a1 Assistant Clinical Professor (Health Policy and Management), Columbia University School of Public Health, and provides bioethics training and consultation services in several New Jersey teaching hospitals.
The era of managed care has arrived with portents of a new calculus to integrate cost and quality in health services. These devises such as “report cards” and “outcome measures” place performance against expectations and thus are expected to gauge the value of specific elements of healthcare delivery. From such measures and comparisons, the public will be able to better judge the appropriate, effective, and attractive place to seek their medical services. What is now widely used by utilization review, guiding reimbursement decisions and allowances for the length of hospital stays, will soon have a more prosperous future as general guidelines built into the very framework of managed care agreements.