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Utilization Review

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  • Topic: Utilization review
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Denial is Preferred Mental Health Therapy in N.Y.'s Chinatown Since September 11th Terrorist Attacks

May 1, 2004 | Program Result Report

In 2002–03, the Asian American Federation of New York, a non-profit leadership organization, conducted a mental health needs assessment of Asian American World Trade Center victims' families as well as vulnerable populations in New York City's Chinatown district — namely, children, elders and dislocated workers — to document the mental health status, needs and actual service use following the September 11th...

Medical Directors Often Apply Different Definitions of "Medical Necessity"

August 1, 2003 | Program Result Report

In this 2000–2001 project, Linda Bergthold, PhD, and researchers at Stanford University, Stanford, Calif., surveyed health plan medical directors in 48 states about medical necessity decision making. The study provides input for policy-making at the state and national levels.

Physicians Among the Chief Drivers of High Drug Costs

January 1, 2001 | Program Result Report

During the 1980s, expenditures on pharmaceuticals nationwide increased by 152 percent. HMOs implemented a number of cost-control mechanisms to slow the rate of growth of pharmaceutical expenditures, and were successful in doing so compared to fee-for-service health plans.

Making Health Insurance More Affordable for Small Businesses

January 1, 2001 | Program Result Report

Starting in September 1991, researchers at the Pittsburgh Research Institute, Pittsburgh, compared the health care costs and use for employees at small firms and individual health plan subscribers with employees at large firms.

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