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A quality measurement framework for managed care organizations
Q Zhou1, D Mickey, D R Lancaster
1Tufts Health Plan, Boston, MA, USA. qi_zhou@tufts-health.com
Abstract:
This article presents a framework for a quality measurement system and its corresponding principles for quality improvement within a managed care environment. The quality measurement system comprises four modes: quality assessment, comparison, improvement, and system evaluation. If these modes are to be effective, the measurement system must incorporate the following five principles: (a) maintain and continually improve the data systems, (b) develop and utilize sound methodology and valid indicators, (c) build a competent measurement team, (d) develop effective strategies for implementation, and (e) protect member confidentiality. This model is helpful in the ongoing development and testing of new measurement systems.