Best: Ethical Strategies In Managed Care

这个项目开始的观察，大部分的争议管理式医疗，如禁言规则，经济激励，限制照顾，和保密性，可以被视为道德问题。批评、病人权利法案或其他方法不太可能让管理式医疗机构变得更有道德。BEST项目基于这样一个想法，即通过向管理式护理计划展示有关这些道德问题的最佳实践列表，他们可能会采用这些最佳实践。成立了一个由12个管理式护理计划组成的财团，包括营利性、非营利性、学术性、“蓝调”和宗教性计划。确定了九个不同的道德维度：（1）社区福利，（2）弱势群体的护理，（3）临终关怀，（4）保密性，（5）组织道德，（6）福利设计和裁定，（7）技术评估，（8）财务激励，（9）成员披露和参与。到目前为止，已经完成了四次不同的实地考察，并为一些领域确定了初步的“最佳做法”。2000年2月举行了一次会议，讨论最佳做法。

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.