Accountability and quality in managed care: implications for health care practitioners.
The development of managed care plans is the most dramatic change in the USA's health care system in recent decades. Despite the widespread growth, society is increasingly concerned with the quality of managed care programs. This article addresses the regulatory pressures that are being placed on managed care organisations and examines what health care practitioners can do to minimize the impact of increased regulation. We look at the major factors that are likely to bring about changes in the health care sector, and predict how these changes will affect the quality of health care that is being delivered in the near future. Addresses how quality can become and remain the primary factor in the delivery of health care services. Finally, concludes that greater involvement by the federal government is necessary to protect consumers' rights, and ensure better quality health care from managed care programs.
Dobalian
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UCLA Department of Health Services, School of Public Health, Los Angeles, USA.
Rivers
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PA
D003254:Consumer Advocacy; D003625:Data Collection; D003659:Decision Making, Organizational; D005161:Facility Regulation and Control / Q000639:trends*; D006297:Health Services Accessibility; D008329:Managed Care Programs / Q000458:organization & administration* / Q000592:standards; D009874:Operations Research; D011050:Policy Making; D011787:Quality of Health Care; D012017:Referral and Consultation; D016079:Refusal to Treat; D012941:Social Responsibility; D014481:United States; D014600:Utilization Review