QUALITY in PRACTICE Applying QFD in a Managed Care Organization3 Managed care wa

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QUALITY in PRACTICE Applying QFD in a Managed Care Organization3 Managed care was introduced in the United States materials to its members as a result of inadequacies nearly two decades ago as a means to maintain qual in the member handbook ty while managing costs. A managed care organiza- To improve the handbook and member satisfac- tion (MCO) contracts with physicians, hospitals, tion, OFD was used to redesign it. The input for the medical equipment companies, and home health QFD process was obtained through a series of focus agencies to provide services to its members groups. A total of 131 MCO customers participated in patients) six focus group sessions. Partiopants were selected based on two criteria: The MCO markets its services and actively enrolls people. Once enrolled, members receive a handbook that explains how they can access the services offered 1. They had to have been members of a competing for the MCO and its affiliated providers. The member MCO-whose member handbook was used handbook has become a main source of information Cmparison for at least two years prior to join- regarding an increasingly complex array of benefits offered by the thousands of MCOs. Designing the handbook and creating its content are, therefore, important components of any MCO's business strat- The focus group process was then administered in egy. Unfortunately, a member satisfaction survey indi two stages cated that members have a poor understanding of their benefits. When members are unable to under Stage 1 Participants were provided with a copy stand their benefits, the MCOs' member services of the company's member handbook and the ng the MCO being studied 2. They had to have been members of the MCO being studied for at least two consecutive years. witchboards are inundated with calls, resulting incompetitor's member handbook. Even though frustration and anger and further delaying patientthe participants had all used the competitor's access to the MCOs' services. The Mco receives an member handbook, it was necessary to provide average of 3,000 calls per day, with each call lasting th with copies to ensure a fair comparison an average of 3.2 minutes. Approximately 50 percent They were allowed to take both handbooks of these calls involve issues discussed in the member handbook. The MCO also spends more than Stage 2. The groups were brought together for a 250,000 per year in providing supplemental follow-up session that focused on data collection home for one week to look them over

Explanation / Answer

It is difficult to implement in service context because of following reason :

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