Health Plan Performance Measurement within Medicare Subvention.
Final rept. Jul 97-Jul 98
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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The Military Health Service MHS, feeling growing pressure to keep costs down and quality up, must be able to strike a cost-quality balance. Success of initiatives like the Medicare Subvention Demonstration Project is dependent on the ability to strike such a balance--and the ability to monitor it. MHSs lack of Medicare HMO experience necessitates the development and adoption of reliable performance measurement systems. Project managers must align organizational mission and health plan performance. Current military measurement initiatives--the Air Force Medical Service Performance Measurement Tool AFMS PMT and the MHS Performance Report Card--compare well to major civilian initiatives. MHS performance measurement systems do, however, require modification to be useful for Medicare health plan management. Emphasis on Medicare population-specific indicators must be included--indicators that stress the importance of long-term versus short-term measurement, wellness and prevention versus treatment and reaction, and primary care investment versus specialty care expenditure. The uniqueness of the Medicare subvention project make it unlikely that any one of the initiatives studied would be sufficient in subvention measurement. However, the combination of the AFMS PMT with two civilian initiatives holds promise as an ideal subvention project performance measurement system.
- Administration and Management
- Economics and Cost Analysis
- Medicine and Medical Research
- Medical Facilities, Equipment and Supplies