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Full-Text Articles in Insurance Law
How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver
How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver
All Faculty Scholarship
Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact discourages providers from improving safety or encourages them to protect patients from avoidable harms is an empirical question that a survey …
Reform At Risk — Mandating Participation In Alternative Payment Plans, Scott Levy, Nicholas Bagley, Rahul Rajkumar
Reform At Risk — Mandating Participation In Alternative Payment Plans, Scott Levy, Nicholas Bagley, Rahul Rajkumar
Articles
In an ambitious effort to slow the growth of health care costs, the Affordable Care Act created the Center for Medicare and Medicaid Innovation (CMMI) and armed it with broad authority to test new approaches to reimbursement for health care (payment models) and delivery-system reforms. CMMI was meant to be the government’s innovation laboratory for health care: an entity with the independence to break with past practices and the power to experiment with bold new approaches. Over the past year, however, the Department of Health and Human Services (HHS) has quietly hobbled CMMI, imperiling its ability to generate meaningful data …
Comparative Effectiveness Research As Choice Architecture: The Behavioral Law And Economics Solution To The Health Care Cost Crisis, Russell Korobkin
Comparative Effectiveness Research As Choice Architecture: The Behavioral Law And Economics Solution To The Health Care Cost Crisis, Russell Korobkin
Michigan Law Review
With the Patient Protection and Affordable Care Act (“ACA”) set to dramatically increase access to medical care, the problem of rising costs will move center stage in health law and policy discussions. “Consumer directed health care” proposals, which provide patients with financial incentives to equate marginal costs and benefits of care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of health care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed. This Article proposes a government-facilitated …
Can Consumers Control Health-Care Costs?, Mark A. Hall, Carl E. Schneider
Can Consumers Control Health-Care Costs?, Mark A. Hall, Carl E. Schneider
Articles
The ultimate aim of health care policy is good care at good prices. Managed care failed to achieve this goal through influencing providers, so health policy has turned to the only market-based option left: treating patients like consumers. Health insurance and tax policy now pressure patients to spend their own money when they select health plans, providers, and treatments. Expecting patients to choose what they need at the price they want, consumerists believe that market competition will constrain costs while optimizing quality. This classic form of consumerism is today’s health policy watchword. This article evaluates consumerism and the regulatory mechanism …
Access To Medicaid: Recognizing Rights To Ensure Access To Care And Services, Colleen Nicholson
Access To Medicaid: Recognizing Rights To Ensure Access To Care And Services, Colleen Nicholson
University of Michigan Journal of Law Reform Caveat
The Supreme Court has defined Medicaid as “a cooperative federal-state program through which the Federal Government provides financial assistance to States so that they may furnish medical care to needy individuals.” In June 2012, the Court found the Patient Protection and Affordable Care Act’s (PPACA) Medicaid expansion unconstitutional. The Court took issue with the threat to withhold all of a state’s Medicaid funding if they did not comply with the expansion, finding it coercive and a fundamental shift in the Medicaid paradigm. However, Medicaid in its current form may not always be effective at providing beneficiaries with timely access to …
The Virtues Of Medicare, Jill R. Horwitz
The Virtues Of Medicare, Jill R. Horwitz
Reviews
Most of us look forward to a heaven where people don't get sick. But if they do, health care would be traded among fully informed patients and providers in perfectly competitive and frictionless markets. In that perfect world, sick citizens simply shop for doctors the way they shop for other consumer goods. The better doctors, like the most elegant hotel rooms and fanciest cars, would cost more than inferior doctors. Patients would consult their utility meters and, with appropriate attention to discounting over an infinite lifetime, choose accordingly. After each treatment, the patients would know the quality of their outcome …
Managed Care- The First Chapter Comes To A Close, Sallyanne Payton
Managed Care- The First Chapter Comes To A Close, Sallyanne Payton
University of Michigan Journal of Law Reform
Introduction to the symposium, Managed Care: What's the Prognosis: Managing Care in the Next Century.
Chicago Hope Meets The Chicago School, Gail B. Agrawal
Chicago Hope Meets The Chicago School, Gail B. Agrawal
Michigan Law Review
Twenty-five years after the enactment of the Federal Health Maintenance Organization Act and nearly five years after the failure of proposed federal health care reform, managed care has come to dominate the medical marketplace. As a result, the relationships among patients, payers, and physicians have changed fundamentally and dramatically. In this market-driven environment, health care - how much it costs, who receives treatment, and who pays for it - may have surpassed the weather as a topic of everyday conversation at dinner tables and water coolers across the country. In the popular press, reports concerning managed care, usually derogatory, are …
Democratizing Hmo Regulation To Enforce The "Rule Of Rescue", Kent G. Rutter
Democratizing Hmo Regulation To Enforce The "Rule Of Rescue", Kent G. Rutter
University of Michigan Journal of Law Reform
Despite heightened public concern about HMOs, misguided regulatory measures have not guaranteed HMO patients access to the treatment options many consider vital. This Note recommends four changes to the current regulatory system that would preserve HMOs' ability to control health care costs while allowing patients and doctors, rather than lawmakers or HMO administrators, to set health care priorities.
Drive-Through Deliveries: In Support Of Federal Legislation To Mandate Insurer Coverage Of Medically Sound Minimum Lengths Of Postpanum Stays For Mothers And Newborns, Freeman L. Farrow
Drive-Through Deliveries: In Support Of Federal Legislation To Mandate Insurer Coverage Of Medically Sound Minimum Lengths Of Postpanum Stays For Mothers And Newborns, Freeman L. Farrow
University of Michigan Journal of Law Reform
President Clinton signed the Newborns' and Mothers' Health Protection Act of 1996 into law on September 26, 1996. The Act requires insurers that provide maternity benefits to cover medically sound minimum lengths of inpatient, postpartum stays according to the joint guidelines of the American Academy of Pediatrics and the American College of Obstetrics and Gynecology. This Note discusses the historical context in which the necessity for passage of protective legislation arose, the interplay between state and federal statutes that created the need for federal legislation to provide desired protections for postpartum patients and examines the provisions of the Act. This …