Dubow J
American Association of Retired Persons, Washington, DC, USA.
Manag Care Q. 1997 Autumn;5(4):48-54.
As managed care grows in the Medicare program, Congress must act to instill greater confidence among beneficiaries that the options offered will provide available and accessible, high-quality care. There must be an effective set of comprehensive standards, applicable to all Medicare contractors, that will ensure proper safeguards and beneficiary protections. These include strengthening quality improvement/assessment and the grievance and appeals process. Adequate levels of assistance should be provided for beneficiary counseling programs. Finally, the Health Care Financing Administration must be given sufficient resources to effectively oversee the managed care program.
随着管理式医疗在医疗保险计划中不断发展，国会必须采取行动，增强受益人的信心，使他们相信所提供的选择将能提供可得且可及的高质量医疗服务。必须有一套适用于所有医疗保险承办商的有效综合标准，以确保适当的保障措施和对受益人的保护。这些措施包括加强质量改进/评估以及申诉和上诉程序。应为受益人咨询计划提供足够水平的援助。最后，必须给予医疗保健财务管理局足够的资源，以有效监督管理式医疗计划。
