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Physician experiences with, and ratings of, managed care organizations in Massachusetts
T V Williams1, A M Zaslavsky, P D Cleary
1Department of Defense, Washington, DC, USA.
Background:
Physicians can provide important information about how managed care plans affect the delivery of health care. Assessments of the quality of managed care plans have rarely used physician evaluations.
Objectives:
To elicit physician evaluations of managed care plans and to determine factors associated with those evaluations.
Research Design:
Physicians were asked in a mail survey to evaluate a managed care plan they were associated with.
Subjects:
Probability sample of 1,336 physicians associated with the five largest managed care health plans in Massachusetts.
Measures:
Physicians were asked about the extent to which the management strategies used by a plan influenced their clinical behavior and about the quality of care available to their patients.
Results:
Evaluations of the plans were significantly different among the eight units evaluated. Some differences between divisions within plans were as large as differences among plans. Physicians reported that the use of education and peer influence influenced their clinical behavior and facilitated the provision of high quality care more than did rules and regulations or financial incentives. Physicians evaluated most positively plans, which they said used educational strategies more than other plans and which used rules and regulations and financial incentives less. Physicians tended to rate staff and group model plans more positively than did other plans.
Conclusions:
Physicians can provide important information about the extent to which the organization and operation of managed care plans affect the provision of high quality care.