Comprehensive managed care evaluation

Article Abstract:

The rising costs of health care has forced many employers to integrate managed care into their benefit programs. Being a relatively new and controversial approach to health care delivery systems, managed care can expose employers to potential liability. To optimize the benefits and lessen the risks of managed care, employers have to evaluate the programs they sponsor. Evaluation of managed care must include information gathering on health care costs, assessing medical service utilization, evaluating quality of care, monitoring of employee satisfaction and appraising plan administration.

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Total health information management: the GTE experience

Article Abstract:

GTE Corp. worked with Hewitt Assoc. to develop a total health information system, which was implemented in 1994. The system integrates data from indemnity plans, managed care plans, health maintenance organizations, employee health risk profiles, disability plans, workers compensation and other related data to help GTE assess the cost-efficiency of its health care plans and their impact on company operations. The integrated information processing system facilitates the management of GTE's $700-million annual health care expenditures for 90,000 employees and 40,000 retirees.

Telecommunications, Telephone Communication, Telecommunications services industry, Telecommunications industry, Information management, GTE Corp., GTE, Health maintenance organizations

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Measuring the savings from managed care: experience at Citibank

Article Abstract:

Citibank N.A. implemented a point-of-service plan (POS) in 1989 to contain employee health care costs. As POS plans were relatively new when Citibank adopted it, there were no standards by which the bank could measure the effectiveness of its health care plan. In 1994, the bank collaborated with its health care consultant to develop a method to compute the savings due to the POS plans to the bank. The method enabled the determination of actual savings rather than computed savings based on projections.

Commercial Banks, Commercial Banking, Banking industry, Management, Measurement, Compensation and benefits, Medical care, Cost of, Health care costs, Citibank N.A. (New York, New York)

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