Managed care and quality
Article Abstract:
The Health Care Financing Administration (HCFA) is developing performance measures to assess and improve the quality of managed care for Medicare and Medicaid enrollees. Performance measures assess patients' access to care, service utilization, patients' satisfaction, and clinical outcomes and must address the unique needs of the Medicare and Medicaid populations. To facilitate the design of these measures, the HCFA is collaborating with the health care community to define standards for reporting data about managed care services. The HCFA is working to adapt performance measures developed by the commercial sector to Medicare and Medicaid populations. This is a step toward the ultimate goal of developing a single set of measures that will apply to all health plans and their enrollees. Performance measures will make managed care plans more accountable for the services they render.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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The past, present, and future of nursing home quality
Article Abstract:
Physicians can play an active role in improving the quality of care in nursing homes. When Congress passed the Omnibus Budget Reconciliation Act of 1987 (OBRA-87), the law included standards for nursing home care. It was prompted in part by a report by the Institute of Medicine that cited the deplorable conditions in some nursing homes in the 1970s. OBRA-87's nursing home standards were implemented in 1990, and the final enforcement regulations were in place by July, 1995. Researchers have found that the use of physical restraints and antipsychotic drugs has dropped substantially since the standards were enforced. The incidence of dehydration has decreased, as has the use of urinary catheters. Hospitalizations have decreased 25% and more eligible nursing home residents are getting hearing aids.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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End-stage renal disease core indicators project
Article Abstract:
The Health Care Financing Administration is working on a project with dialysis patients and renal health care professionals to improve patient care for end-stage renal disease (ESRD). Dialysis or kidney transplantation is necessary to prevent death from ESRD. The ESRD Core Indicators Study showed there is room for improvement in the care of patients with renal diseases. Only 43% of these patients chosen on a random basis received satisfactory care. Evaluation of patients on dialysis can be improved by monitoring hematocrit levels, and ensuring adequate dialysis, proper nutrition and blood pressure control. The study followed adults who receive dialysis treatment at facilities.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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