Cronin C
Managed Health Care Association, Washington, DC 20005.
Jt Comm J Qual Improv. 1994 Jul;20(7):376-80. doi: 10.1016/s1070-3241(16)30082-7.
Business coalitions on health-generally nonprofit, community-based membership organizations primarily composed of local employers-attempt to manage the cost and quality of health care delivery. They are also active in other areas, including member education, data collection, and selective contracting.
With reference to projects related to public accountability for hospital quality of care, coalitions have been involved in legislative support of state public databases, efforts to develop severity-adjusted information on hospital quality, group purchasing from selected hospitals based on cost and quality-an activity conducted in more than 20 locales, and consumer education.
With health care reform, coalitions will need to shift from looking solely at individual physicians and hospitals to looking at them in the context of managed care. Balancing the tension between continuous quality improvement activities and public accountability will also be an important issue for coalitions. The future of coalitions after health care reform is uncertain, with scenarios ranging from their demise to their expansion as active purchasing coalitions or their assumption of new roles and activities. Whatever the future viability and focus of health care coalitions, they have effectively served as change agents in their communities.
健康领域的商业联盟——通常是非营利性的、以社区为基础的会员组织，主要由当地雇主组成——试图管理医疗服务的成本和质量。它们还活跃于其他领域，包括会员教育、数据收集和选择性签约。
在与医院医疗质量的公共问责相关的项目方面，联盟参与了对州公共数据库的立法支持、开发医院质量的病情严重程度调整信息的努力、基于成本和质量从选定医院进行团购（这一活动在20多个地区开展）以及消费者教育。
随着医疗改革，联盟将需要从仅关注个体医生和医院转变为在管理式医疗的背景下看待它们。平衡持续质量改进活动与公共问责之间的矛盾对联盟来说也将是一个重要问题。医疗改革后联盟的未来不确定，可能的情况包括它们的消亡、作为积极采购联盟的扩张，或者承担新的角色和活动。无论医疗联盟未来的可行性和重点是什么，它们都有效地在其社区中充当了变革推动者。
