Quality safeguards for managed care

Discussions about quality of care are seemingly the order of the day. According to a poll of more than 1000 adults conducted by the National Coalition for Health Care, 75% believe there were serious problems with the quality of health care and almost the same percentage believe quality care is often compromised by insurance companies to save money. One can scarcely pick up an issue of JAMA or the New England Journal of Medicine without encountering at least 1 article on quality assessment. Likewise, it is common to find in the lay press exposes and articles that are critical of health care quality in managed care plans, such as that by Jane Bryant Quinn(1) in Newsweek.