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Utilization Review

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  • Topic: Utilization review
  • Location: National
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Utilization Management Can Negatively Impact Health Care Quality and Access

June 1, 1999 | Program Result

From 1992 to 1997, researchers at the University of Washington School of Public Health and Community Medicine evaluated the effects of utilization management on health care quality and access.

How Will Comparative Effectiveness Research Affect the Quality of Health Care?

February 1, 2010 | Issue Brief

Paper explores the potential impact of comparative effectiveness research and looks at implications for quality of care and health outcomes.

Post Claims Underwriting and Rescission Practices

January 1, 2009 | Report

Study details regulations and enforcement needed to fill gaps in protecting consumers in insurance markets.

Spillover Effects of Community Uninsurance on Working-Age Adults and Seniors

September 1, 2011 | Report

This article explores the indirect, or spillover, health care effects of a high uninsurance rates. Working-age adults with private insurance living in areas with a high rate of uninsurance were less likely than their peers in areas with a low uninsurance rate to have a usual source of care, an office-based visit, and any medical care expenditures.

It's Spring and Allergy Season is Upon Us. Is our Primary Care Workforce Ready to Meet Patient Needs?

March 28, 2012 | Human Capital Blog Post

We are so pleased to be partnering with Ed Wagner, MD, MPH, Director of the MacColl Center for Health Care Innovation at Group Health Research Institute and Margaret Flinter, PhD, APRN, senior vice president and clinical director of the Community He ...

New RWJF Program Will Study How to Use Primary Care Workforce More Effectively

March 8, 2012 | Human Capital Blog Post

The Robert Wood Johnson Foundation (RWJF) yesterday announced the launch of a new program designed to make primary care more accessible and effective by identifying practices that maximize the services of the primary care workforce. The Primary Care ...

Analytical Models Project the Utilization and Costs of Long-Term Care

July 1, 1998 | Program Result

The Long-Term Care Data Institute reviewed analytical models then in use for projecting the utilization and costs of different long-term care scenarios, and then used the information gleaned from its analysis to rework its own model.

When a Community Has a Higher Rate of Uninsured Residents, Does that Affect Care for Those with Insurance?

September 19, 2011 | Program Result

In 2009 and 2010, researchers at UCLA and RAND measured the impact of high local rates of uninsurance on access to care and the quality of care among adults with health insurance.

Examining How Intimate Partner Violence is Addressed by Employer Assistance Programs

June 27, 2011 | Program Result

Researchers at Johns Hopkins University Bloomberg School of Public Health examined the practices and services related to intimate partner violence offered by employee assistance programs and the experiences of women using these services.

Medical Directors Often Apply Different Definitions of "Medical Necessity"

August 1, 2003 | Program Result

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.

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