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Related Experiment Videos

Are all health plans created equal? The physician's view

S J Borowsky1, M K Davis, C Goertz

  • 1Department of Medicine, Minneapolis Veterans Affairs Medical Center, MN 55417, USA.

JAMA
|September 25, 1997
PubMed
Summary
This summary is machine-generated.

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Physician feedback reveals health plan quality varies significantly. Key barriers to high-quality care include time constraints and utilization management, highlighting the need for better health plan evaluation tools.

Area of Science:

  • Health Services Research
  • Quality Improvement in Healthcare
  • Physician Practice Patterns

Background:

  • Increasing demand for health plan quality information.
  • Physicians are an underutilized source for quality assessment.
  • Need to understand physician perspectives on health plan practices.

Purpose of the Study:

  • Assess physician views on health plan practices.
  • Identify factors promoting or hindering high-quality care delivery.
  • Compare physician ratings across different health plans.

Main Methods:

  • Survey of 249 physicians across 3 health plans.
  • Utilized Likert-type items to assess health plan practices.
  • Physicians rated practices promoting or impeding quality care.
Keywords:
Empirical ApproachHealth Care and Public HealthMinneapolis

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Main Results:

  • Low physician ratings (<20%) for practices supporting high-quality care.
  • Identified barriers: limited patient time, benefit structures, utilization management.
  • Significant differences in physician ratings and recommendations across health plans.

Conclusions:

  • Physician surveys effectively highlight health plan strengths and weaknesses.
  • Ratings vary significantly between health plans.
  • Physician feedback can guide consumers, purchasers, and quality improvement initiatives.