CHICAGOA consistent worry in the managed care era has been that the purchasers of oncology services (the payers) would be held accountable only for the cost of care because good measures of quality were not available. Now, new sets of quality measures are being developed that cover all parties involved in the provision of health services, said Linda L. Emanuel, MD, PhD, vice president of Ethics Standards for the American Medical Association (AMA).
These measures focus not simply on the technical aspects of health care delivery but on ethical standards as well, she said at the first national conference on purchasing oncology services, sponsored by the American Cancer Society.
Dr. Emanuel invited public and private payers to voluntarily participate in a program that will compare their health plans against these standards of ethics. The standards are being created by a program called Ethical FORCE (Fundamental Obligation Report Card Evaluations), an independent agency that will operate out of the AMAs Institute of Ethics.
The standards will assess many aspects of health care purchasing, including whether payers provide a real choice among health benefits plans for their beneficiaries and whether employers provide sufficient information to employees as they make their choice. This is not just advertising kinds of information, caveat emptor kinds of statements, but real informed consent standards, she said.
The Ethical FORCE program is one of a number of initiatives that are trying to bring accountability to all the parties of health carenot just to the health care plans and physicians, Dr. Emanuel said. These programs are forming because any party that is now able to impact the patients treatment interaction or the delivery of health care must be held accountable on health care values, she said.
The objectives of the health care market are an important consideration, she acknowledged, mainly because the market is the vehicle through which health care delivery is channeled. However, she said, market goals must never supersede the values of the health care profession.