WASHINGTON -- Testifying before the House Ways and Means Committee's
Subcommittee on Health here, GTE Senior Vice President - Human
Resources and Administration J. Randall MacDonald said that government
should join business in becoming a "purchaser" of health-care services
rather than just a "payer" and "regulator."
The committee is conducting hearings to determine how the
government's Medicare program can best move from a traditional "fee-for-
service" system to a managed care environment that uses health-care
providers such as HMOs.
"GTE and other employers that are aggressive and responsible
purchasers of health-care services are in the best position to demand
information and accountability from health plans. We encourage the Health Care
Financing Administration (HCFA) and other governmental purchasers to join us,"
said MacDonald. "We welcome Medicare's efforts to become a more prudent
purchaser of health care on behalf of its 38 million beneficiaries," he added.
MacDonald said GTE provides health-care coverage for a quarter
million employees, retirees and dependents in all 50 states. "GTE spends
more than $500 million each year on direct health-care costs and
estimates an equal amount in lost time at work.
"We've been successful in improving health care by bringing
information, measurement, accountability, health-plan choice and employee
education to the process through relationships with our management and
union employees," he said. As a result, more than 65 percent of GTE's
employees voluntarily chose managed health-care plans for 1997.
Employees Are Satisfied with Managed Care Plans
MacDonald added that surveys show greater employee satisfaction
with managed health-care plans than with traditional fee-for-service
plans. "We believe high employee satisfaction is directly related to the high-
quality plans that we offer. GTE holds health plans accountable in a way that
does not interrupt the doctor-patient relationship and focuses on medical
necessity and appropriateness. A key to quality is insisting that only
physicians make medical decisions. We believe that neither private nor public
health-care purchasers should mandate medical practice," he said.
MacDonald went on to explain how GTE gathers information on
provider performance from a variety of increasingly sophisticated sources
and then shares it with employees in an easy-to-understand format. In
addition, it rates the plans in terms of quality, overall cost effectiveness and
patient satisfaction, awarding the top performers with GTE's "Exceptional
Quality Designation" as a way to assist employees in their selections.
"Our employees have the responsibility for the health-care
choices they make. We assist employees with making informed choices, but they
select the health plan that provides the best value for their individual
circumstances," MacDonald explained.
He said the company also shares the results with all of its providers,
identifying "best practices" that can be used to raise the overall quality of
services for employees. Most importantly, "we now have very good
evidence that the better quality health plans actually cost less: improved
quality drives costs down."
Government Moving In Right Direction, But Must Do More
MacDonald said GTE supports the steps HCFA had already taken to
use its market influence on health-care purchasing but that it can
further enhance its efforts and those of the private sector by exercising its
leverage in demanding improved data, cost and quality; developing a standardized
method to share information with consumers; and, maintaining a commitment to the
development of standards in cooperation with private purchasers such as GTE.
"Congress must be very careful not to undermine managed health-care --
the delivery system that may be crucial to the government's ability to
control its own health-care quality and cost," MacDonald said. "We urge
agencies to build upon the work of private employers and not preempt them
or establish conflicting requirements," he said.
GTE, with revenues of more than $21 billion in 1996, is one of
the largest publicly owned telecommunications companies in the world. It is
also the largest U.S.-based local telephone company and a leading
cellular-service provider -- with wireline and wireless operations that form a
market area covering about one third of the country's population. Outside the
United States, where GTE has operated for more than 40 years, the company serves
over 6 million wireline and wireless customers. GTE is also a leader in
government and defense communications systems and equipment, aircraft-passenger
telecommunications, directories and telecommunications information services and
Additional information about GTE can be found on the INTERNET at