Managed Care and Quality Improvement Essay

1302 Words6 Pages
Managed care is often seen primarily as a cost cutting initiative that is concerned with managing cost and cost only in the healthcare field. For this and a few more reasons managed care organizations face severe judging on the quality of care that they provide. When analyzed correctly, trends prove that managed care has in fact been very significant in determining and improving the quality of care. In this paper, elements such as the state and federal oversights over MCOs, voluntary accreditations, standardized performance indicators and examples of successful quality programs developed by MCOs will be used to prove this statement. Though in the eyes of many managed care and quality do not go together, the research information provided in…show more content…
More methods are being created and taken place to ensure, inspect, repair and correct performance where it is needed to do so. MCOs have developed a new status quo of improving and performing better every year with tools such as the “Quality Drivers of Care” (Miller, 2004). One of these tools, perhaps the most important one, is the voluntary accreditation of MCOs by organizations such as the National Committee on Quality Assurance, the Joint Commission on Accreditation of Healthcare Organizations, and the Utilization Review Accreditation Commission, among others. While MCOs are not required to do so they choose to, to show the industry that they are being assessed in the quality and service they provide and that improvements are in fact being made. They are also drivers in effectiveness and quality assurance as MCOs now find themselves competing amongst each other not only on costs but also on their effectiveness.

Some argue that managed care does not improve the quality of care because according to several studies, performance indicators for such, rank very low in populous states and high in less populous ones. The argument is that if MCO’s in fact are effective in improving the quality of care they should do so no matter the population size. (Jencks S., Cuerdon T., e.t, 2000) To their defense, the indicators in such study consistently varied from state to state therefore the results were not completely conclusive. On the other hand, individual studies by
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