Making medical and disability benefit plans more manageable.
Good managed care health systems require two criteria for success: They must offer a set of checks and balances, and employees need to be given incentive to act in the best interest of the organization by acting in their own best interests. The authors discuss six principles that they claim are likely to reduce the complexity of making routine coverage decisions, while achieving the above two criteria.
Moorhead
J F
JF
Group Life and Disability Division, Prudential Insurance Company, Parsippany, NJ, USA.
Jerde
M J
MJ
D000203:Activities of Daily Living; D003657:Decision Making; D017408:Guidelines as Topic; D015438:Health Behavior; D006264:Health Benefit Plans, Employee / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D019458:Insurance Coverage / Q000592:standards*; D018868:Insurance, Disability / Q000458:organization & administration* / Q000592:standards; D008329:Managed Care Programs / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D009042:Motivation; D018570:Risk Assessment; D014481:United States; D014937:Work / Q000523:psychology; D016526:Workload