A Comparative Analysis of Mandated Benefit Laws, 1949–2002
Identifieur interne : 003D06 ( Pmc/Checkpoint ); précédent : 003D05; suivant : 003D07A Comparative Analysis of Mandated Benefit Laws, 1949–2002
Auteurs : Miriam J. Laugesen ; Rebecca R. Paul ; Harold S. Luft ; Wade Aubry ; Theodore G. GaniatsSource :
- Health Services Research [ 0017-9124 ] ; 2006.
Abstract
To understand and compare the trends in mandated benefits laws in the United States.
Mandated benefit laws enacted in 50 states and the District of Columbia for the period 1949–2002 were compiled from multiple published compendia.
Laws that require private insurers and health plans to cover particular services, types of diseases, or care by specific providers in 50 states and the District of Columbia are compared for the period 1949–2002. Legislation is compared by year, by average and total frequency, by state, by type (provider, health care service, or preventive), and according to whether it requires coverage or an offer of coverage.
Data from published tables were entered into a spreadsheet and analyzed using statistical software.
A total of 1,471 laws mandated coverage for 76 types of providers and services. The most common type of mandated coverage is for specific health care services (670 laws for 34 different services), followed by laws for services offered by specific professionals and other providers (507 mandated benefits laws for 25 types of providers), and coverage for specific preventive services (295 laws for 17 benefits). On average, a mandated benefit law has been adopted or significantly revised by 19 states, and each state has approximately 29 mandates. Only two benefits (minimum maternity stay and breast reconstruction) are mandated in all 51 jurisdictions and these were also federally mandated benefits. The mean number of total mandated benefit laws adopted or significantly revised per year was 17 per year in the 1970s, 36 per year in the 1980s, 59 per year in the 1990s, and 76 per year between 2000 and 2002. Since 1990, mandate adoption increased substantially, with around 55 percent of all mandated benefit laws enacted between 1990 and 2002.
There was a large increase in the number of mandated benefits laws during the managed care “backlash” of the 1990s. Many states now use mandated benefits to prescribe not only what services and benefits would be provided but how, where, and when services will be provided.
Url:
DOI: 10.1111/j.1475-6773.2006.00521.x
PubMed: 16704673
PubMed Central: 1713218
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Laugesen</name></author><author><name sortKey="Paul, Rebecca R" sort="Paul, Rebecca R" uniqKey="Paul R" first="Rebecca R" last="Paul">Rebecca R. Paul</name></author><author><name sortKey="Luft, Harold S" sort="Luft, Harold S" uniqKey="Luft H" first="Harold S" last="Luft">Harold S. Luft</name></author><author><name sortKey="Aubry, Wade" sort="Aubry, Wade" uniqKey="Aubry W" first="Wade" last="Aubry">Wade Aubry</name></author><author><name sortKey="Ganiats, Theodore G" sort="Ganiats, Theodore G" uniqKey="Ganiats T" first="Theodore G" last="Ganiats">Theodore G. Ganiats</name></author></analytic><series><title level="j">Health Services Research</title><idno type="ISSN">0017-9124</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>To understand and compare the trends in mandated benefits laws in the United States.</p></sec><sec><title>Data Sources/Study Setting</title><p>Mandated benefit laws enacted in 50 states and the District of Columbia for the period 1949–2002 were compiled from multiple published compendia.</p></sec><sec><title>Study Design</title><p>Laws that require private insurers and health plans to cover particular services, types of diseases, or care by specific providers in 50 states and the District of Columbia are compared for the period 1949–2002. Legislation is compared by year, by average and total frequency, by state, by type (provider, health care service, or preventive), and according to whether it requires coverage or an offer of coverage.</p></sec><sec><title>Data Collection/Extraction Method</title><p>Data from published tables were entered into a spreadsheet and analyzed using statistical software.</p></sec><sec><title>Principal Findings</title><p>A total of 1,471 laws mandated coverage for 76 types of providers and services. The most common type of mandated coverage is for specific health care services (670 laws for 34 different services), followed by laws for services offered by specific professionals and other providers (507 mandated benefits laws for 25 types of providers), and coverage for specific preventive services (295 laws for 17 benefits). On average, a mandated benefit law has been adopted or significantly revised by 19 states, and each state has approximately 29 mandates. Only two benefits (minimum maternity stay and breast reconstruction) are mandated in all 51 jurisdictions and these were also federally mandated benefits. The mean number of total mandated benefit laws adopted or significantly revised per year was 17 per year in the 1970s, 36 per year in the 1980s, 59 per year in the 1990s, and 76 per year between 2000 and 2002. Since 1990, mandate adoption increased substantially, with around 55 percent of all mandated benefit laws enacted between 1990 and 2002.</p></sec><sec><title>Conclusions</title><p>There was a large increase in the number of mandated benefits laws during the managed care “backlash” of the 1990s. Many states now use mandated benefits to prescribe not only what services and benefits would be provided but how, where, and when services will be provided.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Health Serv Res</journal-id><journal-id journal-id-type="publisher-id">hesr</journal-id><journal-title>Health Services Research</journal-title><issn pub-type="ppub">0017-9124</issn><publisher><publisher-name>Blackwell Science Inc</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">16704673</article-id><article-id pub-id-type="pmc">1713218</article-id><article-id pub-id-type="doi">10.1111/j.1475-6773.2006.00521.x</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>A Comparative Analysis of Mandated Benefit Laws, 1949–2002</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Laugesen</surname><given-names>Miriam J</given-names></name></contrib><contrib contrib-type="author"><name><surname>Paul</surname><given-names>Rebecca R</given-names></name></contrib><contrib contrib-type="author"><name><surname>Luft</surname><given-names>Harold S</given-names></name></contrib><contrib contrib-type="author"><name><surname>Aubry</surname><given-names>Wade</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ganiats</surname><given-names>Theodore G</given-names></name></contrib></contrib-group><author-notes><corresp id="cor1">Address correspondence to Miriam J. Laugesen, Ph.D., Assistant Professor, Department of Health Services, UCLA School of Public Health, 31-293A CHS, Box 1772, Los Angeles, CA 90095-1772. Rebecca R. Paul, 1400 East West Highway, Suite 1519, Silver Spring, MD 20910. Harold S. Luft, Ph.D., is Caldwell B. Esselstyn, Professor of Health Policy and Health Economics, and Director, is with the Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA. Wade Aubry, M.D., Associate Clinical Professor of Medicine, is with the UCSF, Institute for Health Policy Studies, San Francisco, CA. Theodore G. Ganiats, M.D., Interim Chair, is with the Department of Family and Preventive Medicine, University of California, La Jolla, CA.</corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2006</year></pub-date><volume>41</volume><issue>3 Pt 2</issue><fpage>1081</fpage><lpage>1103</lpage><copyright-statement>© 2006 Health Research and Educational Trust</copyright-statement><copyright-year>2006</copyright-year><abstract><sec><title>Objective</title><p>To understand and compare the trends in mandated benefits laws in the United States.</p></sec><sec><title>Data Sources/Study Setting</title><p>Mandated benefit laws enacted in 50 states and the District of Columbia for the period 1949–2002 were compiled from multiple published compendia.</p></sec><sec><title>Study Design</title><p>Laws that require private insurers and health plans to cover particular services, types of diseases, or care by specific providers in 50 states and the District of Columbia are compared for the period 1949–2002. Legislation is compared by year, by average and total frequency, by state, by type (provider, health care service, or preventive), and according to whether it requires coverage or an offer of coverage.</p></sec><sec><title>Data Collection/Extraction Method</title><p>Data from published tables were entered into a spreadsheet and analyzed using statistical software.</p></sec><sec><title>Principal Findings</title><p>A total of 1,471 laws mandated coverage for 76 types of providers and services. The most common type of mandated coverage is for specific health care services (670 laws for 34 different services), followed by laws for services offered by specific professionals and other providers (507 mandated benefits laws for 25 types of providers), and coverage for specific preventive services (295 laws for 17 benefits). On average, a mandated benefit law has been adopted or significantly revised by 19 states, and each state has approximately 29 mandates. Only two benefits (minimum maternity stay and breast reconstruction) are mandated in all 51 jurisdictions and these were also federally mandated benefits. The mean number of total mandated benefit laws adopted or significantly revised per year was 17 per year in the 1970s, 36 per year in the 1980s, 59 per year in the 1990s, and 76 per year between 2000 and 2002. Since 1990, mandate adoption increased substantially, with around 55 percent of all mandated benefit laws enacted between 1990 and 2002.</p></sec><sec><title>Conclusions</title><p>There was a large increase in the number of mandated benefits laws during the managed care “backlash” of the 1990s. Many states now use mandated benefits to prescribe not only what services and benefits would be provided but how, where, and when services will be provided.</p></sec></abstract><kwd-group><kwd>Mandated benefits</kwd><kwd>insurance</kwd><kwd>state legislation/policy</kwd><kwd>managed care</kwd></kwd-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Aubry, Wade" sort="Aubry, Wade" uniqKey="Aubry W" first="Wade" last="Aubry">Wade Aubry</name><name sortKey="Ganiats, Theodore G" sort="Ganiats, Theodore G" uniqKey="Ganiats T" first="Theodore G" last="Ganiats">Theodore G. Ganiats</name><name sortKey="Laugesen, Miriam J" sort="Laugesen, Miriam J" uniqKey="Laugesen M" first="Miriam J" last="Laugesen">Miriam J. Laugesen</name><name sortKey="Luft, Harold S" sort="Luft, Harold S" uniqKey="Luft H" first="Harold S" last="Luft">Harold S. Luft</name><name sortKey="Paul, Rebecca R" sort="Paul, Rebecca R" uniqKey="Paul R" first="Rebecca R" last="Paul">Rebecca R. Paul</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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