There is woefully little research on how caps affect the quality of medical care, but at least one study, published in Health Affairs in 2004, suggested that caps may have lowered quality of care.
There is woefully little research on how caps affect the quality of medical care, but at least one study, published in Health Affairs in 2004, suggested that caps might have lowered quality of care.
Although frequent ED users account for a small percentage of ED visits, these patients can drain the system, contributing to overcrowding and lowered quality of care.
Managed care efforts to regulate access to specialists and reduce costs may lower quality of care.
Because patients of lower SES often have more barriers to self care and worse control of risk factors, clinicians who provide care to many such patients may have lower quality-of-care scores publicly reported, or lose income or incentives related to unadjusted measures of clinical performance.
Such a move could potentially compromise safety and mean a lower quality of care".
"States that spend more per capita often have a lower quality of care," said Karen Davis, a health economist who is president of the Commonwealth Fund.
Worried that financial pressures might lead to lower quality of care, the Medicare commission also examined how hospitals that did a good job of controlling costs compared on measures like mortality rates and readmissions.
Measuring one component of health care delivery and forcing changes based on that measurement, while neglecting other important but harder-to-measure variables, may worsen efficiencies and lower quality of care.
"Racial differences in outcomes were not related to black patients differentially receiving care from physicians who provide a lower quality of care, but rather that black patients experienced less ideal or even adequate outcomes than white patients within the same physician panel," the study concluded.
"Such arrangements have the potential to generate cost savings and quality benefits for patients," said Richard A. Feinstein, director of the Bureau of Competition at the F.T.C. "However, in some cases, the arrangements can create highly concentrated markets that may harm consumers through higher prices or lower quality of care".
