Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-15T04:29:16.002Z Has data issue: false hasContentIssue false
  • English
  • Français

Awareness of Providers' Use of New Medical Technology Among Private Health Care Plans in the United States

Published online by Cambridge University Press:  10 March 2009

Neil R. Powe ,
Claudia A. Steiner ,
Gerard F. Anderson  and
Abhik Das
Neil R. Powe
Affiliation:
The Johns Hopkins Medical Institutions
Claudia A. Steiner
Affiliation:
The Johns Hopkins Medical Institutions
Gerard F. Anderson
Affiliation:
The Johns Hopkins Medical Institutions
Abhik Das
Affiliation:
The Johns Hopkins Medical Institutions
Get access Rights & Permissions [Opens in a new window]

Abstract

In a national survey of medical directors at 231 U.S. private health care plans that cover over two thirds of the privately insured population, we studied whether medical directors are aware when a new technology, such as laser therapy, is being used in procedures for which claims are submitted, the factors alerting them to such use, and the factors prompting them to make a specific coverage decision for the technology. We also examined possible associations between health plans' characteristics (HMO versus indemnity, size, profit status, and time in operation) and their medical directors' awareness of the use of technologies, factors alerting medical directors to their use, and factors prompting specific coverage decisions. The majority of plans were generally not aware that laser technology was being used when it was billed under a general billing code, raising the possibility that less effective or less safe technologies could be introduced rapidly into the treatment of insured populations. Nonprofit and older plans were less likely to be aware that lasers were used in some procedures than for-profit and younger plans.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 12 , Issue 2 , Spring 1996 , pp. 367 - 376
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Banta, D. Lessons from the eight countries. In Banta, H. G., Battista, R. N., Gelband, H., & Jonsson, E. (eds.), U.S. Congress, Office of Technology Assessment, Health care technology and its assessment in eight countries, OTA-BP-H-140. Washington, DC: U.S. Government Printing Office, 1995, 335–53.Google Scholar
2.Banta, D., & Schou, I. (eds.). Lasers in health care. Copenhagen: Academic Publishing, 1991.Google Scholar
3.Bunker, J. P., Fowles, J., & Schaffarzick, R.Evaluation of medical-technology strategies: Effects of coverage and reimbursement. New England Journal of Medicine 1982, 306, 620–24.CrossRefGoogle ScholarPubMed
4.Eckholm, E. While congress remains silent, health care transforms itself. New York Times, 12, 1994, A: 1.Google Scholar
5.Finkelstein, S. T., Isaacson, K. A., & Frishkopf, J. J.The process of evaluating medical technologies for third-party coverage. Journal of Health Care Technology, 1984, 1, 89–101.Google ScholarPubMed
6.Greenberg, B., & Derzon, R. A.Determining health insurance coverage of technology: Problems and options. Medical Care, 1981, 19, 967–78.CrossRefGoogle ScholarPubMed
7.Health Insurance Association of America. Source book of health insurance data 1993. Washignton, DC: Health Insurance Association of America, 1994.Google Scholar
8.Meszaros, E.Looking beyond Fox v. Health Net. Managed Health Care, 1994, 4, 1–4.Google Scholar