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Related Experiment Videos

Quality assurance for delegated services.

A Lenox1

  • 1ACL Consulting, Houston, USA.

Healthplan
|August 5, 1996
PubMed
Summary

Delegating administrative and quality assessment tasks offers health plans cost savings. However, health plans retain ultimate responsibility for care quality, necessitating robust oversight of delegated functions to ensure member standards are met.

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Area of Science:

  • Healthcare Administration
  • Quality Management in Healthcare

Background:

  • Delegation of administrative and quality assessment activities is common in health plans.
  • Cost-efficiency is a key driver for exploring delegation.

Purpose of the Study:

  • To evaluate the effectiveness and cost-efficiency of delegating health plan activities.
  • To emphasize the health plan's continued accountability for care quality.

Main Methods:

  • Review of administrative and quality assessment delegation practices.
  • Analysis of health plan accountability frameworks.
  • Assessment of oversight and monitoring mechanisms for delegated activities.

Main Results:

  • Delegation is an effective and cost-efficient strategy for health plans.
  • Health plans remain fully responsible for the quality of care provided, irrespective of delegation.
  • Effective oversight ensures delegates meet health plan standards.

Conclusions:

  • Delegation requires stringent oversight to maintain high standards of care.
  • Health plans must ensure accountability is maintained throughout the delegation process.
  • Monitoring delegated activities is crucial for consistent, high-quality member care.

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