Growing public interest in the operations of managed care plans has fueled a variety of activities to collect and analyze their performance. These activities include studies of financial performance, analysis of enrollment decisions, and, more recently, the development of systems for measuring healthcare quality to improve accountability to consumers. In this study, the authors focus on the activities of managed care plans that may frustrate patients and providers and, subsequently, motivate patients to file complaints. Using data from three sources, they evaluate the relationships between complaints against managed care plans and two metrics of performance: (a) the financial performance of the plan, and (b) the quality of care provided. Their findings indicate that complaints against health maintenance organizations are significantly related to the plans' levels of quality and to actions that may impede access to care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.