The Employee Health Care Value Survey: round one.

In a groundbreaking arrangement, a consortium of large employers--the Xerox, GTE, and Digital Equipment Corporations--launched the Employee Health Care Value Survey during fall 1993. Completed by 24,306 employees, this survey was used to develop comparable methods for assessing corporate health care benefit strategies. It also enabled fair comparisons of thirty-two health plans across the country on more than sixty criteria. Variation in performance among plans was substantial, with managed care plans--particularly prepaid group practices and individual practice associations (IPAs)--recording the most favorable rankings on disenrollment, overall satisfaction, and other measures of "bottom-line performance." Variation in enrollees' health among plans was more modest, with indemnity enrollees posing a somewhat greater illness burden to their plans than enrollees of other plan types. The employers and evaluated health plans are now using the results for multiple purposes, including quality improvement initiatives, employee-based plan performance reports, employee contribution strategies, and health promotion programs.

Short-term inpatient care and readmission rates: the CMHC approach versus the private approach.

Community mental health centers hospitalize patients for a significantly shorter time than do private psychiatric hospitals. Proponents of the private system of care assert that the shorter hospitalization contributes to an increased probability of readmission. A comparison of the readmission experience of CMHC patients and private patients who were hospitalized at the same institution showed no significant differences in the short-term recidivism rate. It is suggested that an aftercare network that is closely integrated with hospital care is a necessary supplement to brief hospitalization. In addition, it appears that restrictive reimbursement policies for outpatient care result in an increase in the duration of hospitalization and in the probability of rehospitalization.