Humbert V
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In a comprehensive managed care system, all participants benefit from the improved quality and cost efficiency. When payers, beneficiaries, and providers communicate, share data, and participate in decision making, the result is more appropriate and more cost-efficient care. The following articles take a look at how each player in the health care system benefits from a comprehensive approach to health care. Payers (employers) benefit by being able to track the cost effectiveness of their health care through integrated data systems. Beneficiaries (employees and dependents) benefit by becoming more involved in the decisions being made by providers and third party payers about their care through patient education and advocacy programs. And health care providers benefit by gaining an increased leadership role in directing the management of their patients' care through practice guidelines. These guidelines will help doctors make decisions that lead to high quality care as well as build a foundation for standardized review criteria throughout the industry.
在一个全面的管理式医疗系统中，所有参与者都能从质量提升和成本效益提高中受益。当支付方、受益方和医疗服务提供者进行沟通、共享数据并参与决策时，结果便是更恰当且更具成本效益的医疗服务。以下文章探讨了医疗保健系统中的各方如何从全面的医疗保健方法中获益。支付方（雇主）能够通过集成数据系统追踪其医疗保健的成本效益，从而从中受益。受益方（员工及其家属）通过患者教育和宣传项目，更多地参与到医疗服务提供者和第三方支付方关于其医疗护理的决策中，进而受益。而医疗服务提供者则通过实践指南在指导患者护理管理方面发挥更大的领导作用而受益。这些指南将帮助医生做出能带来高质量医疗服务的决策，并为整个行业的标准化审查标准奠定基础。
