This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
Although utilization review has been underscored by WP.L. 89-97, the subject is certainly by no means new to many physicians or to voluntary systems in general, or Blue Cross in particular. On the contrary, provisions relating to utilization review activity and many other provisions as well in the law are a direct reflection of the fact that these processes have been around long enough to have shown themselves as valuable tools for the development of knowledge, understanding, and progress among physicians, hospitals, third parties, patients, and the various publics.
As a subject for national attention and activity, formal utilization and review programs are comparative newcomers to the scene, particularly when one considers the state of the art and the science and the literature. The First National Conference on Utilization, sponsored by the American Hospital Association, the Blue Cross Association, the American Medical Association, and the National Association of Blue Shield
Ensign FM. Third-Party Review Programs From the Blue Cross Vantage Point. JAMA. 1966;196(11):1006-1007. doi:10.1001/jama.1966.03100240140033