Evaluating Managed Care Patient Protection Laws

What are the effects of state managed care patient protection laws on patients, providers, plans, and network, corporate, and market structures? The researchers at Wake Forest University 1) developed an index of regulatory intensity of patient protection laws (among states and over time); 2) learned more about the complexities surrounding the implementation and enforcement of states’ patient protection laws; and 3) determined whether patient protection laws have achieved their intended effects and have avoided unintended or potential harm by assessing the impact of such laws on patients, providers, plans and on network, corporate, and market structures. The first two major tasks were achieved by studying primary legal sources and conducting a systematic national survey of state regulators and health care lawyers. The third major task was achieved through a combination of quantitative and qualitative studies: at least two rounds of the Community Tracking Survey of patients and physicians (1996-7 and 1999) was analyzed, and in-depth case studies in 6 selected states was conducted. Given that policy makers at the federal and state levels have been encumbered by a lack of empirical evidence, the objective of the study was to inform the national debate on the need for laws to protect patients enrolled in managed care organizations.