Outcome Measures for Persons with Disabilities as a Litmus Test for Quality in Managed Care
The Clinton health care reform plan promised universal coverage through the expansion of managed care in the context of an administrative structure of regional alliances that would encourage competition among health plans while ensuring equal access to medically necessary services for all persons in a geographical area. The political defeat of the Clinton plan signaled that managed care could proceed with minimal government regulation. The government has been operating more as a buyer of health care than as a regulator. As a result, there has been greater attention paid to increasing the consumer's capacity to choose among managed-care plans than to ensuring the quality of health care within managed care. One of the groups most vulnerable in managed care are persons with disabilities. This chapter examines the use of outcome measures for persons with disabilities as a litmus test for quality in managed care.
With the rapid and largely unregulated transformation of the health care system toward corporatization, privatization, and managed care, people with disabilities have an important role to play as a litmus test for quality in managed care. In the traditional health insurance system with providers paid on a fee-for-service basis, the services which patients received from different providers were not always coordinated, necessary, or perhaps even
This chapter summarizes research in progress which is being conducted with support from the Robert Wood Johnson Foundation and from a project on measuring quality in managed care for persons with disabilities jointly funded by the Administration on Developmental Disabilities and the Centers for Disease Control and Prevention in the U.S. Department of Health and Human Services.