Medicare: Private-Sector and Federal Efforts to Assess Health Care Quality.Statement of William J. Scanlon, Director Health Financing and Systems Issues, Health, Education and Human Services Division

摘要

The Health Care Financing Administration (HCFA) now estimates that 4.3 millionMedicare beneficiaries are enrolled in health maintenance organizations (HMO), and enrollment is growing at a rate of about 100,000 new members per month. I am pleased to be here today to discuss ways to ensure that quality of care is furnished to Medicae beneficiaries joining these HMOs. Like large private-sector purchasers of health care, HCFA, which administers Medicare, finds the potential for cost savings associated with managed care attractive. But stakeholders--HCFA, private-sector purchasers, and others, such as individual consumers--are concerned that the cost control strategies HMOs use could lead to diminished quality of care. As a result, stakeholders are interested in programs that protect consmers from cost reduction strategies that might adversely affect their health care.