REFERRALS: Communication Lapses Compound Problem
A recent study has found that miscommunication between patients and doctors contributes to the controversy surrounding the referral process used by HMOs to regulate access to medical specialists. The study was commissioned by the California Public Employees' Retirement System (CalPERS), the nation's "second-largest health benefits purchaser after the federal government," according to Bloomberg News/St. Louis Post-Dispatch. California Health Decisions, the non-profit research group conducting the study, found that problems with access to specialists were "compounded by misunderstandings among patients and doctors about how the referral process is supposed to work." Janet Backes, director of business development for California Health Decisions, said, "There is a need for better communication aimed at both enrollees and physicians. ... All parties involved -- the health plans, medical groups, individual physicians and patients -- need to understand the process and know what their responsibilities are." Having identified the need for improved communication, CalPERS said it will develop solutions, "implement them through pilot projects," and publicize the recommendations for use by HMOs nationwide (8/19).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.