Improving Managed Health Care In California Executive Summary

New medical technologies--pharmaceuticals, medical devices, and procedures--often allow great improvements in the outcomes of medical care, but they are also widely believed to be a major cause of increasing costs. Selective adoption of new technologies is crucial in the quest to control health care costs while preserving or enhancing the quality of care. This volume is the executive summary of a report that focuses on evaluation and adoption of innovative procedures and medical devices by managed care organizations (MCOs).

The leaders of the State of Calif. have opened an important debate on health care, looking to solve the problem of its citizens who lack health care insurance. As California¿s single largest purchaser of health care, the Medi-Cal program is too big to be an afterthought in the debate on how to untie the knot of rising health costs, the lack of affordability, and the growing burden of cost-shifting on business. The sheer size of the Medi-Cal budget -- $37.7 billion and growing fast -- demands a smarter approach. Better by far for the state to focus on what the state is buying for its billions -- better for accountability to taxpayers and better for delivering promised health benefits to Calif.¿s poor and disabled, 6.6 million of whom are enrolled in Medi-Cal. Tables and graphs.

Leadership/Management/Administration

A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas.