The Fund supports networks of state health policy decision makers to help identify, inspire, and inform policy leaders.
A bipartisan group of state health policymakers from both the executive and legislative branches who are focused on improving population health.
Supporting networks of state officials, advocates, and others aiming to invest in and transform primary care.
Advancing state-based efforts to make health care more affordable for residents, employers, and states.
The Milbank Memorial Fund supports two state leadership programs for legislative and executive branch state government officials committed to improving population health.
A leadership development program for early and mid-career state government officials who are committed to improving the health of all people in their communities.
A leadership program for senior state government officials who are committed to improving population health.
The Fund focuses on creating an affordable health care system built on strong primary care and partnerships that improve health outcomes for all.
Improving state leaders ability to enact and implement evidence-based health policies.
Advancing policies that create a more prevention- and primary care-oriented health system.
Improving population health through policies that contain health care cost growth.
Our state health policy resources provide relevant data analysis and best practices.
The Fund publishes reports, issues briefs, and case studies on state health policy issues.
Short takes on health policy issues from Milbank staff and guest authors.
Insights from Milbank President Debra Lubar on state health policymaking.
Reported articles and Q&As on timely health policy issues, as well as foundation updates.
Upcoming and past Milbank Memorial Fund and Milbank Quarterly webinars featuring state health policymakers and researchers.
Updates and expert contact information for reporters.
The Milbank Memorial Fund is a private foundation that works to improve population health and health equity.
September 1973 (Volume 51)
Quarterly Article
Bruce Stuart
Ronald Stockton
Sep 17, 2026
Sep 14, 2026
Sep 9, 2026
Back to The Milbank Quarterly
During recent years, the health care industry has been characterized by rapid increases in the volume of services delivered. This escalation is in part unjustified by medical need, and has produced a variety of efforts on the part of payers and providers to restrict overuse. In this article the authors consider the issues and problems involved in the control of medical utilization. Five categories of control are considered in detail: supply limitations, financial disincentives, authorization requirements, review mechanisms, and legal action. The article suggests that the success or failure of these various control mechanisms hinges upon four factors: whose use is being regulated, who performs the control activities, whether the attempted control involves a judgment as to the appropriateness of treatment, and whether the attempt to control occurs before, after, or during treatment. It is concluded that most current forms of utilization control suffer from ambiguity of purpose, organizational inefficiency, and undesirable side effects. The authors offer several proposals to correct these shortcomings, but conclude that the only long-range solution to overutilization lies in a more integrated approach to medical resource allocation and a consequent change in the structure of provider and user incentives.
Author(s): Bruce Stuart; Ronald Stockton
Download the Article
Read on JSTOR
Volume 51, Issue 3 (pages 341–394) Published in 1973