Ensuring Quality and Access in Managed Care

Through mergers, acquisitions, joint ventures, and contracting, proprietary managed care organizations are steadily assuming health care responsibilities formerly delegated to government-owned and not-for-profit health care institutions. An examination of existing quality assurance initiatives for managed care organizations reveals several areas of concern: incentives for providing substandard services; a shortage of visible, measurable, and enforceable quality standards; and inadequate data and reporting systems for producing reliable quality indicators.