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- W2028021634 abstract "Health systems throughout the world face rising demands for and escalating costs of care. Both are fueled by the rapid pace of change in medical science and technology. In response, governments try to control healthcare spending by introducing changes in healthcare financing and organization. The health reform agenda in many countries is built on care which derives from the earlier model of health maintenance organizations (HMOs). Increasingly, reforms include attempts to foster competitive markets for purchase of health services. Inevitably, concerns arise about the quality of that is delivered when there is competition among managed plans— variously called plans or funds—aid per capita or by fixed budget. Are services kept within budget by limiting access and quality of care, or are access and quality being improved, despite cost controls, by greater efficiency in health delivery? How can we tell? Not surprisingly then, growth in managed has been accompanied by an evolution in methods of quality measurement and monitoring. We offer a brief overview of approaches to quality oversight for managed in the US with hopes that policy makers and program developers everywhere can profit from examples of US successes and mistakes. Just as layers in an icecream parfait melt and merge in the glass, layers of quality oversight that were originally developed as distinct activities have a tendency over time to mix together. The first layer for quality in managed in the US was laid down in the early 1970s and consisted of demonstration projects in internal quality assurance. A layer of external oversight was added in the early 1980s, then a layer of accreditation from the late 1980s into the 1990s, and lastly a layer of competition and report cards beginning in the early 1990s." @default.
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- W2028021634 date "1996-01-01" @default.
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- W2028021634 title "Managed Care and Melting Moments" @default.
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- W2028021634 doi "https://doi.org/10.1093/intqhc/8.4.317" @default.
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