Health Affairs

Posting date: May 19, 2004

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Health Affairs, 10.1377/hlthaff.w4.300
Copyright © 2004 by Project HOPE

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Conference Summary: Setting Priorities In Medical Care Through Benefit Design And Medical Management

Jill Mathews Yegian ^1*

¹ Jill Yegian is director, health insurance, of the California HealthCare Foundation in Oakland.

^*Corresponding author.

Abstract

As health care costs continue to increase, so does the importance of setting priorities in the allocation of medical care resources. Based on a November 2003 roundtable, this paper discusses the potential for benefit design (the definition of covered benefits) and medical management (the criteria by which benefits are applied to specific patients) to contribute to priority setting, particularly in the context of increasing emphasis on evidence-based medicine.

Key Words: Business of Health, Consumer Issues, Managed Care, Managed Care - Consumers, Managed Care - Physicians, Managed Care - Quality, Insurance Coverage, Quality of Care

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