Improving managed care through coding, monitoring, and trending quality-of-care concerns.
With the rise of managed care, purchasers and payers are increasingly demanding value in healthcare. Traditionally, patient satisfaction surveys and focus groups have been used to elicit information regarding customers' perspectives. This article explores the use of an inexpensive alternative methodology--that of monitoring quality-of-care concerns and complaints. A nomenclature and a process for tracking, trending, and reporting quality-of-care issues are detailed; they encompass both the patient's and the provider's perception of a specific care experience. This methodology promotes the use of quantifiable data to support strategic planning and compliance with National Committee for Quality Assurance accreditation standards.
Miller
J A
JA
Physicians Health Plan of Mid-Michigan, Lansing, USA.
Lowe
P V
PV
D000043:Abstracting and Indexing; D005568:Forms and Records Control; D008329:Managed Care Programs / Q000592:standards*; D017060:Patient Satisfaction; D018024:Peer Review, Health Care; D017064:Process Assessment, Health Care; D012308:Risk Management / Q000145:classification / Q000379:methods*; D012985:Software Design; D017749:Total Quality Management / Q000379:methods*; D014481:United States