Patient Choice Under Managed Care

The topic of this folder is patinet choice and how it relates to managed care. Since its inception managed care has been accused of restricting patient choice in favor of cutting costs. This folder contains reviews of five sites and five documents which relate to this topic. The documents are reviewed based on their relevance to the topic and "usability" among other features. Each site or document review will also include a short summary of its contents and a five star rating.

Documents

An In-depth Discussion of Dental Benefits for the Consumer

This document contains excerpts from a booklet published by the California Dental Association titled, "What Everyone Should Know About Selecting and Using Dental Benefits." It is a tremendous help for anyone who needs help in deciding on a dentist, choosing dental coverage, and/or determining the costs of either. It describes all types of dental treatments, gives laymens definitions of all terms utilized, and explains what types of treatment are covered by what types of plans. It talks about the differences between open and closed panels of dentists and also explains the differences between indemnity plans, capitation and direct reimbursement. Finally it provides the eight biggest items to consider when choosing a dental plan. The document is laid out in an easy to read format and avoids dental jargon. This site is an excellant starting point for anyone in the process of choosing a new dentist or dental plan. My only complaint would be that although most of the information is useful to anyone, there is a significant amount of information that applies solely to residents of California. I rate this document at four stars.

Citizens for Choice in Health Care

This site is dedicated to insuring that the residents of Minnesota are as informed as possible about all aspects of health care policy and legislation ongoing in their state. It allows viewers to read the group's mission statement, and also provides a detailed analysis of any pending legislation. Viewers are also able to access letters to the editor and can send e-mail to the publishers. There are documents that suggest courses of action to address certain hot topics and the site provides a recommended reading list. While the group is titles Citizens for Choice in Health Care it does appear to be more of a self-serving web site than an informatin site for the residents of Minnesota. So while the essence of the site is supposedly to encourage citizens freedom of choice, I can only give it two stars. Because while the site is interesting to look at and quite easy to use it does not seem to achieve its advertised purpose.

Freedom of Choice in Health Care Threatened

This site basically is trying to spread the word that all types of complimentary medicine, including Environmental Medicine, accupuncture, homeopathy, and chelation therapy are in danger of being obliterated by managed care. They claim the freedom of patients to choose these therapies or choose physicians who practice these types of medicine is being severely threatened. In particular the site is soliciting funds to assist Dr. J. Krop of Ontario, Canada in his battle to prevent his medical license from being taken. While this site relates directly to patient choice, it truly only affects a small percentage of the population. The way in which the site is arranged and written serves to sensationalize this topic. It appears almost too shocking to affect any but the most ardent supporters of complimentary medicine. For this reason I give it one star.

National Org. of Physicians Who Care: Medicare Reform

This particular document is part of a rather large site sponsored by the National Organizations of Physicians Who Care. The site has many features all of which deal with Medicare reform. The documents include opinions, position statements and copies of letters sent to Congressmen. This particular document deals with the need to make the patient the true consumer of health care and not the insurer. The group proposes to ensure this by providing consumers with expanded choices of physician, hospital and other health care providers. It also proposes that patients be made more responsible for their health care decisions by eliminating first dollar coverage of many health benefits. The site appears to be intended to foster a reasonable attempt at addressing the spiraling costs of health care shile giving patients more freedom of choice in its provision. The abundance of medical language makes the document difficult to read for all but the trained medical professional and for that reason I give it three stars.

Primary care reform

This document is a rather lengthy summary of a 150 page proposal by the Primary Care Reform Physician Advidsory Group of Ontario, Canada which discusses a proposed strategy for reforming the provision of primary care medicine in Canada. It utilizes reformed fee-for-service as its payment basis. In the document are sections on global budgets, performance goals, and tools for quality improvement. In the section on patient choice, the group very strongly feels that patient choice of physician is central to a strong patient/physician relationship. It also feels that this relationship is essential for the quality provision of care. The site is essentially the groups proposal for healthcare reform in Canada and as such is of little interest to anyone except those in the field. For that group however it provides for interesting reading in a very organized manner. I rate it at three stars.

Sites

excite NetDirectory: General/Health_and_Medicine/

The Excite net directory is another general topic searching site. The general topic I chose to explore was "Health and Medicine". In the Health and Medicine general category there were many sub categories each of which contained multiple information sources. There was one site in particular which is decribed in a later bookmark which related directly to patient choice. It was a site sponsored by Citizens for Choice in Health Care. The entire site is very well organized and extremely easy to use. However I noticed that many of the sub sites did not show up on general Webcrawler searches for topics included in their site. Overall I would rate this site at 4 stars.

Medscape

The MEDSCAPE site on the Internet is geared towards both health professionals and consumers. It features peer-reviewed articles, medical news, self assessment features and stored literature searches among other things. One of its main general topics is Managed Care, in which there are 118 articles, some of which relate to patient choice. I would rate this site as 4 stars as it contains current and accurate information in an easy to read and easy to access format. Medscape also has a rather unique feature in that it will give you annotated links to other Internet resources when you search for a particular topic. I found this feature particularly useful.

NCQA

The National Committee for Quality Assessment (NCQA) is a not-for profit organization dedicated to collecting and analyzing data relative to HMOs and MCOs. They generate report cards on these organizations as well as other healthcare providers. Access to this type of information will consumers valuable data with which to make their healthcare choices. NCQA's website contains many sub-directories allowing the user access to individual report cards as well as raw data. I found it to be very useful for its intended purpose. My only complaint would be that some of the information is quite technical and could tend to confuse rather than assist the average consumer.

STATE CAPITALS News on state legislation and laws -Catalog

The Catalog of State Capitals weekly newsletters provides extremely current news on what is going on in the states . Two of the major topic headings are Insurance Regulation and Public Health. Both of these topics are of interest when discussing patient choice. The site also provides a weekly highlight page that summarizes important goings on around the country. Probably the most useful feature of the site is the Subject Guide. By clicking on a particular subject of interest the site will provide a list of recent issues dealing with the topic. These issues may then be ordered if desired. I would rate it at 3 stars because the amount of actual information delivered is quite small. While it is understandable why detailed information cannot be provided, it does leave the audience wanting for more.

The Internet: Surfing the Medical Resources

The Internet: Surfing the Medical Resources is an excellant beginners guide to using the Internet to find any kind of medical information. It is a text and slide show presentation thet reviews among other things: The history of the Internet, using a modem, E-mail, FTP, On-line services, gopher, the World Wide Web, and Medical Resource Links. This site is a great starting point for anyone wishing to access any type of medical information on the Internet. I was able to find several sites dealing with patient choice and how to choose healthcare providers, hospitals, and healthcare plans using the Medical Resource Links portion of the site. I would not, however recommend this site for experienced Internet users looking for detailed information as it is intended for beginners. That being the case I would rate it at 5 stars for those individuals looking for a starting point to surf the 'Net.