1997
DOI: 10.1111/j.1945-1474.1997.tb00888.x
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Medical Management Committees Promote Quality and Cost-Effective Managed Care

Abstract: MedSpan, a managed care organization, believes it should provide physicians with maximum input regarding utilization management and practice guidelines. This has been accomplished through nine committees, all of which report to a Medical Management/Quality Management Committee. This committee structure has allowed MedSpan to avoid the unilateral imposition of guidelines and has enhanced the quality of care and service while decreasing utilization and reducing costs. Examples of specific physician committee act… Show more

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“…The MM/QMC also has nine subcommittees (cardiology, mental health, substance abuse, obstetrics/gynecology, general medicine, pediatrics, surgery, credentialing, and pharmaceutical/therapeutics) that make recommendations regarding their area of specificity. (Cook and Wetstone, 1997).…”
Section: Tricare's Capitation Program Is Enrollment Based Capitation mentioning
confidence: 99%
See 1 more Smart Citation
“…The MM/QMC also has nine subcommittees (cardiology, mental health, substance abuse, obstetrics/gynecology, general medicine, pediatrics, surgery, credentialing, and pharmaceutical/therapeutics) that make recommendations regarding their area of specificity. (Cook and Wetstone, 1997).…”
Section: Tricare's Capitation Program Is Enrollment Based Capitation mentioning
confidence: 99%
“…For instance, based on recommendations of the MM/QMC, some examples of what MedSpan has achieved are as follows: the average length of stay (ALOS) for vaginal deliveries was reduced from 2.3 to 1.7 days; the ALOS for mental health/substance abuse patients was reduced from 11.3 to 9.1 days and days per 1000 plan members was reduce from 75 to 43; general medicine guidelines have been developed and distributed reduce costs while maintaining quality; cardiology practice guidelines for cardiac stress testing resulted in a reduction of improper utilization as well as a reduction in overall costs (Cook and Wetstone, 1997).…”
Section: Tricare's Capitation Program Is Enrollment Based Capitation mentioning
confidence: 99%