This project begins with the observation that most of the controversy about managed care, such as gag rules, financial incentives, limits on care, and confidentiality, can be viewed as ethics problems. It is unlikely that criticism, a patients bill of rights, or other approaches will get managed care organizations to be more ethical. The BEST project is based on the idea that by showing managed care plans a list of best practices regarding these ethical issues, they might adopt them. A consortium of 12 managed care plans was established, including for-profit, not-for-profit, academic, """"""""Blues,"""""""" and religious-based plans. Nine different ethical dimensions were identified: (1) community benefit, (2) care of vulnerable populations, (3) end-of-life care, (4) confidentiality, (5) organization ethics, (6) benefit design and adjudication, (7) technology assessment, (8) financial incentives, and (9) member disclosure and participation. So far, four different site visits have been completed and preliminary """"""""best practices"""""""" have been identified for a number of areas. A conference delineating best practices was held in February 2000. Study completed. Book contract with Oxford University Press, estimated publication in spring 2003.
| Randel, L; Pearson, S D; Sabin, J E et al. (2001) How managed care can be ethical. Health Aff (Millwood) 20:43-56 |
