Outcomes improvement: the true mark of quality in managed care

The definition of the term "quality" continues to be centered on health care providers and not the health of the community. The shift to managed care financing provides a unique opportunity to raise the importance of health outcomes as the true mark of quality in managed care. A widespread fear that managed care organizations are too ready to reduce quality for increased profits has lead to a current national backlash against managed care. Instead of only viewing health plan members as recipients of medical services, health plans should also view members as a population group with subpopulations within them, needing both medical and nonmedical services to improve their health. We introduce the Outcomes Improvement System, an outcomes-driven method for managed care plans and other health systems that incorporates both medical care and population-based health services in a managed care setting.