Decisions about access to health care and accountability for reasonableness

  title={Decisions about access to health care and accountability for reasonableness},
  author={Dr. Norman Daniels},
  journal={Journal of Urban Health},
Insurers make decisions that directly limit access to care (e.g., when deciding about coverage for new technologies or formulary design) and that indirectly limit access (e.g., by adopting incentives to induce physicians to provide fewer or different services). These decisions raise questions about legitimacy and fairness. By holding health plans accountable for the reasonableness of their decisions, it is possible to address these questions. Accountability for reasonableness involves providing… CONTINUE READING
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