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beneficiaries;
Information needs of beneficiaries
age, 198-200
with chronic health problems, 202-203
committee focus, 7
demographics, 23-25 , 196
disabled, 196 , 198 , 202-203
disenrollment, 54-5
diversity, 37 , 50-51
dually eligible, 7 , 37
elderly, 11
end-stage renal disease, 11
experiences in managed care, 2 , 206-215
health outcomes, 208-213
health status, 25-27 , 50 , 200-202
in HMOs, 4 , 51-54 , 196 , 290
income and poverty status, 203-205
information of interest to, 271 , 275-282
knowledge about benefits/Medicare, 27-28 , 56 , 241-242
minorities, 198
number, by state, 18-19
out-of-pocket expenditures, 206
patient satisfaction, 213-214
qualified, 13 , 205
range of options, 80-82 , 191
rights, 332
role and responsibility, 33
severely disabled, 7 , 11 , 37
utilization of services, 203
vulnerable population, 50 , 197-198
Benefit plans
comparison charts, 57-58 , 73 , 78 , 89 , 97-99 , 161 , 224 , 247-248
design, 161-162 , 164-166 , 173 , 176-177 , 192
information wanted by consumers, 58 , 59
number and type offered, 161-162 , 192
standardization, 47 , 49 , 69-70 , 73 , 98 , 99 , 161 , 184 , 186 , 192 , 344 -345
Benova, 255 , 256 , 260
Best practices.
See also individual case studies
benchmarks, 143 , 151 , 156-157
concept, 34
HMO, 320-321
in purchasing plans, 151-152
Bethlehem Steel, 250
Blue Cross and Blue Shield, 164 , 294
Brook, Robert, 155
C
California
counseling programs, 316
Department of Corporations, 296 , 342
disenrollment data, 249
dispute resolution process, 303
emergency care, 308
HMO enrollees, 16 , 18 , 152 , 196
information on benefits, 61 , 262
Knox-Keene Health Care Service Plan Act of 1975, 342
marketing abuses, 297
plan purchasing strategies, 152
reform legislation, 171
risk adjustment, 161 n.1
risk-based HMOs, 52
satisfaction with care, 147 , 296-298
state oversight of HMOs, 171 , 296 , 307 , 308
California Public Employees' Retirement System (CalPERS), 48-49
accountability measures, 48-49
background, 35-36 , 340-342
benefit design, 344-345
cost and performance data, 346-348
customer service, 348-351
number of plans, 48 , 150
purchasing role, 153
provider access, 343-344
requirements for participation, 342-348
statutory and regulatory compliance, 342
Capitation payments, 14-15 , 21 , 45
Cardinal Health, 259
Case management, 52 , 221 , 222-223
Center for Health Care Rights, 249 , 296
Centers for Disease Control and Prevention, 259
Centers of excellence, 156-157
Choice of health plan options.
See also Informed purchasing
benefit plan designs and, 192