Ensuring quality and accountability in managed care.
The rapid growth of new forms of managed care in the United States in recent decades has brought with it increasing concerns regarding the quality of care delivered by practitioners in these plans. This article examines the various regulatory demands that are being placed on Managed Care Organizations (MCOs). The authors look at the major determinants that are likely to bring about significant changes in the health care sector for both patients and providers and predict how these shifts will affect the quality of health care services in the near future. They discuss how the quality of health care, rather than the cost of those services, can become and remain the primary factor in the delivery of health care services. Ultimately, they conclude that increased participation by the federal government is required to protect the rights of patients and ensure better quality and accountability for health care services delivered by MCOs.
Dobalian
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A
University of California, Los Angeles, USA.
Rivers
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PA
D003258:Consumer Behavior; D003625:Data Collection; D006297:Health Services Accessibility; D008329:Managed Care Programs / Q000331:legislation & jurisprudence / Q000458:organization & administration / Q000592:standards*; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D012941:Social Responsibility; D014481:United States; D014600:Utilization Review