Can Physicians Diagnose Strengths and Weaknesses in Health Plans?

Editorials1 August 1996Can Physicians Diagnose Strengths and Weaknesses in Health Plans?Steven J. Borowsky, MD, MPH, Christine Goertz, DC, and Nicole Lurie, MD, MSPHSteven J. Borowsky, MD, MPHMinneapolis Veterans Affairs Medical Center Minneapolis, MN 55417University of Minnesota School of Public Health Minneapolis, MN 55455Hennepin County Medical Center University of Minnesota School of Public Health Minneapolis, MN 55455, Christine Goertz, DCMinneapolis Veterans Affairs Medical Center Minneapolis, MN 55417University of Minnesota School of Public Health Minneapolis, MN 55455Hennepin County Medical Center University of Minnesota School of Public Health Minneapolis, MN 55455, and Nicole Lurie, MD, MSPHMinneapolis Veterans Affairs Medical Center Minneapolis, MN 55417University of Minnesota School of Public Health Minneapolis, MN 55455Hennepin County Medical Center University of Minnesota School of Public Health Minneapolis, MN 55455Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-3-199608010-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In a competitive market, maintaining health care quality while containing costs requires that consumers and large purchasers of care have access to data on the cost and quality of care in health plans. Both individual health plans and more neutral bodies, such as the National Committee for Quality Assurance, have attempted to meet this demand for information by presenting plan-specific performance data in a "report card" format. Although the perspective of the consumer figures prominently in such reports, the perspectives of physicians, nurses, and other health professionals who deliver care are notably absent. Practicing health care providers are often the ...References1. Corrigan JM, Nielsen DM. Toward the development of uniform reporting standards for managed care organizations: The Health Plan Employer Data and Information Set. Jt Comm J Qual Improv. 1993; 19:566-75. Google Scholar2. Epstein A. Performance reports on quality—prototypes, problems, and prospects. N Engl J Med. 1995; 333:57-61. Google Scholar3. Lichtenstein R. Measuring the job satisfaction of physicians in organized settings. Med Care. 1984; 22:56-68. Google Scholar4. Schulz R, Girard C, Scheckler WE. 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Sanazaro PJ, Williamson JW. Physician performance and its effects on patients: a classification based on reports by internists, surgeons, pediatricians, and obstetricians. Med Care. 1970; 8:299-308. Google Scholar12. Nelson EC, Larson CO, Hays RD, Nelson SA, Ward D, Batalden PB. The physician and employee judgment system: reliability and validity of a hospital quality measurement method. QRB Qual Rev Bull. 1992; 18:284-92. Google Scholar13. Hays RD, Nelson EC, Larson CO, Batalden PB. Short-form measures of physician and employee judgments about hospital quality. Jt Comm J Qual Improv. 1994; 20:66-77. Google Scholar14. Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality of care. Inquiry. 1988; 25:25-36. Google Scholar15. Laine C, Davidoff F. Patient-centered medicine: a professional evolution. JAMA. 1996; 275:152-6. Google Scholar16. Stewart AL, Ware JE. Measuring Function and Well-Being: The Medical Outcomes Study. Durham, NC: Duke University Pr; 1992. Google Scholar17. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993; 118:622-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: Minneapolis Veterans Affairs Medical Center Minneapolis, MN 55417University of Minnesota School of Public Health Minneapolis, MN 55455Hennepin County Medical Center University of Minnesota School of Public Health Minneapolis, MN 55455Corresponding Author: Steven J. Borowsky, MD, MPH, Section of General Internal Medicine (111-0), Minneapolis Veterans Affairs Medical Center and the University of Minnesota, 1 Veterans Drive, Minneapolis, MN 55417.Current Author Addresses: Dr. Borowsky: Section of General Internal Medicine (111-0), Minneapolis Veterans Affairs Medical Center and the University of Minnesota, 1 Veterans Drive, Minneapolis, MN 55417. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPhysician perceptions of managed care strategies, and impact of these on their clinical performance, in the South African private health sectorPatient protection and risk selectionCan Joint Negotiation Restore Physicians' Professional Autonomy?David C. Hsia, JD, MD, MPHTo Help or HinderCommentary: Public Disclosure in the Health Field: Is There a Relevant Option?Comparing provider perceptions of access and utilization management in full-risk and no-risk medicaid programs for adults with serious mental illnessMeasuring Physician Job Satisfaction in a Changing Workplace and a Challenging EnvironmentPhysician Experiences With, and Ratings of, Managed Care Organizations in MassachusettsWhat do Consumers Want and Need to Know in Making Health Care Choices?U.S. Women Physicians' Assessment of the Quality of Healthcare They Receive 1 August 1996Volume 125, Issue 3Page: 239-241KeywordsHealth careHealth care providersHealth care qualityHealth care quality assessmentHealth information technologyPatientsPerceptionPerformance measuresQuality of lifeResearch design Issue Published: 1 August 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...