The beleaguered managed-care industry has done a marvelous job of back-pedaling, fence-mending and attitude-adjusting as it attempts to make friends and influence enemies.
But this seemingly never-ending series of public relations gestures has done little to narrow the understanding gap between health plans and providers, and patients and politicians.
For example, hospital and physician groups in California recently slammed the performance of the state's major HMOs. Meanwhile, after several HMOs exited the Medicare+Choice program, managed-care plans were bashed for leaving nearly a million seniors searching for alternatives.
Maybe it's an appropriate time for providers to tone down the rhetoric and turn their attention to measuring whether all these touchy-feely programs and policy changes have produced anticipated behavioral changes.
In last week's issue, reporter Laura Benko revealed that an American Association of Health Plans' 3-year-old vow to impose a "code of conduct" on its 1,000-plus member plans hasn't resulted in a single ouster.
Another effort that deserves close attention is the Coalition for Affordable Quality Healthcare, a new group of 22 health plans and trade groups that cover more than 100 million Americans.
In its ambitious agenda, the coalition wants to simplify insurance forms, standardize physician credentialing and tear down access barriers between patients and physicians.
The group also plans to take steps to encourage the practice of evidence-based medicine and make it easier for consumers to compare quality and cost differences among health plans.
The effort is timely. Upcoming elections are delaying progress on the patient-protection bill, which is bogged down in a House-Senate conference committee.
But if--and it's a mighty big if--HMOs are to escape more-stringent government regulation, these kinds of managed-care initiatives must produce a documented payoff.
Managed-care pioneer Leonard Schaeffer, chairman of the coalition and chief executive officer of WellPoint Health Networks, understands bottom-line numbers. Acknowledging that HMOs "have lost the trust of many Americans," he said the coalition will report on its progress in six months.
In the meantime, providers should keep their own box score.