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April 1995

Assessing the Quality of Care for Children: Prospects Under Health Reform

Author Affiliations

From RAND, Santa Monica, Calif (Drs McGlynn, Halfon, and Leibowitz), and the Department of Pediatrics, University of California–Los Angeles School of Medicine, and Department of Community Health Sciences, University of California–Los Angeles School of Public Health (Dr Halfon).

Arch Pediatr Adolesc Med. 1995;149(4):359-368. doi:10.1001/archpedi.1995.02170160013002

The failure to pass federal health reform legislation this year does not mean that the health care crisis has been solved. As we look forward to predictably more incremental efforts to reduce costs, increase access, and improve quality, key issues from the most recent round of deliberations will undoubtedly reemerge. In the last session of Congress, private and public policymakers sent a clear signal that the era of accountability had arrived. In the health reform bills that Congress considered last year, a range of "measurement" strategies were put forth as essential elements for achieving accountability in a reformed health care system. For example, routine monitoring of the quality of care delivered by health plans and health providers was viewed as necessary to balance the impact of policies to control the cost of health care. Each of the major bills that were introduced this past year—Gephardt/Mitchell (S 1757/HR 3600), Cooper/Grandy (HR

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