Measuring outcomes: the key to quality management

Abstract

Managed care continues to encroach upon virtually all health care delivery systems. Cost controls within these systems have been governed in the past by selection/deselection procedures and utilization management that are primarily based upon claims cost data. The recent movement toward integration of health care quality measures with financial data offers some hope that quality will not be unduly compromised in the efforts to control health care costs. In this new milieu there are increasing opportunities for health care professionals to participate in the development and refinement of managed care products. A model for a worker's compensation managed care system being developed in Colorado is offered as an example of the movement toward more meaningful partnering between health care payers and providers.