A practical approach to managing care under managed care. Case examples in pulmonary medicine

As managed care medicine penetrates the health care marketplace, all those involved in the health care delivery process will have to redesign and restructure the way they provide health care services. With the current emphasis on controlling health care costs, providers will be compelled to come up with the successful strategies and methodologies that lead to the delivery of cost-effective high-quality care with positive, successful patient outcomes. Having the capability to analyze the information necessary to identify, measure, and monitor processes and outcomes is one of the key critical factors for success. Using information to identify opportunities for improvement, developing and implementing the appropriate process improvement activities, and being able to document and demonstrate the results of one's efforts are crucial for survival in a competitive managed care market.