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Managed Care and Performance Measurement

Author

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  • Dennis Scanlon
  • Michael Chernew

Abstract

Performance measurement systems and report cards which attempt to measure and report the quality of care provided by managed health-care organizations, have become mainstream in health insurance markets as managed care penetration continues to increase. However, little is known about the impact formal plan evaluations have on the contracting and enrollment decisions made by health insurance purchasers and consumers. Information regarding the link between performance evaluations and enrollment is crucial for those charged with projecting future enrollments in and risk profiles of managed care organizations. This paper describes the performance measurement systems currently being used to evaluate managed care plans and reviews the empirical literature for evidence regarding the impact of measures on plan enrollments.

Suggested Citation

  • Dennis Scanlon & Michael Chernew, 2000. "Managed Care and Performance Measurement," North American Actuarial Journal, Taylor & Francis Journals, vol. 4(2), pages 128-138.
    • Handle: RePEc:taf:uaajxx:v:4:y:2000:i:2:p:128-138
    DOI: 10.1080/10920277.2000.10595912
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    Cited by:

    1. Kelaher, Margaret & Prang, Khic-Houy & Sabanovic, Hana & Dunt, David, 2019. "The impact of public performance reporting on health plan selection and switching: A systematic review and meta-analysis," Health Policy, Elsevier, vol. 123(1), pages 62-70.
    2. Patricia H. Born & Evan M. Eastman & E. Tice Sirmans, 2023. "Managed care or carefully managed? Management of underwriting profitability by health insurers," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 5-31, January.
    3. Harris, Katherine & Schultz, Jennifer & Feldman, Roger, 2002. "Measuring consumer perceptions of quality differences among competing health benefit plans," Journal of Health Economics, Elsevier, vol. 21(1), pages 1-17, January.
    4. Scanlon, Dennis P. & Chernew, Michael & McLaughlin, Catherine & Solon, Gary, 2002. "The impact of health plan report cards on managed care enrollment," Journal of Health Economics, Elsevier, vol. 21(1), pages 19-41, January.

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