Adjudicare

Adjudicare is a proposed framework for resolving disputes related to care decisions and resource allocation in healthcare and linked social services. The term blends adjudication with care, signaling a formal, impartial process to determine appropriate actions in medical and welfare contexts.

In its typical conception, adjudicare involves a neutral adjudicator or panel that reviews submissions from patients, providers, insurers, and administrators. It is used for disputes over medical necessity, coverage, eligibility, or interpretations of guidelines where individual judgment would otherwise vary.

A standard adjudicare process may include defined evidentiary standards, written or oral hearings, consultation with clinical or methodological experts, and a reasoned decision with guidelines for implementation. Depending on design, decisions can be binding or advisory, with mechanisms for appeal or external review.

The aims are to improve consistency, transparency, and accountability in care decisions, while creating a predictable path for dispute resolution and potentially faster resolution compared with ad hoc negotiations.

Critics point to risk of bureaucratic delays, higher administrative costs, potential erosion of clinician autonomy, risk of bias if panel composition is not diverse or independent, and concerns about privacy and data security.

Despite limited universal adoption, proponents describe adjudicare as a tool for balancing patient rights with resource constraints in health systems, and it has been discussed in policy analyses and administrative law literature as a model for organized dispute resolution.

It remains a theoretical construct with varying implementations.