Independent Medical Review Poised to Dramatically Improve Quality, Safety of Health Care, Study Says

AAHP's Ignagni Sees 'Unprecedented Opportunity' for Washington



Apr 26, 2001, 01:00 ET from American Association of Health Plans

    WASHINGTON, April 26 /PRNewswire/ -- Independent medical review -- the
 process America's physicians say is the best means of resolving health care
 disputes -- can also dramatically improve the quality and safety of health
 care in America if Congress will examine the lessons learned at the state
 level and move to encourage the program's use nationally.  That is the
 conclusion of a sweeping new study of the independent medical review process
 in 39 states plus the District of Columbia, released this morning by the
 American Association of Health Plans.  The study finds that independent review
 organizations are poised to influence the quality of health care significantly
 in the coming years, by reassuring consumers that their health plans are
 accountable, and by spotlighting best medical evidence.
     The study was released amid the backdrop of an evolving debate on patient
 protection, in which consumers, doctors and employers now agree that
 independent medical review -- not new lawsuits -- is the right approach to
 patient protection.
     "Independent medical review is steadily emerging as a crucial component of
 the health care framework, with the potential to give patients both the piece
 of mind that comes with increased accountability, and the assurance that their
 care is keeping pace with science," said AAHP President and CEO Karen Ignagni.
 "We urge Washington to seize this unique opportunity."
     According to the study, the independent review organizations (IROs) that
 currently operate in most states have earned generally favorable reviews --
 with high marks given to the credentials of the reviewers and the quality of
 their decisions.  The study also concludes that IROs are uniquely positioned
 to help address the gap between knowledge and practice that was recently
 discussed in the landmark Institute of Medicine report, Crossing the Quality
 Chasm:  A New Health System for the 21st Century.
     "Independent review organizations are in a position to ensure that the
 practice of medicine is based on the best scientific evidence," said Ignagni.
 "But in order to fulfil this promise, independent medical review organizations
 must base their standards on the best medical evidence, the same standards by
 which America's health plans operate."  In particular, the report recommends
 the following improvements to the IRO process:
 
     *  Use uniform standards based on best scientific evidence
 
     *  Make IRO process uniform across state lines
 
     *  Streamline paperwork requirements for determining eligibility and
        processing cases
 
     "Consumers, doctors and employers agree that independent medical review
 should form the basis for a patient protection bill that gives consumers the
 accountability they seek and deserve," said Ignagni.  "Health plans are
 committed to providing this accountability, and we look forward to working
 with all members of the health care community, as well as policymakers in
 Washington, toward creating an independent review system that fulfils its
 potential."
 
     For complete copies of the two new studies, please visit
 http://www.aahp.org and click on Government & Advocacy tab.
 
     The American Association of Health Plans (AAHP) is the largest national
 trade organization representing more than 1,000 health maintenance
 organizations (HMOs), preferred provider organizations (PPOs), and other
 similar health plans that provide health care coverage to more than 140
 million Americans.
 
                     MAKE YOUR OPINION COUNT -  Click Here
                http://tbutton.prnewswire.com/prn/11690X96688828
 
 

SOURCE American Association of Health Plans
    WASHINGTON, April 26 /PRNewswire/ -- Independent medical review -- the
 process America's physicians say is the best means of resolving health care
 disputes -- can also dramatically improve the quality and safety of health
 care in America if Congress will examine the lessons learned at the state
 level and move to encourage the program's use nationally.  That is the
 conclusion of a sweeping new study of the independent medical review process
 in 39 states plus the District of Columbia, released this morning by the
 American Association of Health Plans.  The study finds that independent review
 organizations are poised to influence the quality of health care significantly
 in the coming years, by reassuring consumers that their health plans are
 accountable, and by spotlighting best medical evidence.
     The study was released amid the backdrop of an evolving debate on patient
 protection, in which consumers, doctors and employers now agree that
 independent medical review -- not new lawsuits -- is the right approach to
 patient protection.
     "Independent medical review is steadily emerging as a crucial component of
 the health care framework, with the potential to give patients both the piece
 of mind that comes with increased accountability, and the assurance that their
 care is keeping pace with science," said AAHP President and CEO Karen Ignagni.
 "We urge Washington to seize this unique opportunity."
     According to the study, the independent review organizations (IROs) that
 currently operate in most states have earned generally favorable reviews --
 with high marks given to the credentials of the reviewers and the quality of
 their decisions.  The study also concludes that IROs are uniquely positioned
 to help address the gap between knowledge and practice that was recently
 discussed in the landmark Institute of Medicine report, Crossing the Quality
 Chasm:  A New Health System for the 21st Century.
     "Independent review organizations are in a position to ensure that the
 practice of medicine is based on the best scientific evidence," said Ignagni.
 "But in order to fulfil this promise, independent medical review organizations
 must base their standards on the best medical evidence, the same standards by
 which America's health plans operate."  In particular, the report recommends
 the following improvements to the IRO process:
 
     *  Use uniform standards based on best scientific evidence
 
     *  Make IRO process uniform across state lines
 
     *  Streamline paperwork requirements for determining eligibility and
        processing cases
 
     "Consumers, doctors and employers agree that independent medical review
 should form the basis for a patient protection bill that gives consumers the
 accountability they seek and deserve," said Ignagni.  "Health plans are
 committed to providing this accountability, and we look forward to working
 with all members of the health care community, as well as policymakers in
 Washington, toward creating an independent review system that fulfils its
 potential."
 
     For complete copies of the two new studies, please visit
 http://www.aahp.org and click on Government & Advocacy tab.
 
     The American Association of Health Plans (AAHP) is the largest national
 trade organization representing more than 1,000 health maintenance
 organizations (HMOs), preferred provider organizations (PPOs), and other
 similar health plans that provide health care coverage to more than 140
 million Americans.
 
                     MAKE YOUR OPINION COUNT -  Click Here
                http://tbutton.prnewswire.com/prn/11690X96688828
 
 SOURCE  American Association of Health Plans