Are managed care plans organizing for quality?

This article examines the degree to which managed care organizations (MCOs) are reorganizing to fake responsibility for the quality of care and servic e they provide. Specifically, factors prompting plans to focus on quality i mprovement (QI) and how they may be building the capacity to improve qualit y are considered. The authors' analysis is based on executive interviews wi th the plan medical directors, QI directors, and chief executive officers ( CEOs) in a sample of 24 health plans. The overall response rate was 58.3 pe rcent (medical director = 62.5 percent, QI director = 79.2 percent, CEO = 3 3.3 percent). The aut hers queried respondents about (1) perceived drivers and obstacles to the development of an effective QI program, (2) plan organ izational structure for QI, and (3) technical capacities for data collectio n, management, and performance measurement. The results suggest that MCOs a re responding to outside pressures to engage in QI. They are reorganizing t heir management structures and more slowly and tentatively are building tec hnical capacity for QI.