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Quality in Womens Health: Taking the Measure of Managed Care

 

 

 

 

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 July 23, 1998 Washington, DC -- The limits on choice that form a key component of most current innovations in health care financing and delivery have prompted renewed concerns over quality of care, according to Elizabeth McGlynn, PhD, of the Rand Corporation. She predicted that in response, quality measurement for purposes of accountability will eventually spread throughout the health care system. Dr. McGlynn was one of two commissioned paper presenters at todays Jacobs Institute symposium on womens health and quality assessment in managed care. Currently, quality measurement suffers from several limitations, including a lack of measures across a broad range of clinical areas (especially acute and chronic conditions), lack of consensus on the most useful type of measures (structure, process, outcomes), and an absence of information on certain parts of the delivery system. Dr. McGlynn went on to describe several current quality assessment projects, noting which are focusing on womens health and the challenges to be met in each.

Patricia Venus, MA, of the Center for Health Care Policy and Evaluation at United HealthCare, one of the nations largest managed care companies, presented results from surveys of female Medicaid enrollees in four United plans. The surveys were conducted using the new Consumer Assessment of Health Plans (CAHPS) tool. With 40% of Medicaid recipients now in managed care (mostly low-income women and children), it is important to understand if their needs are being met as they move into new delivery systems. Ms. Venuss research centered on relationships between use of health care services and ratings of the delivery system. High utilization is associated with chronic disease or pregnancy, and high utilizers rate their specialists more favorably than low users. The only measure with a statistically significant difference between high and low users was for "getting the care you need" - higher users reported a higher rate of getting the care they needed and of seeing a specialist when there was perceived need. It is possible that some low users found lack of ease in finding a personal doctor and getting referrals to specialists to be barriers to services and would otherwise have used more health services; alternatively, low users might not be seeing specialists because of appropriate control by primary care physicians.

Other panelists at todays symposium included: Carol S. Weisman of the University of Michigan; Thomas Purdon, MD, FACOG, Vice President of the American College of Obstetricians and Gynecologists; Robin Richman, MD, FACOG, of Tufts Health Plan; and Joanne Hustead, JD, of the National Partnership for Women and Families.

Todays program was the eighth and final by the Jacobs Institute in a series on the impact of managed care on health care services for women. Support for the project has been provided by The Commonwealth Fund, the Henry J. Kaiser Family Foundation, Wyeth-Ayerst Laboratories, and the Lilly Center for Women's Health (Eli Lilly and Company). Additional information on the project and press copies of the briefing paper Insights and drafts of the commissioned papers by Dr. McGlynn and Ms. Venus are available from the Jacobs Institute at 202/863-4990.

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For Immediate Release

For more information contact:
Shannon R. Mouton
The Jacobs Institute
(202) 863-4989