Jacobs Institute of Women's Health
The George Washington University School of Public Health and Health Services
950 New Hampshire Ave., NW, 2nd Floor
Washington, DC 20052
D. Richard Mauery, MS, MPH
> National Summit on Managed Care
National Summit on Women's Health and Managed Care
The Jacobs Institute partnered with the American Association of Health Plans to build on and incorporate the lessons learned from the Jacobs Institute's 8-part managed care seminar series.
The summit brought together managed care representatives to contribute their expertise to an action plan for improving managed care's approach to women's health care. The following recommendations and comments were made by the various working groups:
- Identify responsibility for various aspects of patient care
- Establish realistic cost-sharing models for primary care (i.e. affordable co-payments for prescriptions)
- Expand opportunities for health care counseling outside of clinics
- Provide financial and other incentives for patients to seek preventive services
- Focus on special populations
- Create standard codes for reimbursement to cover counseling
- Compensate providers for taking the time to counsel patients
- Create accountability for physician competence in primary care
- Further discuss the role of ob/gyn's in primary care
- Expand or provide better coverage of contraception, such as offering incentives or reimbursements for condom use
- Develop programs to increase chlamydia screening and treatment
- Encourage community-based clinics to forge good working relationships with managed care organizations
- Develop ways to measure outcomes, which capture positive outcomes as well as recidivism
- Train all primary-care specialists in basic mental health
- Develop algorithms on primary care treatment vs. referral for mental health
- Provide primary-care providers with more education on drug interactions and side effects.
- Good programs require multi-disciplinary teams and guidelines, allow patients to direct their own care, establish outcome measures at the beginning of a program, and allow programs enough time to show results.
- A multidisciplinary approach was seen as the most important element of successfully treating chronic conditions.
- Managed care organizations should know its members, their cultural needs, and how it can promote sensitivity through diversity training, disability access, etc.