The role of risk adjustment in the assessment of medical practices in managed care.

As reliance on managed care to control the cost of health care in the United States grows, clinicians and managers will come under increasing competitive and regulatory pressure to identify and adopt the strategies and interventions that are not only most economical but that also best improve the health of the populations served. Explicit criteria will be embodied in public performance reports. Clearly, in comparing the performance of firms and of individuals who provide health care, disparities in risk among the patient populations will have to be compensated.