    • http://www.hmohelp.ca.gov/library/arbitrations/gen-default.aspx.
  • 43
    • 84905140165 scopus 로고    scopus 로고
    • http://www.dmhc.ca.gov/dmhc-consumer/pc/pc- Arbitration.aspx.
  • 44
    • 84905140167 scopus 로고    scopus 로고
    • http://www.hmohelp.ca.gov/.
  • 45
    • 0000438048 scopus 로고
    • The emergence and transformation of disputes: Naming, blaming, claiming
    • William L. Felstiner, Richard L. Abel, and Austin Sarat, "The Emergence and Transformation of Disputes: Naming, Blaming, Claiming, " Law and Society Review 15, 3 (1981): 631-654.
    • (1981) Law and Society Review , vol.15 , Issue.3 , pp. 631-654
    • Felstiner, W.L.1    Abel, R.L.2    Sarat, A.3
  • 46
    • 84905140169 scopus 로고    scopus 로고
    • http://www.dmhc.ca.gov/library/reports/complaint/2005.pdf.
  • 47
    • 84905140170 scopus 로고    scopus 로고
    • http://www.mass.gov/Eeohhs2/docs/dph/patient-protection/annual-report-03. pdf.
  • 48
    • 84905140171 scopus 로고    scopus 로고
    • http://www.mass.gov/Eeohhs2/docs/dph/patient-protection/annual-report-04. pdf.
  • 49
    • 84905140172 scopus 로고    scopus 로고
    • www.naic.org/documents/committees-b-uniform-health-carrier-ext-rev-model- Act.pdf.
  • 50
    • 79955499532 scopus 로고    scopus 로고
    • New standards for medical review organizations: Holding them and health plans accountable for their decisions
    • Marc A. Rodwin, "New Standards for Medical Review Organizations: Holding Them and Health Plans Accountable for Their Decisions, " Health Affairs 30, 3 (2011): 519-524.
    • (2011) Health Affairs , vol.30 , Issue.3 , pp. 519-524
    • Rodwin, M.A.1
  • 51
    • 79955520602 scopus 로고    scopus 로고
    • Representing consumers in managed health care
    • Marc A. Rodwin, "Representing Consumers in Managed Health Care, " Journal of Health Law 34, 2 (2001): 223-272.
    • (2001) Journal of Health Law , vol.34 , Issue.2 , pp. 223-272
    • Rodwin, M.A.1


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.