In a landmark development, Blue Cross Blue Shield (BCBS) has reached a $2.8 billion settlement to resolve antitrust claims brought by health care providers, including chiropractors. The lawsuit accused BCBS of dividing the nation into exclusive regions and limiting competition, which resulted in lower reimbursements for providers. Although BCBS denies any wrongdoing, the company agreed to the settlement to avoid lengthy litigation – and you can get a piece of the pie.
The New Health Care Lexicon
Outcomes Management vs. Outcomes Research
As our world changes, so does our language. This column presents definitions of terms that are part of the new health care reform lexicon.
Outcomes Management
A system that encourages doctors to follow a set of guidelines (also called practice parameters or clinical paths) that research has shown to be the "one best way" to treat a medical ailment. Eventually, physicians' outcome records may be combined with their cost and quality-management profiles (see economic credentialing) and made public, to help consumers make informed decisions about quality care (see "Outcomes research").
Outcomes Research
The attempt to determine which medical treatments get the best results. The goal is to standardize care and ensure predictable, desired outcomes in patients' health.
These definitions are reprinted with permission from the glossary of Revolution: The New Health Care Takes Shape authored by noted health care futurist Russell C. Coile Jr.; published by Whittle Direct Books 1993.