In their article ‘‘Impacts of Managed Care Patient Protection Laws on Health Services Utilization and Patient Satisfaction with Care,’’ Sloan, Rattliff, and Hall use data from three rounds (1996–1997, 1998–1999, and 2000–2001) of the Community Tracking Study (CTS) to assess the impact on health utilization and patient satisfaction of ‘‘patient protection’’ laws. Each of the three rounds of the CTS surveyed approximately 32,000 individuals about the care received by themselves and their families (a total of approximately 60,000 persons). Patient protection laws include those that address: the size and scope of provider networks, the range of covered benefits, the procedures essential to access covered benefits, and the financial incentives used by managed care plans to affect provider behavior. Specifically, they include gag-clause bans, direct-access to specialist laws, any-willing-provider laws, freedom-of-choice laws, mandated minimum length of stays for delivery laws, and laws limiting the size of physician withholds and bonuses. The basic purpose of these laws is to improve the care provided to enrollees of managed care plans. The proportion of American workers enrolled in managed care plans has risen from 4 percent in 1977 (Gabel 1999) to 93 percent in 2001 (Supreme Court to Rule on Patients’ Rights 2003), and all but three states have enacted a comprehensive set of patient protection laws (Sloan and Hall 2002). Thirty-five states enacted patient protection laws between 1997 and 1999. Proponents of these laws maintain that they help ensure that enrollees have a reasonable choice of providers at the time of service, do not face limits on services that may adversely affect their health, are not arbitrarily denied access to covered services, and are not treated by a physician who faces inordinately high financial risks for ordering necessary services. Opponents of these laws (who often refer to them as ‘‘anti-managed care’’ laws) maintain that they reduce the flexibility of plans in their dealings with physicians, prevent plans from limiting particular services in order to increase efficiency, preclude plans from implementing cost-effective utilization management techniques,
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