Ensuring quality and access in managed care: how well are we doing?
Through mergers, acquisitions, joint ventures, and contracting, proprietary managed care organizations are steadily assuming health care responsibilities formerly delegated to government-owned and not-for-profit health care institutions. An examination of existing quality assurance initiatives for managed care organizations reveals several areas of concern: incentives for providing substandard services; a shortage of visible, measurable, and enforceable quality standards; and inadequate data and reporting systems for producing reliable quality indicators.
Silberman
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Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, USA.
D000068:Accreditation / Q000191:economics / Q000592:standards; D002204:Capitation Fee; D003258:Consumer Behavior; D003625:Data Collection; D004465:Economic Competition; D017598:Efficiency, Organizational; D006269:Health Facilities, Proprietary / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D006297:Health Services Accessibility / Q000191:economics; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards*; D010067:Ownership; D010816:Physician Incentive Plans; D011785:Quality Assurance, Health Care / Q000191:economics; D012941:Social Responsibility; D013219:State Government; D014481:United States