The managed care environment is diverse, and for the purposes of this workshop summary, only for-profit types of managed care organizations are considered in detail. However, in addition to non-profit and for-profit organizations, other significant players are governmental, including the VA and the U.S. Department of Defense. Of particular note, the VA has the largest fully integrated health care system in the world and is the only national safety net for many highly vulnerable patients. Appendix A presents an overview of VA health care systems with regard to emerging infections and managed care.
Representatives from managed care organizations, hospitals, government agencies, pharmaceutical companies, and academia were invited to give panel presentations moderated by Forum members. Each panelist was asked to highlight important issues, suggest possible practical solutions, and recognize impediments that must be overcome. By the end of the workshop discussions, participants noted that no two managed care organizations are identical. Moreover, the Forum members and participants recognized that the information cited may be unrepresentative of managed care organizations and that additional presentations from managed care organizations were needed for a greater exploration of the subject, Thus, by default, the workshop focused on a few model systems to stimulate discussion and to provide examples of successful programs.
In identifying organizations that could serve as examples of organizations whose practices effectively fight infectious diseases, the Forum recognized the Group Health Cooperative of Puget Sound for its leadership in research, the National Independent Practice Association Coalition and the Healthcare Education and Research Foundation for examples of clinical practice guidelines, the Harvard Pilgrim and Latter-Day Saints Hospital as models of effective surveillance and monitoring systems, and the Group Health Association of America for its guidance in educational and outreach programs. Through the workshop the Forum has identified some examples of best practices in managed care and infectious disease control, and through this workshop summary it hopes to disseminate information on why certain programs are effective, as well as provide for others guidance on how to achieve positive results in a variety of settings.
This report of the Forum-sponsored workshop is prepared in the form of a workshop summary by and in the name of the editor with the assistance of staff and consultants, as an individually authored document. Sections of the workshop summary not specifically attributed to an individual reflect the views of the editor and not those of the Forum on Emerging Infections. The content of those sections is based on the presentations and the discussions that took place during the workshop. Accordingly, each of the next five chapters begins with an opening statement of context and background authored by the editor, followed by descriptions of the presentations that were made by invited participants. At the end of each of these chapters is a summary by the editor of the issues and themes that emerged from the presentations and during the discussions. The last chapter contains concluding remarks authored by the Chair of the Forum.