Institutes of Quality: Prudential's approach to outcomes management for specialty procedures

The Prudential Institutes of Quality program was developed to respond to the growing interest in the quality of care available to patients through both indemnity and managed medical plans and clients' concern about the continued escalation of health care costs. The program is based on the premise that high-quality care is the most efficient care that utilizes resources appropriately because of the experience of both the hospital and the physicians. Hospitals and physicians are selected through a questionnaire and site-visit process based on criteria developed from a literature review and outside expert counsel. Networks of facilities meeting the criteria serve the Prudential patient population. The history and results through the third quarter of 1989 and the implications of selective contracting for health care policy are presented.