PubMed · 11061120
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J R Coleman. Managed care is going down a bumpy road.. https://doi.org/10.1016/s1061-9259(99)80104-0
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When it comes to managing medical care for their enrollees, payors are moving towards a broader focus for medical management that includes both costs and quality. In the twelfth installment of Straight Talk, we look at how health plans, such as CIGNA, are developing incentives to reward high-quality, low-cost providers of medical care and transitioning their utilization management operations to a new model. To ensure quality, they are beginning to compare providers' performance to national standards for medical outcomes. Through these initiatives, known as "medical management," payors hope to improve not only medical care but also their relationships with providers.