PLYMOUTH MEETING, PA—The nonprofit health services research agency, ECRI, will be providing third-party reviews of managed care decisions through its newly established nonprofit, National Center for Independent Medical Review.
ECRI, which has been designated an Evidence-based Practice Center by the U.S. Agency for Health Care Policy and Research, brings clinical expertise as well as the tools of technology assessment to independent reviews of managed care decisions .
Several states have passed legislation guaranteeing consumers the right to an independent review of managed care decisions and this consumer protection is being considered at the federal level."Some patients may fare better or worse in a specific intervention than the statistical’ patient. The Center has bridged this gap by linking the best research about effective treatment with a network of case reviewers who are not only clinicians but who also are among the leading researchers, teachers, and practitioners in their field," states a release on the new Center. The Center’s Medical Review Service also will explain the rationale behind reviewers’ decisions and disclose its review process.
Contact Don Cummins at 610-825-6000, ext. 170.
RWJ Foundation to award $6.8 million in smoking-cessation grants
PRINCETON, NJ—Managed care plans that want to experiment with ways to help their members quit smoking can apply for a grant under a new Robert Wood Johnson Foundation program called Addressing Tobacco in Managed Care. The Foundation will be awarding $6.76 million in grants. In 1998, the program’s first year of funding, up to eight projects will be awarded one-year planning grants of $45,000 each and up to five will receive two- or three- year implementation grants averaging $500,000 each.
The goal of the RWJF grants is not necessarily to test smoking cessation treatments, but to try systems-based changes such as implementing a tobacco user identification system at the clinic level, promoting hospital policies that support and provide smoking cessation services, providing incentives for clinicians to deliver smoking cessation treatments and including these treatments as paid services or covered services.
Applicants may be either managed care organizations, group practices or researchers. Applicant workshops will be held in Arlington, VA and Chicago in February. Letters of intent must be submitted in April with full proposals to be submitted in August. Contact Marguerite Burns at the Center for Tobacco Research and Intervention at 608-265-4601. The Call for Proposals is available at the Foundation’s website www.rwjf.org.
ECRI to provide third-party reviews of managed care decisions
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