Managed Care Programs Should Be Held To Higher Standards Than Those Proposed For Population At Large

June 30, 1998

In response to a research study that found that nationally established goals for population screening of high-density lipoproteins (HDLs) were exceeded by a managed care organization, Kurland (Regional Director for New England of the Department of Health and Human Services) and Robbins (past president of the American Public Health Association and editor of Public Health Reports) write that that is not good enough.

The survey, conducted by the Prudential HealthCare organization of three of its sites and published in the July/August 1998 issue of Public Health Reports, determined that 84% of patients in the study group had received at least one total blood cholesterol level, exceeding the 75% target established by the National Cholesterol Education Program.

"It seems reasonable that managed care plans should be expected to reach 100% of their enrolled members," write Kurland and Robbins in a related commentary. The 75% target is "taken from a national goal, intended to include both unenrolled fee-for-services users and managed care enrollees." This broad national goal includes allowances for public health efforts that require outreach and public education to bring citizens in to see the doctor. "Managed care, with enrolled members, should not be granted such a handicap."

CONTACT for commentary: Judith Kurland; tel. 617-565-1500; e-mail jkurland@os.dhhs.gov. For study: Dr. Koplan, MD MPH; tel. 770-801-7880; e-mail jeffrey.koplan@prudential.com.
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Public Health Reports

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