Medicare. Vol. 1 : a strategy for quality assurance / Committee to Design a Strategy for Quality Review and Assurance in Medicare, Division of Health Care Services, Institute of Medicine, Division of Health Care Services ; Kathleen N. Lohr, editor.

"This study was supported by the Health Care Financing Administration, U.S. Department of Health and Human Services, under cooperative agreement no. 17-C-99170/3"--Title page verso

Includes bibliographical references and indexes.

Print version record.

MEDICARE -- Copyright -- Contents -- Preface -- Introduction to the Study and This Report -- CONGRESSIONAL CHARGE -- STUDY METHODS -- ORGANIZATION OF THIS REPORT -- Summary -- FINDINGS AND CONCLUSIONS -- A MODEL OF QUALITY ASSURANCE FOR MEDICARE -- DEFINING QUALITY OF CARE -- RECOMMENDATIONS -- Medicare Mission and Quality Assurance -- Quality Assurance Goals of the Medicare Program -- Medicare Program to Assure Quality (MPAQ) -- Public Accountability and Evaluation -- Hospital Conditions of Participation -- Research and Capacity Building -- FUNDING

ORGANIZATIONAL AND OPERATIONAL FEATURES OF THE MEDICARE PROGRAM TO ASSURE QUALITYStarting Points -- Structure -- The Federal and Local Levels -- The Internal Organization-Based Level -- Operational Overview of the Proposed Model -- An Emphasis on Outcomes -- The Importance of the Process of Care -- Continuity of Quality Assessment -- Potential Problems -- IMPLEMENTATION STRATEGY AND PHASES -- Phase I: Years 1 and 2 -- Phase II: Years 2 through 8 -- Data Collection -- Data Analysis Capabilities -- Information Dissemination -- Special Projects

Phase III: Years 9 and 10CONCLUDING REMARKS -- 1 Health, Health Care, and Quality of Care -- DEFINING QUALITY OF HEALTH CARE -- Elements of the Committee's Definition -- Implications of the Committee's Definition -- HEALTH AND HEALTH CARE IN THE UNITED STATES -- Health and Illness -- Structure of the U.S. Health Care System -- Major Health Policy Issues with Implications for Quality of Care -- Health Care Expenditures -- Access to Services -- Settings of Care -- Integration of Financing and Delivery of Services

Utilization Management and Utilization ReviewMedicare's Physician Payment System -- Summary -- QUALITY OF HEALTH CARE AS A PUBLIC POLICY ISSUE -- Burden of Harm of Poor Quality -- Assuring Quality: A Professional and a Public Responsibility -- Professional Responsibilities -- Public Sector Responsibilities and Regulation -- Health Care as a Public Good -- Other Forces for Quality Assurance -- Market Forces and Competition -- Malpractice and Risk Management -- Value Purchasing -- Decision Making and Population-Based Outcomes -- SUMMARY -- NOTES

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