All FSI Projects

Decreasing Variation in Medical Necessity Decision-Making

The goals of this study are:

  1. to describe for consumers, providers and policymakers how health plans and medical groups (i.e., multi-specialty groups, IPAs, etc.) in California define and use medical necessity in coverage decision making
  2. to understand what works and what does not and to make practical recommendations for change and
  3. to reduce variation and inconsistency in the decision making process.

Publications

Sara J. Singer
;
Linda A. Bergthold
;
C Vorhaus
;
S Olson
;
I Mutchnick
;
YY Goh
;
S Zimmerman
;
Alain C. Enthoven