PubMed · 8820259
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L BeSaw, S Carter. 1996. Pricing your practice.. https://pubmed.ncbi.nlm.nih.gov/8820259/
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For the first time, the Health Plan Employer Data and Information Set, better known as HEDIS 3.0, takes the lid off managed care quality and patient satisfaction on a national scale. Not-for-profit plans, our analysis shows, have the edge on both counts. They also lose the most money.
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Following the continuing expansion of managed care is a growing public interest in the quality of care provided by managed care organizations. Public and private organizations are actively developing systems for measuring and monitoring quality of care with the intention of holding plans more accountable for quality improvements and encouraging health care consumers to make responsible choices. This article examines correlations between a prevention-based quality measure and other commonly used measures of differentiating health plans, including financial performance and profit status. The findings are instructive in efforts to develop a quality measurement system that incorporates a variety of measures of plan performance.