A vision of quality in health care delivery.

Empirical evidence is thin, so one must reply on informed judgment, common sense, and theory when describing a high-quality health plan. Using this approach, a high-quality health plan would be characterized by excellence in the following areas: physician selection and development; health improvement; information systems; continuous quality improvement; cooperation with health care purchasers; alignment of financial incentives and appropriate capitation; and patient involvement. High-quality health plans would be nurtured by a national context in which medical education recognizes managed care and quality measurement, risk-adjusted premiums are the norm, competition is managed, and government has a limited role.

[1]  P. Cleary,et al.  What information do consumers want and need? , 1996, Health affairs.

[2]  D. Berwick.  Quality of health care. Part 5: Payment by capitation and the quality of care. , 1996, The New England journal of medicine.

[3]  R. Hays,et al.  Quality assurance in capitated physician groups. Where is the emphasis? , 1996, JAMA.

[4]  J. Gold.  New Rules: Regulation, Markets, and the Quality of American Health Care , 1996 .

[5]  A. Enthoven,et al.  Managed competition and California's health care economy. , 1996, Health affairs.

[6]  R. Hays,et al.  Quality Assurance in Capitated Physician Groups , 1996 .

[7]  L. Casalino,et al.  The growth of medical groups paid through capitation in California. , 1995, The New England journal of medicine.

[8]  R. Berenson,et al.  A national survey of the arrangements managed-care plans make with physicians. , 1995, The New England journal of medicine.

[9]  T. Brennan,et al.  New Rules: Regulation, Markets, and the Quality of American Health Care , 1995 .

[10]  D. Eddy.  Clinical decision making: from theory to practice. Rationing resources while improving quality. How to get more for less. , 1994, JAMA.

[11]  Robert H. Miller,et al.  Managed care plan performance since 1980. A literature analysis. , 1994, JAMA.

[12]  E L Hannan,et al.  Improving the outcomes of coronary artery bypass surgery in New York State. , 1994, JAMA.

[13]  A. Enthoven.  Why managed care has failed to contain health costs. , 1993, Health affairs.

[14]  K. Lorig,et al.  Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. , 1993, Arthritis and rheumatism.

[15]  Albert Gore,et al.  Creating a government that works better & costs less : the report of the National Performance Review , 1993 .

[16]  A. Enthoven,et al.  The history and principles of managed competition. , 1993, Health affairs.

[17]  A. Hillman,et al.  HMO managers' views on financial incentives and quality. , 1991, Health affairs.

[18]  J. Wennberg.  Improving the Medical Decisionmaking Process , 1988 .

[19]  J. Wennberg.  Improving the medical decision-making process. , 1988, Health affairs.

[20]  A. Hillman,et al.  Financial Incentives for Physicians in HMOs , 1987 .

[21]  S. Kaplan,et al.  Expanding patient involvement in care. Effects on patient outcomes. , 1985, Annals of internal medicine.

[22]  J. Wennberg,et al.  Dealing with medical practice variations: a proposal for action. , 1984, Health affairs.