Promoting Quality through Managed Care

Abstract

Managed care organizations will be able to promote quality care as well as control costs by utilizing qual ity management approaches and practice guidelines. By so doing, organized systems of care could promote adherence to standards of quality and appropriate ness. Focusing on systems of care is a major compo nent of the quality improvement process and fits well with the development and utilization of practice guidelines. Practice guidelines, as well as risk man agement, quality assurance, and quality improvement techniques, can help reduce undesirable variation in practice patterns and prevent problems from occur ring. Guidelines may be based on different levels of explicitness ranging from subjective judgment to spe cific outcomes and patient preferences. The use of guidelines and quality improvement mechanisms will enhance the effectiveness of clinical decision making and enable managed care organizations to work pro ductively with physicians to promote quality.