One of the most difficult things to judge in a health care setting is how effective both the treatments and physicians giving it actually are. It seems like a simple proposition, but many plans which feature excellent health insurance coverage have low rates of customer satisfaction and quality assurance. In recent years, a trend has begun to develop whereby quality management committees, also known as quality assurance committees, have been created. These are in-house boards that are typically composed of doctors within the health program, be it an HMO, PPO, or self-directed plan. Their job is to assess the level of care which is being given and to determine if improvements can be made.

For years, there was little interest in improving quality of care or the way in which physicians were managed. Malpractice suits were unheard of, and treatment regimens were far simpler. Results did not need to be as scrupulously reported, and doctors were, by and large, assumed to be correct in almost every instance. As the health care world has evolved, however, and the nature of the health insurance coverage industry has changed, a need has arisen for both more accountability among doctors and a way to more accurately measure the level of care being given to patients. This is largely because of two factors – the shift to a more litigious system in which many patients are willing to go to court if they believe they have been wronged, and the fact that health insurance is now a very diverse field, affording patients the opportunity to find a plan that best suits their needs.

In response to these factors, quality management committees have sprung up. These QA committees can be responsible for everything from dealing directly with patient concerns to reviewing and streamlining pending claims, or even tracking statistical data. A committee needs to be made up of physicians who are dedicated to improving the overall care offered by their clinic or health care plan, and the QA team must be well-structured. The key for successful committees is to start small with a specific initiative and work upwards from there in an effort to address the larger concerns of the organization. At their best, quality management committees can even help to investigate claims of malpractice within the organization and develop new best practices and areas of education for the entire medical staff.

The concept of QA committees is still new and growing in many plans, which means that they are often less effective than they could be, or are handicapped by red tape. Nonetheless, the trend toward better patient care and physician accountability bodes well for both clients and providers alike.