Managed Care Expert Witnesses

Managed Care is the most common form of healthcare in the United States. It is a healthcare system in which patients agree to only see doctors, hospitals and health care providers within a certain network. The treatment is monitored by a managing insurance company. Managed care organization are responsible for ensuring and improving the quality of the care and services they provided to their members. These organizations received per-person, per-month payment to manage care for their members. The advantages of Managed Care are that it provides health care for patients when needed, specialist referrals are processed quicker within the network, and patients who stay in network receive a discounted rate for medical services. Disadvantages to Managed Care include limits for those without insurance coverage, only one in-network provider with HMO/PPO, and second opinions obtain outside of network are not covered leaving insured to pay out of pocket. Our managed care expert witnesses, speakers, and consultants are scholars and researchers from major universities and industry professionals ranging from physicians to hospital and managed care plan administrators to medical malpractice attorneys. Areas of expertise include contracting and operations, administration, health policy, pharmaceutical strategy and marketing, antitrust law, promotion/advertising, pricing, product management, health economics, pharmacy management, business valuation, quality of care, technology assessment, cost-effectiveness, influencing physician behavior, health insurance, Medicare, managed care litigation, and much more. Our managed care experts have extensive experience providing litigation support.