Expanded managed care liability: what impact on employer coverage?

Policymakers are considering legislative changes that would increase managed care organizations' exposure to civil liability for withholding coverage or failing to deliver needed care. Using a combination of empirical information and theoretical analysis, we assess the likely responses of healt...

Full description

Saved in:
Bibliographic Details
Published in:Health Affairs 1999-11, Vol.18 (6), p.7-27
Main Authors: Studdert, D M, Sage, W M, Gresenz, C R, Hensler, D R
Format: Article
Language:English
Subjects:
Costs and Cost Analysis
Decision making
Decision Making, Organizational
Effects
Empirical analysis
Employee benefits
Employee Retirement Income Security Act - economics
Employee Retirement Income Security Act - legislation & jurisprudence
Employees
Employers
Employers' liability
Health Benefit Plans, Employee - economics
Health Benefit Plans, Employee - legislation & jurisprudence
Health care policy
Health Care Reform - economics
Health Care Reform - legislation & jurisprudence
Health insurance
Health Services Research
Humans
Income security
Information sharing
Insurance coverage
Insurance Coverage - economics
Insurance Coverage - legislation & jurisprudence
Liability
Liability, Legal - economics
Litigation
Malpractice - legislation & jurisprudence
Managed care
Managed Care Programs - economics
Managed Care Programs - legislation & jurisprudence
Medical malpractice
Occupational health
Policy making
Preemption
Retirement
Risk
Studies
Surveys and Questionnaires
Theoretical analysis
Torts
United States
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Policymakers are considering legislative changes that would increase managed care organizations' exposure to civil liability for withholding coverage or failing to deliver needed care. Using a combination of empirical information and theoretical analysis, we assess the likely responses of health plans and Employee Retirement Income Security Act (ERISA) plan sponsors to an expansion of liability, and we evaluate the policy impact of those moves. We conclude that the direct costs of liability are uncertain but that the prospect of litigation may have other important effects on coverage decision making, information exchange, risk contracting, and the extent of employers' involvement in health coverage.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.18.6.7