quality. Such employers believe that quality health care represents a better value and costs less.

In recent years, 33 large companies on the West Coast of the United States have formed the Pacific Business Group on Health (PBGH) to provide leadership to steer the health care market toward increased quality and accountability. This coalition of businesses strives to improve quality through the administration of their health care programs. The strategy includes encouraging employees to select certain systems of care voluntarily and ensuring that those decisions are based on value. However, employers tend to regard health care in terms of prevention, acute care, and chronic care, not in terms of specific infections, emerging or otherwise. From the point of view of PBGH, too many managed care organizations are only managing costs and are not paying attention to accountability. A larger problem is the lack of timely, accurate, and complete information about employee's health care encounters that can be used appropriately by health plans, individual practitioners, and payers. These data were previously available through the claims information routinely collected by fee-for-service, indemnity-based plans.

MANAGED CARE AND INFECTIOUS DISEASE SURVEILLANCE: OPPORTUNITIES FOR COLLABORATION

Presented by Denise Koo, M.D., M.P.H.

Director, Division of Public Health Surveillance and Informatics, Centers for Disease Control and Prevention

Public health surveillance and monitoring activities are a cornerstone of public health practice, providing information essential for assessing public health status, monitoring trends, suggesting public health priorities, and evaluating the effectiveness of public health programs. In one of these monitoring functions, the Centers for Disease Control and Prevention (CDC) manages a system of national surveillance of notifiable diseases in coordination with state health departments and publishes data on a weekly basis.

When considering how public health surveillance may be conducted through managed care organizations, there is great potential for many benefits and opportunities to be gained through partnerships with managed care. Because the improved health of a population is a primary goal of managed care organizations and public health agencies, both will benefit by sharing data and working together. There are, however, several impediments to conducting surveillance through managed care organizations.

First, there is a lack of understanding on the part of health care providers about the roles of state and local public health departments in infectious disease surveillance. In general, few health care providers understand the importance of public health surveillance, the role of the provider as a source of data, and the role of the health department in response to infectious diseases. Some of this



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