Content area
Full Text
Managed care figures prominently in current proposals for health care reform. An important element in some proposals is the health plan "report card." This would provide consumers and purchasers with information on the quality of the performance of health plans, including outcomes of care and patient satisfaction. Such reports do not now exist, but they might look like a Consumer Reports table to aid persons in making choices among health plans. The technology for producing such report cards is beginning to be tested. This DataWatch discusses the results of a feasibility test of the capacity of thirteen managed care organizations to capture outcomes information for two health conditions.
The patient outcomes assessment methodology builds in part on the proposal made by Paul Ellwood in his 1988 Shattuck Lecture. He challenged physicians, health care executives, and payers to implement outcomes management, a systematic approach to collecting information on the impact of medical care on patients' health outcomes:
Outcomes management consists of a common patient-understood language of health outcomes: a national data base containing information and analysis on clinical, financial, and health outcomes that estimates as best we can the relation between medical interventions and health outcomes, as well as the relation between health outcomes and money; and an opportunity for each decision-maker to have access to the analyses that are relevant to the choices they must make.(1)
Medical care is now largely directed at the diagnosis and treatment of symptoms and problems. Establishing an outcomes management system represents a significant change from usual practice. The feasibility of accomplishing this goal is largely untested.
Consortium of employers and insurers. Eleven members of the Managed Health Care Association (MHCA) took seriously the challenge of understanding outcomes. As major employers who pay for the medical care of employees and dependents, they recognized the promise of managed care as a solution to many health system problems The key to managed care is timely and reliable information that can guide informed decision making. In 1990 these MHCA members joined to test the feasibility and usefulness of outcomes management in meeting their and their employees' needs for better information They included their managed care organizations as partners in the effort to develop and apply patient outcomes information. They enlisted the assistance of...