Assessing process of care under capitated and fee-for-service Medicare.

In 1986 more than 770,000 Medicare beneficiaries were enrolled in risk-based health plans that had very little experience in providing medical care to elderly patients. This article addresses one major facet of the National Medicare Competition Evaluation of capitated versus fee-for-service delivery of Medicare benefits, sponsored by the Health Care Financing Administration: the assessment of the quality of the process of care delivered to Medicare enrollees. The rationale, design, and analysis plans for this subpart of the larger evaluation and its interrelationships with the other components of the project are described.