Assessment of Strategies to Promote Cost and Management Efficiencies in Tribal and Contract Health Service Programs. Volume 1

摘要

Indian Health Service (IHS) has been exploring the use of alternative methods of providing and managing health care. The two-phase project analyzes information concerning: (1) the feasibility of applying managed health care techniques to selected tribal and contract health services administered or contracted by the IHS; (2) the data needed to plan and develop alternative methods of health care delivery; and (3) the risks, benefits, and cost-efficiency of the alternative methods deemed to be feasible. The report discusses the findings of phase I of the project. Data for the assessment were collected by four site visits: (1) the Mashantucket Pequot Health Department; (2) the Devils Lake Sioux Health Systems; (3) the Taholah Service Unit Formulary Project; and (4) the Puget Sound Service Unit. The alternative health care options examined in the study included: (1) program modifications that adopt alternative health care management techniques; (2) purchase of select services; and (3) purchase of comprehensive health care through an alternative health care system. Findings concerning these alternative options include that alternative health care delivery systems such as health maintenance organizations (HMOs), competitive medical plans (CMPs), and some preferred provider organizations (PPOs), address the need for coordinated health care, and transfer of risk.