Biomaterial Database

Legal liability under managed care. 1995

K S Robbins

Market forces are driving the delivery of health care into managed care. New alignments among health care providers, payers, utilization reviewers and hospitals create new legal liability. Better-informed patients, concurrent credentialing by hospitals and payers, and new incentives to reduce hospital and physician-related costs have resulted in new federal legislation and agencies that reshape health care delivery and legal liability.

UI	MeSH Term	Description	Entries
D008329	Managed Care Programs	Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.	Case Management, Insurance,Insurance Case Management,Managed Health Care Insurance Plans,Managed Care,Care, Managed,Managed Care Program,Management, Insurance Case,Program, Managed Care,Programs, Managed Care
D005102	Health Expenditures	The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.	Expenditure,Expenditures, Health,Health Expenditure,Out Of Pocket Expenditure,Out-of-Pocket Cost,Out-of-Pocket Expense,Out-of-Pocket Payment,Expenditures,Expenditures, Direct,Expenditures, Indirect,Expenditures, Out-of-Pocket,Out-of Pocket Expenditures,Out-of-Pocket Costs,Out-of-Pocket Expenses,Out-of-Pocket Payments,Out-of-Pocket Spending,Cost, Out-of-Pocket,Costs, Out-of-Pocket,Direct Expenditure,Direct Expenditures,Expenditure, Direct,Expenditure, Health,Expenditure, Indirect,Expenditure, Out-of Pocket,Expenditure, Out-of-Pocket,Expenditures, Out of Pocket,Expenditures, Out-of Pocket,Expense, Out-of-Pocket,Expenses, Out-of-Pocket,Indirect Expenditure,Indirect Expenditures,Out of Pocket Cost,Out of Pocket Costs,Out of Pocket Expenditures,Out of Pocket Expense,Out of Pocket Expenses,Out of Pocket Payment,Out of Pocket Payments,Out of Pocket Spending,Out-of Pocket Expenditure,Out-of-Pocket Expenditure,Out-of-Pocket Expenditures,Payment, Out-of-Pocket,Payments, Out-of-Pocket,Spending, Out-of-Pocket
D006254	Hawaii	A group of islands in Polynesia, in the north central Pacific Ocean, comprising eight major and 114 minor islands, largely volcanic and coral. Its capital is Honolulu. It was first reached by Polynesians about 500 A.D. It was discovered and named the Sandwich Islands in 1778 by Captain Cook. The islands were united under the rule of King Kamehameha 1795-1819 and requested annexation to the United States in 1893 when a provisional government was set up. Hawaii was established as a territory in 1900 and admitted as a state in 1959. The name is from the Polynesian Owhyhii, place of the gods, with reference to the two volcanoes Mauna Kea and Mauna Loa, regarded as the abode of the gods. (From Webster's New Geographical Dictionary, 1988, p493 & Room, Brewer's Dictionary of Names, 1992, p2330)	Midway Island,Midway Islands
D006291	Health Policy	Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.	Health Care Policies,Health Policies,Healthcare Policy,National Health Policy,Care Policies, Health,Health Care Policy,Health Policy, National,Healthcare Policies,National Health Policies,Policies, Health,Policies, Health Care,Policies, Healthcare,Policy, Health,Policy, Health Care,Policy, Healthcare
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D016270	United States Agency for Healthcare Research and Quality	An agency of the PUBLIC HEALTH SERVICE established in 1990 to "provide indexing, abstracting, translating, publishing, and other services leading to a more effective and timely dissemination of information on research, demonstration projects, and evaluations with respect to health care to public and private entities and individuals engaged in the improvement of health care delivery..." It supersedes the National Center for Health Services Research. The United States Agency for Health Care Policy and Research was renamed Agency for Healthcare Research and Quality (AHRQ) under the Healthcare Research and Quality Act of 1999.	Agency for Health Care Policy and Research,United States Agency for Health Care Policy and Research,Agency for Healthcare Research and Quality (U.S.)
D016365	Liability, Legal	Accountability and responsibility to another, enforceable by civil or criminal sanctions.	Institutional Liability,Personal Liability,Professional Liability,Legal Liability,Medical Liability,Torts,Institutional Liabilities,Legal Liabilities,Liabilities, Institutional,Liabilities, Legal,Liabilities, Medical,Liabilities, Personal,Liabilities, Professional,Liability, Institutional,Liability, Medical,Liability, Personal,Liability, Professional,Medical Liabilities,Personal Liabilities,Professional Liabilities,Tort