Improving Fairness in Coverage Decisions: Performance Expectations for Quality Improvement |
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Authors: | Matthew K Wynia Deborah Cummins David Fleming Kari Karsjens Amber Orr James Sabin |
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Institution: | 1. American Medical Association;2. University of Illinois College of Medicine , Chicago;3. University of Missouri—Columbia School of Medicine;4. Harvard Pilgrim Health Care, Harvard Medical School |
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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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Keywords: | health insurance benefits ethics coverage quality improvement performance |
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