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HMOs Can Improve the Use of Therapies
Health maintenance organizations (HMOs) have been around for almost 30 years. They have proven so popular (figure 2) that there are now more than 650 HMOs in the U.S., covering more than one in four Americans. HMOs are responsible for the quality of health care that their members receive. This includes ensuring that they receive appropriate drug treatment for their medical conditions. An example would be receiving beta-blockers after a heart attack to reduce the risk of death.
To ensure appropriate therapy, HMOs collect and examine extensive information about their members' medical conditions and treatment. They also capture and analyze information about the caregivers providing such treatment. The CERTs at the HMO Research Network is going to put this information to good use.
Although HMOs have developed several ways to help caregivers prescribe the right drugs for the right patients, and to help patients to take these drugs, there is no organized source of information about which strategies have been tried, how well they work, or how they compare with other approaches. Thus individual HMOs often "reinvent the wheel" when trying to decide which are the best treatment strategies.
Dr. Stephen Soumerai, of the HMO Research Network CERTs; Dr. Sallie-Anne Pearson, project coordinator; and their colleagues are addressing this need by reviewing both published and unpublished studies of approaches used to improve medication use among HMO members.
They are organizing this information into a database that will allow patients, caregivers, and HMO planners to determine what type of strategies have been tested, the conditions for which they have been used, and their impact. By means of the main CERTs Web site, the research team will make the information available to all. The group also is preparing a report that summarizes this information, to serve as a guide.
"This will be the first comprehensive review of the effectiveness of drug-related interventions in managed care organizations," notes Soumerai.