Many consumer and health care advocacy initiatives are converging toward a mandate to provide public access to many types of information about managed care organization (MCO) performance, costs, and quality.

N502 Health Care Systems

Module 5 Discussion

Discussion Question:

Many consumer and health care advocacy initiatives are converging toward a mandate to provide public access to many types of information about managed care organization (MCO) performance, costs, and quality. In fact, employers in the many parts of the country who are the major purchasers of health insurance are now requiring MCOs to make “health plan performance data” available to subscribers to facilitate their choice of plans.

Discuss and provide the rationale for your opinion on providing data in areas such as patient outcomes, compliance with national standards for preventive and chronic care, and comparative costs to the public.

What obligation, if any, does an employer, and/or MCO have to educate subscribers in how to interpret performance data? At whose expense should such education be provided?

What are the possible benefits or disadvantages to making such performance data available to the public?

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