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Title
Toward a 21st century quality-measurement system for managed-care organizations.
First Author
Armstead, Rodney C
Date of Pub
1995 Summer
Pages
25-37
Volume
16
Issue
4
Other Authors
Elstein, Paul; Gorman, John K
Abstract
As the Nation's largest managed-care purchaser, the Health Care Financing Administration (HCFA) is working to develop a uniform data and performance-measurement system for all enrollees in managed-care plans. This effort will ultimately hold managed-care plans accountable for continuous improvement in the quality of care they provide and will provide information to consumers and purchasers to make responsible managed-care choices. The effort entails overhauling peer review organization (PRO) conduct of health maintenance organization (HMO) quality review, pilot testing a new HMO performance-measurement system, establishing criteria for Medicaid HMO quality-assurance (QA) programs, adapting employers' HMO performance reporting systems to the needs of Medicare and Medicaid, and participation in a new alliance between public and private sector managed-care purchasers to promote quality improvement and accountability for health plans.
Abstract Continued
N/A
MeSH
Capitation Fee : Health Services Research : Managed Care Programs/standards : Medicaid/standards/trends : Medicare/standards/trends : Professional Review Organizations/organization & administration : Quality Assurance, Health Care/organization & administration/trends : Social Responsibility : United States : United States Health Care Financing Administration
NTIS Number
PB99-106445