Managed Care

Ease of navigating system varies by condition






















Do patients with differing conditions have different experiences within the health care system? A sampling of California patients suggests that they do. The Health Rights Hotline, a Sacramento-area organization that provides information about and assistance with the health care system, found common threads among patients with diabetes, cancer, mental health, and respiratory as well as other conditions. The data reflect the nature of 3,600 calls to the hot line over a two-year period. The group hopes its report will serve as a tool for policy makers considering appropriate health care reforms.

Nature of problem*...

...reported by percentages of patients with:

*Access issues include unaffordable premiums/copayments or not knowing what to do when ineligible for public programs. Delays are for referrals to specialists or appointments for diagnostic tests. Denials/coverage disputes involve needed medical supplies, equipment, or treatment. Inappropriate care encompasses failure of primary care physicians to recognize symptoms or to order appropriate diagnostic tests. Prescription drug issues include off-formulary products or, in the case of mental illness, difficulty getting appointments with physicians for medication monitoring or to obtain refills.

SOURCE: WHEN WHAT'S AILING YOU ISN'T ONLY YOUR HEALTH, HEALTH RIGHTS HOTLINE, SACRAMENTO, CALIF., 2000

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