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Local Health Departments in a Managed Care Environment

Impact of Managed Care on Community Health

What Performance Measures Make Sense?


Bobbie Berkowitz, Ph.D., R.N., C.N.A.A., F.A.A.N., Deputy Director, Turning Point National Program Office, School of Public Health and Community Medicine, University of Washington, and Co-Chair, Institute of Medicine's Committee on Using Performance Monitoring to Improve Community Health, Seattle, WA.

Many local health departments (LHDs) across the country have wrestled with the question of how to tie in or link the activities of managed care plans into the overall objective of improving the health status of the community, defined broadly to include persons enrolled in these plans and those without coverage.

In this session, Bobbie Berkowitz described the report of an Institute of Medicine Committee, which she co-chaired, that examined the issue of using performance monitoring to improve community health. Recognizing that health status is influenced by a broad range of factors, she described the committee's recommendations to develop performance measures in the context of a broad-based community health assessment, prioritization, and improvement process.

Dr. Berkowitz also shared with participants examples of performance measures developed by the committee for illustrative purposes, but stressed that the priority health areas and measures for a given community should be developed in the context of a broader community-specific process.


Institute of Medicine—Reports from the Committee on Using Performance Monitoring to Improve Community Health.

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