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SEATTLE-For a year, the American Assn. of Health Plans has been trying to convince its more than 1,000 member companies of the gravity of adopting the group's new quality standards.

Last week, at its annual AAHP Institute in Seattle, the association's message got some added emphasis from Mother Nature.

An earthquake hit the city at about 12:15 p.m. on the conference's first day, causing floors to sway underfoot, presenters to stop dead in mid-sentence and audiences to gaze at the ceiling of the Washington State Convention & Trade Center in eerie expectation. Fortunately the temblor, which measured 4.9 on the Richter scale, caused no injuries and only slight damage in the region.

More dramatic for the industry was a vote by the association's board of directors the previous evening. The board gave its official imprimatur to initiatives, announced over the past year, designed to prod plans to improve care and safeguard the rights of patients.

The board approved a requirement that all existing and new members must abide by "Putting Patients First" policies, which include:

Member plans cannot require patients to undergo outpatient mastectomies.

Patients should be fully informed about how their health plan operates and should be able to talk freely with doctors about any treatment option.

Care denials should be in clear English, and the appeals process should be timely.

The AAHP, formed last year when the Group Health Assn. of America and the American Managed Care & Review Assn. merged, named this year's conference "Patients, Providers & Plans: Effective Partnerships That Work." Emphasizing the need for plans to be conciliatory and conscious of public opinion, the conference attracted a record 3,445 people.

The Institute included a keynote address by Bill Gates, president and chief executive officer of Redmond, Wash.-based Microsoft Corp., and a speech from Washington via satellite by former Surgeon General Dr. C. Everett Koop. Educational seminars covered medical management, health policy, business and communication challenges for health plans, marketplace issues and trends, new health care delivery partnerships, and consumer issues.

More than 300 companies, from diagnostic test manufacturers to drug companies to software firms, displayed exhibits.

Next year's AAHP Institute will be held June 14-17, 1998, at the John B. Hynes Veterans Memorial Convention Center in Boston.