Skip to main content Accessibility help
×
Home

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

  • Neil R. Powe (a1), Claudia A. Steiner (a1), Gerard F. Anderson (a1) and Abhik Das (a1)

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.

Copyright

References

Hide All
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.
2.Banta, D., & Schou, I. (eds.). Lasers in health care. Copenhagen: Academic Publishing, 1991.
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.
4.Eckholm, E. While congress remains silent, health care transforms itself. New York Times, 12, 1994, A: 1.
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, 89101.
6.Greenberg, B., & Derzon, R. A.Determining health insurance coverage of technology: Problems and options. Medical Care, 1981, 19, 967–78.
7.Health Insurance Association of America. Source book of health insurance data 1993. Washignton, DC: Health Insurance Association of America, 1994.
8.Meszaros, E.Looking beyond Fox v. Health Net. Managed Health Care, 1994, 4, 14.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed