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Focus on quality assessment: the need for evaluation.

M L Finkel1, S Oliveria

  • 1Cornell University Medical College, USA.

Employee Benefits Journal
|April 2, 1999
PubMed
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Managed care may compromise healthcare quality for cost savings. Employers should insist that managed care organizations (MCOs) prove they deliver both high-quality and low-cost services.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Quality Improvement

Background:

  • Growing concerns exist regarding the potential trade-off between cost savings and quality of care in managed care settings.
  • Purchasers, consumers, and regulators are increasingly scrutinizing managed care organizations (MCOs).

Purpose of the Study:

  • To highlight the need for employers, as major purchasers of healthcare, to demand evidence of high-quality, low-cost care from MCOs.
  • To advocate for accountability in managed care delivery.

Main Methods:

  • This is a conceptual analysis and recommendation based on current healthcare market trends.
  • It synthesizes concerns from various stakeholders in the healthcare system.

Main Results:

Related Experiment Videos

  • Managed care's focus on cost reduction may inadvertently lead to diminished healthcare quality.
  • Employers possess significant leverage to influence MCO performance.

Conclusions:

  • Employers must actively demand and verify that their chosen MCOs provide a balance of high-quality services and cost-efficiency.
  • Ensuring accountability in managed care is crucial for patient well-being and system sustainability.