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Annual Review of Public Health 2003In addition to influencing care for patients enrolled in managed care plans, growth in managed care could lead to broad changes in the structure and functioning of the... (Review)
Review
In addition to influencing care for patients enrolled in managed care plans, growth in managed care could lead to broad changes in the structure and functioning of the health care system that could ultimately influence care for all patients, even those not covered by managed care plans. This paper summarizes the mechanisms by which these effects could arise, including shifts in the types of services available in markets and changes in physician practice patterns. The paper summarizes available empirical evidence on broad-level effects of managed care, concluding that the literature supports the view that managed care can have generalized effects on health care spending, utilization patterns, and infrastructure, although existing literature has not clearly identified effects on health outcomes.
Topics: Delivery of Health Care; Evaluation Studies as Topic; Health Expenditures; Humans; Managed Care Programs; Social Change; United States
PubMed: 12471276
DOI: 10.1146/annurev.publhealth.24.100901.141000 -
Current Opinion in Obstetrics &... Dec 2012This article provides an overview of types and trends in managed care, as well as insights into how obstetrician/gynecologists can work with managed care plans to... (Review)
Review
PURPOSE OF REVIEW
This article provides an overview of types and trends in managed care, as well as insights into how obstetrician/gynecologists can work with managed care plans to improve process and outcomes for patients.
RECENT FINDINGS
Although studies of managed care between 1990 and 2005 generally did not show clear positive impact on cost or outcomes of care for women, more recent literature indicates the emergence of new models of care with greater success. Promising practices often focus on quality assurance and improvement.
SUMMARY
Managed care is the predominant form of healthcare delivery in the United States, including millions of women with public or private health coverage.
Topics: Female; Gynecology; Humans; Managed Care Programs; Obstetrics; Pregnancy; United States
PubMed: 23014140
DOI: 10.1097/GCO.0b013e328359efa9 -
Gastroenterology Clinics of North... Dec 1997Managed care organizations and their products will continue to change in response to consumer demands, competitive pressures, and regulatory requirements. Providers who... (Review)
Review
Managed care organizations and their products will continue to change in response to consumer demands, competitive pressures, and regulatory requirements. Providers who gain an understanding of the world managed care organizations live in can also expect to influence these organizations for mutual benefit. Just as managed care organizations differ in the sophistication of their functional elements, providers and their organizations differ in their ability to shift their focus from the physician-patient relationship to improving the health of a population. As the future of managed care evolves, there are opportunities for those physicians who strive for a greater understanding of the broad spectrum of forces shaping the health care industry.
Topics: Health Care Costs; Health Care Sector; Health Personnel; Humans; Managed Care Programs; United States
PubMed: 9439950
DOI: 10.1016/s0889-8553(05)70328-9 -
Seminars in Roentgenology Jul 1999
Topics: Managed Care Programs; United States
PubMed: 10432544
DOI: 10.1016/s0037-198x(99)80029-7 -
Journal of General Internal Medicine Feb 1999
Review
Topics: Female; Humans; Male; Managed Care Programs; Quality of Health Care; United States
PubMed: 10051786
DOI: 10.1046/j.1525-1497.1999.00299.x -
The Medical Clinics of North America Mar 1996The authors have examined managed care from several perspectives in this article. A look at the origins of managed care provided a historical perspective. The current... (Review)
Review
The authors have examined managed care from several perspectives in this article. A look at the origins of managed care provided a historical perspective. The current state of managed care and its issues were presented. Finally, the authors speculated what the future may bring in terms of both continued current trends and significant changes in managed care. The authors hope that this presentation provides some insight to the practicing physician on how to work in a world with managed care and what the future may bring. Managed care brings changes in the way physicians practice, but it also offers physicians many opportunities to improve the quality and cost-effectiveness of health care. Managed care is the wave of the present and of the future. It is the health care market's choice to address the challenges that health care faces in quality, cost-effectiveness, accountability, access, and choice. Although there are numerous proposed, alternative, and theoretic solutions, managed care has insurmountable momentum. It will be molding the shape of health care as society enters the twenty-first century.
Topics: Education, Medical; Health Care Reform; Health Maintenance Organizations; Managed Care Programs; Physicians; Quality of Health Care; United States
PubMed: 8614171
DOI: 10.1016/s0025-7125(05)70438-7 -
NIDA Research Monograph 1992Managed care has become an important subject for health service research and is used increasingly by health care payers to control health care use and costs. Health... (Review)
Review
Managed care has become an important subject for health service research and is used increasingly by health care payers to control health care use and costs. Health services research on managed care has relevance to the evaluation of case management of persons with substance abuse problems. Two issues in managed care that are particularly relevant to case management are the lack of explicit, widely accepted criteria for managed care and the lack of demonstrated cost savings attributable to managed care. Thorough, systematic evaluative research needs to be done before these issues are well understood.
Topics: Cost Savings; Health Services Research; Humans; Managed Care Programs; Patient Care Planning; Substance-Related Disorders
PubMed: 1436002
DOI: No ID Found -
Health Care Management (Philadelphia,... Oct 1995An examination of the history of managed care organization over the past 30 years, in both private and public sectors, forms the basis for evaluating the success of such... (Review)
Review
An examination of the history of managed care organization over the past 30 years, in both private and public sectors, forms the basis for evaluating the success of such programs in meeting the expectation of both physicians and consumers. The authors point to areas that must receive special attention if managed care organizations are to satisfy the quality and cost demands of the future.
Topics: Capitation Fee; Cost Control; Forecasting; Health Maintenance Organizations; Health Services Accessibility; Health Services Research; History, 20th Century; Managed Care Programs; Medicaid; Medicare; Quality of Health Care; Risk Management; State Health Plans; United States
PubMed: 10165642
DOI: No ID Found -
The Health Care Manager Dec 1999The emergence and development of managed care has been and will continue to be a major force in America's health care delivery system. Specifically reviewed in this... (Review)
Review
The emergence and development of managed care has been and will continue to be a major force in America's health care delivery system. Specifically reviewed in this article are those legislative initiatives that contributed to the formation of this system of reimbursement and utilization management. Also addressed are responsibilities that can be ascribed to all stakeholders in necessitating this system as well as the adjustments required to make the system more responsive to the needs of higher-risk populations. This article concludes with a series of recommended actions that will be required of all individual citizens in assuring the future economic viability of this nation's health care programs.
Topics: Health Services Accessibility; Humans; Insurance Selection Bias; Managed Care Programs; Quality of Health Care; Social Responsibility; United States
PubMed: 10787629
DOI: 10.1097/00126450-199912000-00009 -
The New England Journal of Medicine Apr 1997
Topics: Economic Competition; Managed Care Programs; United States
PubMed: 9077382
DOI: 10.1056/NEJM199704033361408