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   National Summit on Managed Care


National Summit on Women’s Health and Managed Care
1999

 

The Jacobs Institute partnered with the American Association of Health Plans to build on and incorporate the lessons learned from the Jacobs Institute’s 8-part managed care seminar series.

 

The summit brought together managed care representatives to contribute their expertise to an action plan on improving managed care’s approach to women’s health care. The following recommendations and comments were made by the various working groups:

 

Primary Care

  • Identify responsibility for various aspects of patient care;
  • Establish realistic cost-sharing models for primary care (i.e. affordable co-payments for prescriptions);
  • Expand opportunities for health care counseling outside of clinics;
  • Provide financial and other incentives for patients to seek preventive services;
  • focus on special populations;
  • create standard codes for reimbursement to cover counseling;
  • compensate providers for taking the time to counsel patients;
  • create accountability for physician competence in primary care; and
  • further discuss the role of ob/gyn’s in primary care.

 

Reproductive Health

  • provide more and better coverage of contraception, such as offering incentives or reimbursements for condom use;
  • develop programs to increase chlamydia screening and treatment; and
  • encourage community-based clinics to forge good, working relationships with managed care organizations.

 

Mental Health

  • develop ways to measure outcomes, which capture positive outcomes as well as recidivism;
  • train all primary-care specialists in based mental health;
  • develop algorithms on primary care treatment vs. referral for mental health;
  • and provide primary-care providers with more education on drug interactions and side effects.

 

Chronic Conditions

  • Good programs include multi-disciplinary teams and guidelines, allow patients to direct their own care, establish outcome measures at the beginning of a program, and allow programs enough time to show results.
  • A multidisciplinary approach was seen as the most important element of successfully treating chronic conditions.
  • Managed care organizations should know who its members are, their cultural needs, and how it can promote sensitivity through diversity training, disability access, etc.

 





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