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Utilization Review

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  • Topic: Utilization review
  • Topic: Physicians
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How Satisfied are Physicians and Patients When Medical Groups Control Access to Care?

April 1, 1997 | Program Result Report

The University of California, Los Angeles, School of Medicine examined how the structure and intensity of utilization management in physician groups with capitated contracts affect primary care physician and patient satisfaction.

Health Expenditures for Privately Insured Adults Enrolled in Managed Care Gatekeeping vs Indemnity Plans

February 1, 2005 | Journal Article

Gatekeeping arrangements, whereby health maintenance organizations mandate that primary care providers approve referrals to specialists, were the focus of the current investigation. Data from the 1996 Medical Expenditure Panel Survey (MEPS) of the A ...

The Effect of the Medicare Part D Prescription Benefit on Drug Utilization and Expenditures

February 5, 2008 | Journal Article

The focus of this study was to estimate changes in prescription utilization and out-of-pocket expenditures attributable to Part D among a sample of persons eligible for the benefit.

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.

Reducing Payment for Imaging in Referring Doctor's Facility Does Not Reduce Utilization

August 1, 1998 | Program Result Report

From 1994 to 1996, researcher teams at the University of Virginia and the Primary Care Outcomes Research Institute (PCORI) at the New England Medical Center conducted two distinct but parallel studies.

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.

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

September 19, 2011 | Program Result Report

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.

Variations Found During Physician Profiling Study Are Difficult to Explain

March 1, 2000 | Program Result Report

The Center for Research in Ambulatory Health Care Administration developed, tested and demonstrated a national physician profiling system for ambulatory health care.

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