External quality assurance in managed care: Experience from the USA;Externe qualitätssicherung für managed-care-organisationen - Erfahrungen aus den USA

Gesundheitsokonomie und Qualitatsmanagement

Volumn 8, Issue 1, 2003, Pages 52-59

  Courté Wienecke, Sonja ^a  

^a INSTITUTE OF EPIDEMIOLOGY   (Germany)

Author keywords

Accreditation; Consumer reports; Managed care; Performance measurement; Quality assurance

Indexed keywords

GERMANY; HEALTH CARE QUALITY; MANAGED CARE; MEASUREMENT; PERFORMANCE; QUALITY CONTROL; REVIEW; UNITED STATES;

EID: 0037294768     PISSN: 14322625     EISSN: None     Source Type: Journal    
DOI: 10.1055/s-2003-37178     Document Type: Review

References (41)

1. Draper DA, Hurler RE, Lesser CS, Strunk BC. The changing face of managed care. Health Aff 2002; 21: 11-23
2. Iglehart J. The National Committee for Quality Assurance. N Engl J Med 1996; 13: 995-999
3. Palmer RH. Managed care and melting moments. Int J Qual Health Care 1996; 8: 317-319
4. Epstein A. Rolling down the runway: The challenges ahead for quality report cards. JAMA 1998; 279: 1691-1696
5. Maxwell J, Temin P, Watts C. Corporate Health care purchasing among Fortune 500 firms. Health Aff 2001; 20: 181-188
6. Geraedts M. Qualitätsbewertung in amerikanischen Managed-Care-Organisationen. Gesundh ökon Qualmanag 1999; 4: 4-13
7. Courté-Wienecke S. Zertifizierungsverfahren für ambulante Versorgung in den USA. Z ärztl Fortbild Qualsich 2000; 94: 634-638
8. McGlynn EA. Six challenges in measuring the quality of health care. Health Aff 1997; 16: 7-21
9. National Committee for Quality Assurance. The state of managed care quality - 2001 Washington, DC: NCQA, 2001
10. Bishop W, Park K, Rector J, Faulkner M. HEDIS audits: Meeting the challenge. J Healthc Qual 1998; 20: 10-15
11. Scanlon DP, Darby C, Rolph E, Doty HE. Use of performance information for quality improvement. The role of performance measures for improving quality in managed care organizations. Health Serv Res 2001; 36: 619-641
12. Hibbard JH, Jewett JJ, Legnini MW, Tusler M. Choosing a health plan: do large employers use the data? Health Aff 1997; 16: 172-180
13. Gabel JR, Hunt KA, Hurst K, Peat Marwick KP. When employers choose health plans. Report 293. Ergebnisse zitiert in Marshall et al. 2000 [30]. New York, NY: Commonwealth Fund, 1998
14. Legnini MW, Rosenberg LE, Perry MJ, Robertson NJ. Where does performance measurement go from here? Health Aff 2000; 19: 173-177
15. Schauffler HH, Brown C, Milstein A. Raising the bar: the use of performance guarantees by the Pacific Group on Health. Health Aff 1999; 18: 134-142
16. Riley T. The role of states in accountability for quality. Health Aff 1997; 16: 41-43
17. American Association of Health Plans. Guide to Accreditation. 1999/2000
18. Letwat KJ. The current quality of health plan report cards. J Med Syst 1999; 23: 325-333
19. Schneider EC, Lieberman T. Publicly disclosed information about the quality of health care: response of the US public. Qual Health Care 2001; 10: 96-103
20. Marshall MN, Shekelle PG, Leatherman S, Brook RH. Public disclosure of performance data: learning from the US experience. Qual Health Care 2000; 9: 53-57
21. Thompson JW, Bost J, Ahmed F, Ingalls C, Sennett C. The NCQA's Quality Compass: Evaluating managed care in the United States. Health Aff 1998; 17: 152-158
22. Chernew M, Scanlon DP. Health insurance report cards and insurance choice. Inquiry 1998; 35: 9-22
23. Schoenbaum SC, Coltin KL. Competition on quality in managed care. Int J Qual Health Care 1998; 10: 421-426
24. Gibbs DA, Sangl JA, Burrus B. Consumer perspectives on information needs for health plan choice. Health Care Financ Rev 1999; 18: 55-73
25. Robinson S, Brodie M. Understanding the quality challenge for health consumers: The Kaiser/AHCPR survey. Jt Comm J Qual Improv 1997; 23: 239-244
26. National Committee for Quality Assurance in Collaboration with Health Research Center, Institute for Research and Education, Health-System Minnesota. Do consumers use health plan report cards? Findings from two evaluations. December 1998
27. Scanlon DP, Chernew M. HEDIS measures and managed care enrollment. Med Care Res Rev 1999; 56 Suppl. 2: 60-84
28. Schneider EC, Epstein AM. Patient use of public performance reports: a survey of cardiac surgery patients. JAMA 1998; 279: 1638-1642
29. Mukamel DB, Mushlin Al. Quality of care information makes a difference: an analysis of market share and price changes after publication of the New York State cardiac surgery mortality reports. Med Care 1998; 36: 945-954
30. Marshall MN, Shekelle PG, Leatherman S, Brook RH. The public release of performance data. What do we expect to gain? A review of the evidence. JAMA 2000; 283: 1866-1874
31. Hibbard JH. Being strategic with public reports. Editorial. Int J Qual Health Care 2001; 13: 353-355
32. National Committee for Quality Assurance. The state of managed care quality - 2000. Washington, DC: NCQA, 2000
33. National Committee for Quality Assurance. The state of managed care quality - 2000. Washington, DC: NCQA, 2000
34. Halverson PK, Mays GP. Health promotion and disease prevention in managed care: Managerial perceptions of benefits and costs. Abstr Book Assoc Health Serv Res 1997; 14: 27
35. Hannan E, Kliburn H Jr, Racz M, Shields E, Chassin MR. Improving the outcomes of coronary artery bypass surgery in New York State. JAMA 1994; 271: 761-766
36. Rosenthal GE, Quinn L, Harper DL. Declines in hospital mortality associated with a regional initiative to measure hospital performance. Am J Med Qual 1997; 12: 103-112
37. Longo DR, Land G, Schramm W, Praas J, Hoskins B, Howell V. Consumer reports in health care. Do they make a difference in patient care? JAMA 1997; 278: 1579-1584
38. Sozialgesetzbuch Fünftes Buch (SGBV) Gesetzliche Krankenversicherung. Stand: Januar 2000
39. Preuβ KJ. Die Perspektive der Kostenträger (GKV und PKV) bei der praktischen Anwendung von Benchmarking, Evaluation und Zertifizierung. In: Preuβ K-J, Räbiger J, Sommer JH (Hrsg). Managed Care. Evaluation und Performance-Measurement integrierter Versorgungsmodelle. Stuttgart: Schattauer, 2002: 43-64
40. EQUAM-Stiftung c/o Schweizerisches Tropeninstitut, Basel, Schweiz. Dokumentation EQUAM. Externe Qualitätskontrolle in Managed Care. 3.9.1999
41. Räbiger J, Hasenbein U, Klatt S, Sinha M, Brenner HM, Henke KD. Konzept für eine standardisierte Evaluation Managed-Care-orientierter Versorgungsmodelle in Deutschland: Ein Werkstattbericht. In: Preuβ K-J, Räbiger J, Sommer JH (Hrsg). Managed Care. Evaluation und Performance-Measurement integrierter Versorgungsmodelle. Stuttgart: Schattauer, 2002: 116-131