Biomedical subjects

R C Armstead

Publications and source records attributed to R C Armstead.

3 recordsLinked to original sources

PubMed1995

Toward a 21st century quality-measurement system for managed-care organizations.

As the Nation's largest managed-care purchaser, the Health Care Financing Administration (HCFA) is working to develop a uniform data and performance-measurement system for all enrollees in managed-care plans. This effort will ultimately hold managed-care plans accountable for continuous improvement in the quality of care they provide and will provide information to consumers and purchasers to make responsible managed-care choices. The effort entails overhauling peer review organization (PRO) conduct of health maintenance organization (HMO) quality review, pilot testing a new HMO performance-measurement system, establishing criteria for Medicaid HMO quality-assurance (QA) programs, adapting employers' HMO performance reporting systems to the needs of Medicare and Medicaid, and participation in a new alliance between public and private sector managed-care purchasers to promote quality improvement and accountability for health plans.

Capitation Fee↗

PubMed1995

Managed care: a foundation for evolution.

An examination of the history of managed care organization over the past 30 years, in both private and public sectors, forms the basis for evaluating the success of such programs in meeting the expectation of both physicians and consumers. The authors point to areas that must receive special attention if managed care organizations are to satisfy the quality and cost demands of the future.

Capitation Fee↗

PubMedDate not supplied

Baby love and budget relief: some promising practices in prenatal managed care in Medicaid.

The provision of prenatal health care is one of the most important functions of Medicaid, as approximately three-quarters of program enrollees are poor women and children. A rapidly increasing number of states are seeking to address the dual crises of spiralling program costs and inadequate access to services through the use of managed care in Medicaid. Medicaid managed care is growing rapidly and now stands at more than 8 million enrollees, the overwhelming majority of whom are women and children. The focus on accessible preventive and primary care that is, in theory, the hallmark of managed care, should apply well to prenatal health services for Medicaid beneficiaries, though this is not always the case. The more successful managed prenatal care programs thus far have some common characteristics, which are examined here in the hope that they will be replicated by other states.

Centers for Medicare and Medicaid Services, U.S.↗