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Improving fairness in coverage decisions: performance expectations for quality improvement
Authors:Wynia Matthew K  Cummins Deborah  Fleming David  Karsjens Kari  Orr Amber  Sabin James  Saphire-Bernstein Inger  Witlen Renee;Oversight Body of the Ethical Force Program
Institution:American Medical Association, USA.
Abstract:Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups.
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