Stanfield C R
William M. Mercer Meidinger Hansen, Incorporated, Milwaukee, WI 53202-4409.
Am J Hosp Pharm. 1990 Sep;47(9):2053-5.
Current trends in employer management of health-care plans are summarized, and the role of managed care is emphasized. Employers realize that employees perceive health-care plans as an important benefit and that attractive benefit plans will help in recruiting and retaining employees. At the same time, companies are faced with the need to find new ways in which to curtail the rising cost of health-benefit plans, which often constitute their largest and most uncontrollable budget item. Such techniques as more effective claims administration, plan design changes, plan financing arrangements, education of employees, and increased employee cost sharing are among the cost-containment actions that employers are implementing. Managed-care networks including health maintenance organizations are often viewed as the ultimate cost-containment model; however, the effectiveness of these evolving arrangements must be rigorously evaluated on the basis of appropriate performance criteria and documentation of achievement. Faced with cost-containment pressures, employers are taking a more assertive and informed role in health-plan purchasing decisions. The future course of health-care delivery will depend in large part on the response of corporate management to the challenge of ensuring that their employees receive quality health care at controllable costs.
总结了雇主管理医疗保健计划的当前趋势，并强调了管理式医疗的作用。雇主意识到员工将医疗保健计划视为一项重要福利，有吸引力的福利计划将有助于招聘和留住员工。与此同时，公司面临着寻找新方法来削减医疗福利计划不断上涨的成本的需求，医疗福利计划往往是公司最大且最难以控制的预算项目。诸如更有效的理赔管理、计划设计变更、计划融资安排、员工教育以及增加员工成本分担等技术，都是雇主正在实施的成本控制措施。包括健康维护组织在内的管理式医疗网络通常被视为终极成本控制模式；然而，必须根据适当的绩效标准和成果记录，对这些不断发展的安排的有效性进行严格评估。面对成本控制压力，雇主在医疗计划采购决策中发挥着更加积极和明智的作用。医疗保健服务的未来发展在很大程度上将取决于企业管理层对确保员工以可控成本获得优质医疗保健这一挑战的应对。
