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June 19, 1996

Quality Health Care

Author Affiliations

Harvard School of Public Health, Boston, Mass

JAMA. 1996;275(23):1851-1852. doi:10.1001/jama.1996.03530470079047

A new reality is emerging as cost limits are set for health care: quality of care is becoming a major concern to payers and patients. Increasingly, employers and state and federal governments pay fixed premiums per enrollee to managed care organizations (MCOs), who then pay physicians by mechanisms designed to limit use of service; the question inevitably arises, "Are necessary tests and treatments, safe implementation, or communication with patients cut to save money?" Employers and governments therefore demand information to compare plans on the quality of care they provide.1

Most physicians encounter this new reality in the form of requirements for access to medical records and claims data for use in measuring performance. Managed-care organizations use these performance measurements to demonstrate accountability to employers and accreditors, but too few give the information back to physicians—a shocking waste of valuable information. [See also Medical Informatics.—Ed.] Physicians need periodic feedback