FOR IMMEDIATE RELEASE
September 30, 1999

Paul Herndon (APA)
202-336-5901
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(Washington, DC) -- The American Psychological Association (APA) today urged Congress to refocus the current health care debate back to the critical role played by health plan accountability in assuring quality patient care. Despite protests by the insurance and managed care industries, holding managed care accountable for the care they provide is a sound way to encourage greater attention to quality and less attention to profits, says the APA.

Through an advertisement in Roll Call, a Capitol Hill newspaper, the APA is encouraging Congress not to lose sight of the benefits that can occur by including health plan accountability as part of any patient protection legislation it passes. The advertisement, "Do HMOs care about the treatment your family gets," caricatures an HMO executive whose decisions to deny care through the utilization review process result in considerable profits to the company. The ad underscores the financial incentives that currently exist in the health care system to aggressively limit or deny patient care. The ad urges Congress to counter this financial incentive by enacting health plan accountability and passing the Norwood-Dingell Bill (H.R. 2723).

"What?s gotten lost in the health care debate is that little incentive exists for managed care companies to provide high quality care while considerable financial incentive exists to provide as little care as possible, says Russ Newman, Ph.D., J.D., APA?s executive director for professional practice. "Even an external review process ? which is a step in the right direction ? can be used by the industry to increase profits at patients? expense if legal accountability is not also required."

APA recently released a study that revealed managed care?s financial incentive to deny needed care. The APA analysis showed the income that can be generated by investing the money saved while denied claims are undergoing review ? a scenario based on the Senate-passed Patients? Bill of Rights Plus Act (S. 1344). The PricewaterhouseCoopers analysis found that the insurance and managed care industries could generate interest income of up to $280 million per year if as little as one percent of the year?s claims are denied and later paid after the maximum amount of time allowed by the review process.

"Also overlooked in the patient protection debate is that the main purpose of the accountability provision is to prevent injury to patients before it occurs, not to spawn lawsuits," says Newman. "Holding managed care companies accountable for its actions is a powerful incentive to insure that patient care is provided correctly in the first place."

To download the APA advertisement in Roll Call, visit the APA web site at http://www.apa.org/practice/factory.html