Coalition Outlines Progress, Next Steps of 24 MCOs in Consumer and Provider Satisfaction
In its first biannual progress report, the Coalition for Affordable Quality Healthcare, an alliance of 24 "major" health plans, said it has made "significant progress" toward improving consumers' and providers' experiences with managed care, the Denver Post reports. The coalition formed in July to "alleviate patient distrust and distaste for HMOs and to repair relationships with physicians," the Post reports. Health plan executives "fear" that federal lawmakers will pass "stringent patient-protection laws" or implement a government-run health care system unless executives can keep costs under control, show "marked improvement" in quality of care and dispel their "profit before patients" reputation. Bill McCallum, CEO of the Denver-based Great West Life and a coalition member, said, "We're demonstrating that the right place to solve health care problems is in the private sector. We're solving the problems that the government hasn't been able to solve." To that end, the coalition has targeted three areas of improvement -- access to care, collaboration with physicians and administrative processes. Coalition members have agreed to:
- guarantee plan members direct access to OB/GYNs and pediatricians without referrals;
- pay for emergency care that a "reasonable" person would consider necessary;
- implement a standard complaint-review process, under which an independent physician considers patient grievances;
- begin to create a single credentialing application for doctors;
- dedicate themselves to Web-based communication with patients, doctors and hospitals;
- compile a database of 80 top health and wellness programs that plans in the coalition now share and plan to implement nationwide; and
- combat misuse of antibiotics and prevent spread of new and untreatable viruses.
