A physician's view of managed care

While more Americans receive their medical care from managed care organizations, managed care's track record for restraining costs has not been impressive. Premiums for conventional coverage and managed care programs have increased in double-digit ranges, exceeding 20% over 1989-1990. Advocates...

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Bibliographic Details
Published inHealth Affairs Vol. 10; no. 4; pp. 106 - 119
Main Author Berenson, R A
Format Journal Article
LanguageEnglish
Published United States The People to People Health Foundation, Inc., Project HOPE 1991
Subjects
Attitude of Health Personnel
Capitation
Capitation Fee
Conflicts of interest
Contract Services - economics
Cost Control
Economic Competition
Economics, Medical
Educational opportunities
Fees & charges
Flexibility
Health care
Health care expenditures
Health care industry
Health care policy
Health insurance
Health maintenance organizations
Health Maintenance Organizations - economics
Health services
HMOs
Innovations
Insurance industry
Internal medicine
Managed care
Managed Care Programs - economics
Managed Care Programs - legislation & jurisprudence
Managed competition
Markets
Medicare
Medicine
Organizations
Physicians
Physicians - psychology
Preferred Provider Organizations - economics
Primary care
Profits
Relative Value Scales
Rewards
Skills
Standardization
United States
Utilization review
United States
United States > US
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Summary:While more Americans receive their medical care from managed care organizations, managed care's track record for restraining costs has not been impressive. Premiums for conventional coverage and managed care programs have increased in double-digit ranges, exceeding 20% over 1989-1990. Advocates of managed competition envision the development of mutually beneficial relationships between payers and providers, where providers reap the benefit of improving the quality of their practice. Unfortunately, managed care has not lived up to this promise. Instead, what has developed are marginally effective, follow-the-leader, regulatory interventions that are concerned more with restricting benefits and hassling providers than with developing cost-effective programs. The best hope for reformed managed care might be a national health program incorporating the Pepper Commission's "play or pay" concept.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.10.4.106