Ensuring health care quality: a purchaser's perspective--an employer

This paper explores the idea of accountability in the managed care arena and the need for employers to demand accountability if they are to establish themselves as customers. Four key principles for establishing greater accountability are outlined: addressing health care issues at the local level; focusing on quality of health care as well as cost; collecting data on quality; and creating an accountable health care system through value-based purchasing. A review of methods for establishing accountability when negotiating contracts with managed care organizations (MCOs) focuses on the significance of collecting and understanding claims data, defining performance standards, and establishing and using MCO incentives.