Allen H M, Darling H, McNeill D N, Bastien F
Health Institute, New England Medical Center.
Health Aff (Millwood). 1994 Fall;13(4):25-41. doi: 10.1377/hlthaff.13.4.25.
In a groundbreaking arrangement, a consortium of large employers--the Xerox, GTE, and Digital Equipment Corporations--launched the Employee Health Care Value Survey during fall 1993. Completed by 24,306 employees, this survey was used to develop comparable methods for assessing corporate health care benefit strategies. It also enabled fair comparisons of thirty-two health plans across the country on more than sixty criteria. Variation in performance among plans was substantial, with managed care plans--particularly prepaid group practices and individual practice associations (IPAs)--recording the most favorable rankings on disenrollment, overall satisfaction, and other measures of "bottom-line performance." Variation in enrollees' health among plans was more modest, with indemnity enrollees posing a somewhat greater illness burden to their plans than enrollees of other plan types. The employers and evaluated health plans are now using the results for multiple purposes, including quality improvement initiatives, employee-based plan performance reports, employee contribution strategies, and health promotion programs.
1993年秋季，施乐公司、通用电话电子公司和数字设备公司等大型雇主组成的财团做出了一项开创性的安排，发起了员工医疗保健价值调查。这项调查由24306名员工完成，用于开发评估企业医疗保健福利策略的可比方法。它还能在60多个标准上对全国32种健康计划进行公平比较。各计划之间的绩效差异很大，管理式医疗计划——尤其是预付费团体医疗模式和个人执业协会（IPA）——在退保率、总体满意度和其他“底线绩效”指标上排名最靠前。各计划参保人员的健康差异较小，与其他类型计划的参保人员相比，赔偿型计划的参保人员给其计划带来的疾病负担略重。雇主和接受评估的健康计划现在正将这些结果用于多种目的，包括质量改进计划、基于员工的计划绩效报告、员工缴费策略和健康促进项目。
