Question

description on Managing Quality Improvement in Managed Care

Answer 1

in managed care, to reduce the cost of healthcare and to make profit by improving the quality of the care health care settings are doing a group of activities. In the private sector quality improvement reflects on the accreditation process and widely based on employers demand and other purchasers. But, in the public sector, performance assessment is the primary tool for spending public funds on health care.

quality improvement mainly focuses on:

• access to a comprehensive range of providers
• prevention of avoidable diseases and timely treatment
• emergency availability of service
• convenient and comfort of services
• compassion and kindness of care
• appropriate evaluation and treatment in the healthcare system
• promote quality support

Methods to assess quality of care

accreditation

the best method for creating accountability and quality

Professional review of care

review of care by other professionals for granting credentials and privileges.

Licensing

it has become a major state function by monitoring numerous and varying requirements established by legislatures and regulatory agencies.

Auditing

the health care financing administration regularly conducts audits of certain medical program using both staff financial auditors and professional reviewers.

Clinical Practice Standards and Guidelines

The opportunities for high-quality clinical care are enhanced when providers follow steps in evaluation and treatment through scientific research and clinical experience.

consumer satisfaction

Health service research has shown that patient satisfaction is one of the most relevant markers for quality.