• jective process for measuring performance (e.g., centralized, standardized consumer surveys). Such a system of accountability is not currently in place for Medicare enrollees.
  • Should consumer information only compare plans with each other or should plans also be compared against benchmarks or standards? Relative plan comparisons provide useful information for selecting among alternatives; however, several purchasers (notably Xerox and Southern California Edison) are setting objective standards, based on regional and national norms, and reporting plan performance against these norms directly to consumers.
  • How will plans be marketed and presented to enrollees? Those purchasers described here who serve the small group and individual markets use agents as brokers to some degree. Among the concerns related to using agents to market to Medicare enrollees are standard agent training or certification, equitable compensation regardless of the plan selected by the enrollee, and systems of monitoring and accountability for agents.


Darling, H. 1991. Employers and managed care: What are the early returns? Health Affairs 10(Winter):147-160.

Darling, H. 1992. HealthLink-Xerox innovative healthcare strategy. Xerox Corporation Report. April 1992. Photocopy.

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