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PubMed1994

How JCAHO, WEDI, ANSI, HCFA, and Hillary Clinton will turn your systems upside down.

JCAHO, WEDI, ANSI, HCFA, the Clinton Administration health care reform task force, and other local, state, and national organizations are having a major impact on the health care system. Health care providers will become part of larger health care organizations, such as accountable health plans (AHPs), to provide health care services under a managed care or contracted fee-for-service basis. Information systems that were designed under the old health care model will no longer be applicable to the new health care reform system. The new information systems will have to be patient-centered, operate under a managed care environment, and function to handle patients throughout the continuum of care across a multiple-provider organization. The new information system will require extensive network infrastructures operating at high speeds, integration of LANs and WANs across large geographic areas, sophisticated interfacing tools, consolidation of core patient data bases, and consolidation of the supporting IS infrastructure (applications, data centers, staff, etc.). The changes associated with the health care reform initiatives may, indeed, turn current information systems upside down.

Computer Communication Networks↗
PubMedDate not supplied

What reforms physicians want. Interview by Debra Mamorsky.

An executive vice president of the American Medical Association says that while physicians across the United States have mixed reviews of the President's proposal, they are basically looking for stability and predictability in a new system.

American Medical Association↗
PubMed1994

Health reform and employee health benefits programs.

The impact of health reform on employee health benefits programs could be dramatic. Depending on the health reform program adopted, employers could face significant new regulatory and economic burdens in operating employee health benefits programs or could find themselves greatly relieved of such burdens. President Clinton's proposal, in particular, would dramatically alter today's practices. This article focuses on how the Clinton proposal would change employee health benefits programs. Although President Clinton has indicated a willingness to compromise, his legislation may prove to be a house of cards, with all provisions interdependent. Employers should study all pending proposals carefully and weigh in on the debate so as to ensure that lawmakers are fully educated before making potentially irreversible decisions.

Costs and Cost Analysis↗
PubMed1994

Memphis Business Group on Health: a model for health care reform and cost containment.

A market-driven, community-based, competitive health care model has effectively assisted Memphis employers to achieve their cost containment and health care reform objectives. Members of the Memphis Business Group on Health joined forces and successfully implemented a variety of programs and services that resulted in dramatic cost savings and reform of health care delivery systems. Programs included development of a purchasing alliance for negotiating contracts for hospital, medical, workers' compensation, psychiatric, and substance abuse care and other service and product options. Utilization management programs focused on appropriate consumption of resources and intensive management of critical cases. While increases in per employee costs averaged 14.7 percent per year for five years nationally, members of the Memphis Business Group on Health held their increases to an average of 6 percent per year.

Cost Control↗
PubMed1994

Small group reform politics and the real world: Cleveland's Council of Smaller Enterprises.

The Clinton Administration's efforts at health care reform are somewhat hamstrung by a lack of working analogues, i.e., a scarcity of examples of what effective reforms might look like. While several excellent models of effective small group reform exist, the environment in which these living models operate and the tough decisions they have made to adapt to respond to the environment, have rendered them less than perfect. Rather than rely on these working models for guidance on both the promise and the limitations of health care reform, Administration officials appear to have chosen instead to highlight the models' inadequacies and discuss in a very general way how a government-based model might perform better. Instead of being guided by existing reality, government officials have chosen to attempt to reinvent it. The experience of one of the nation's largest and most successful purchasing cooperatives shows that workable reform will come not from broad vision or elegant models but from obsessive attention to the details in the real world.

Cost Control↗
PubMed1994

A community quality initiative for health care reform.

In 1989, the Madison Area Employers Health Care Coalition conducted a feasibility study for the purpose of finding solutions to common health care concerns. The study revealed three conclusions: (1) there was little or no price competition among providers; (2) employers lacked useful data and information regarding health care costs and outcomes; and (3) employers and employees lacked basic health care consumerism. These conclusions led to the development of a health care purchasing group in the spring of 1990 with the formation of the Employers Health Care Alliance Cooperative (The Alliance). The conclusions outlined above became the cornerstone of the services offered by The Alliance, which include provider contracting, data collection, and consumer education and advocacy. The Alliance also developed the community quality initiative, a partnership of employers, health care consumers, and providers committed to using continuous quality improvement methods.

Community Health Services↗