The results of this project show that there is a wealth of information available on the internet and that patients and employers do indeed have choices. The problems one might have encountered five or ten years ago with managed care should not occur today with the legislation designed to protect patient rights to choice in health care and with the media's sensitivity to managed care horror stories. Naturally, the source of the information is key to understanding the information and the perspective through which it should be interpreted. There are also plenty of groups who do not support managed care and whose experiences testify to the lack of choice within managed care. Of these, many are providers who understandably resist managed care. It is up to patients to decide what is best for themselves amidst the political and personal agendas behind various groups.
Your Guide to Managed Care by Health Pages
Rate: 5
Excellent site providing definitions, concepts and background information
on managed care, as well
as what to look for in health plans and links to other sites, such
as the NCQA. This is probably the
most comprehensive, objective information to be found for the consumer.
American
Federation
of
State,County
and
Municipal
Employees
Rate: 5
This site gives a series of fact sheets concerning patient protection
in managed care. Some of the
topics are: Quality, Access and Affordability; Enrollment and
Premium Trends in Managed Care;
Choice of Providers and Plan: Access to Specialists; Using Purchasing
Power to Improve Quality;
Patient Protection Legislation. Sponsored by the American Federation
of State, County and
Municipal Employees (AFSCME), which is “the nation's largest public
employee and health care
workers union”, the information is given from the perspective of a
union members. However, the
principles can be applied to patients/employees whether they belong
to a union or not. The last two
sheets are the most useful to influence change.
American
Center
for
Patient
Decisionmaking
Rate: 4
This site is by the American Center for Patient Decisionmaking (ACPD),
which is non-profit
organization funded by contributions, grants, fundraising and by charging
for their services on a FFS
basis. This center offers three main services: 1) to help gather,
and decipher the terminology in, the
information available on treatment options for various conditions;
2) once a treatment program has
been decided, to find the right physician or hospital to receive treatment,
by analyzing data available
on health outcomes and measures (patient satisfaction, survival rates,
length-of stay, etc.); and 3)
advocate for the patient, with MCOs, hospitals, or medical staff from
other countries. For the lay
person, the information this center provides is probably the most critical
and helpful, particular in a
managed care environment that fosters distrust for one’s own physician’s
and MCO’s motives.
Although this excludes a significant population of people who cannot
afford their services, it provides
a tremendous service to those who can. This is about as unbiased
and pro-patient as professional,
medical opinions come today. Because the organization is non-profit,
it immediately gives the reader
a sense of relief that the center is not in this for the money (although
I do not know what their hourly
fee is).
This site provides a link to a potentially powerful source of information,
and I believe that it is
sincerely geared towards helping people make an informed decision about
their health care. Its
perspective is that of empathy and understanding for the process of
making decisions in a medical
crisis. The only drawback to this site is its readability; every
word in the document is blue and
underlined (making it difficult to read if you do not have 20/200 vision,
but probably easy to read, if
you do), giving the false impression that they are all links to other
sites.
Health
Care
Financing
Administration's
Plan
and
Provider
Home
Page
Rate: 4
A site for plans and providers concerned with Medicare, Medicaid and
Child Health issues. Plenty
of information, with an index to find things easily. Of interest
to consumers is the section on Quality
of Care. There are summaries of various legislative acts and
issues of concern for providers and
health plans (payment systems, fraud, data exchange), as well as links
to plenty of other sources of
information (national statistics, various studies, publications, etc.).
Physicians
Who
Care
Rate: 3
This site is definitely anti-managed care, as depicted by its first
sentence: “HMOs have introduced a
novel innovation in American Health care: incentives for physicians
not to treat patients.” Sponsored
by “Physicians Who Care”, this is a clear example of how politcally
saturated and how divided the
different stakeholders are over the issue of health care reform.
This site serves as a forum for
patients and physicians to voice their complaints, which is a necessary
part of having a competitive
market place approach to health care. To be realistic, and perhaps
a little cynical, physicians have to
foster an anti-managed care feeling among patients, if they want to
influence change (e.g., return to
FFS health care) in their favor. This site does provide recent
news and links to other pro-patient
resources, but depending on your perspective, all of the information
has a managed-care-is-bad twist
to it. If you are a patient looking for empathy or a way to voice
your frustration, this may be the
vehicle to do so; how constructive it will be is debatable.
HMO
Buyers
Zone
Rate: 2
This is the “HMO Buyers Zone” for businesses shopping around for an
HMO. The information this
site provides is broken into 5 areas: The Buyers Guide, Industry
Lingo, Where to Buy, Buyers
Forum and the Resource Center. Although the site has some flaws,
overall, it does point out that
employers have a choice in choosing a health plan.
Advantages:
If I were a business looking for an HMO, I might use this as a first
step but then go to other sources
for more reliable facts. The Industry Lingo contains 6 terms,
so although it is useful, having only 6
terms defined leaves too many undefined. The Resource Center
suggests 2 buyers guide type books
and a link to the American Association of Health Plans and the NCQA.
Disadvantages:
The Where to Buy page was not very useful. I attempted putting
in a request using various
combinations of local zip codes and number of employees (their choices
were: <10, 10-50 and >50)
and the reply was the same each time, saying that there were no matches
for my request, fill in the
information below to be contacted when the information is available.
The Buyers Forum has a Q&A
forum and a Buyers Ratings, which are based only on buyers’ opinion,
which is a good idea, but the
rating for most plans listed were based on one response The Q&A
forum is also a good idea, but
the responses to questions posted varied from 3-day to 2-month response;
other questions (posted
in 1997) never received a response. Whether they did receive
a response through a different
medium such as a personal e-mail or telephone call is unclear, but
the purpose of posting the question
is to post the response in a timely fashion, so that it is useful to
the person asking and the public.
Documents
MedHelpInternational
Rate: 5
Excellent overview for the patient to understand the issues and choices
involved in health care. This
highlights the fact that patients do have a choice in choosing a health
plan.
The
Library
of
Congress
-
Senate
Bill
1890
:
Patients'
Bill
of
Rights
Act
of
1998
The
Library
of
Congress
-
House
of
Representatives
Bill
4250
:
Patient
Protection
Act
of
1998
Rate: 5
The homepage is a library of legislation. These two addresses
should locate the legislation pertinent
to protecting patient rights. [Sometimes I’ve found that the
address changes, so if these don’t work,
go to the homepage of this site http://thomas.loc.gov and from there,
under Legislation, select
Previous under “Bill Summary & Status” or “Bill Text”; then select
105 (1997-1998) and either
“S.1890” or “H.R.4250” by bill number, or search by word/phrase and
use “patients bill of rights”.
Searching by word/phrase will give more documents to choose from.]
President's
Advisory
Commissionon
Consumer
Protection
and
Quality
in
the
Health
Care
Industry
Rate: 5
This is the Consumer Bill of Rights and Responsibilities: Report
to the President of the United States,
Prepared by Advisory Commission on Consumer Protection and Quality
in the Health Care Industry.
The
Commonwealth
Fund
:
Employees
Lack
Options
Among
Health
Plans
Rate: 4
This is a summary of a presentation, entitled “Employees Lack Options
Among Health Plans”, given
by the president of the Commonwealth Fund in an effort to show the
President’s Advisory
Commission on Consumer Protection and Quality in the Health Care Industry
that most Americans
are not given a choice of health plans by their employer.
| Note: The information below may contain additional relevant materials and documents. Some of the information may be duplicate. The evaluations depend on both the student doing the review and the information contained at the time of the review. Sites are subject to change! |