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The term "managed care" is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care techniques"), organizations that use those techniques or provide them as services to other organizations ("managed care organizations"), or systems of financing and delivering health care to enrollees organized around managed care techniques and concepts ("managed care delivery systems"). According to the National Library of Medicine, the term "managed care" encompasses programs:

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Wikipedia about Managed care

The term "managed care" is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care techniques"), organizations that use those techniques or provide them as services to other organizations ("managed care organizations"), or systems of financing and delivering health care to enrollees organized around managed care techniques and concepts ("managed care delivery systems"). According to the National Library of Medicine, the term "managed care" encompasses programs:

...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.

The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973. While managed care techniques were pioneered by health maintenance organizations, they are now used by a variety of private health benefit programs. Managed care is now nearly ubiquitous in the U.S, but has attracted controversy because it has largely failed in the overall goal of controlling medical costs. Proponents and critics are also sharply divided on managed care's overall impact on the quality of U.S. health care delivery.

History

Paul Starr suggests in his analysis of the American health care system (i.e., The Social Transformation of American Medicine) that Ronald Reagan was the first mainstream political leader to take deliberate steps to reform American health care from its longstanding not-for-profit business principles into a for-profit model that would be driven by the insurance industry. In 1973, Congress passed the Health Maintenance Organization Act, which encouraged rapid growth of HMOs, the first form of managed care.

Managed care plans are widely credited with subduing medical cost inflation in the late 1980s by reducing unnecessary hospitalizations, forcing providers to discount their rates, and causing the health-care industry to become more efficient and competitive.The backlash against managed care, Nation's Business, July 1998, accessed 2007-10-05 Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts created widespread perception that they were more interested in saving money than providing health care. In a 2004 poll by the Kaiser Family Foundation, majorities of those polled said they believed that managed care decreased the time doctors spend with patients, made it harder for people who are sick to see specialists, and had failed to produce significant health care savings. These public perceptions have been fairly consistent in polling since 1997.

Search results for Managed Care

Managed Care magazine tables of contents

www managedcaremag.com. 2008. 2007. 2006. 2005. 2004. 2003. 2002. January. February. March. April. May. June. July. August. January. February. March. April. May ...www.managedcaremag.com/previous.html

Department of Human Services

New Jersey Medicaid and Managed Care ... Under managed care, clients enroll in one of five HMOs , which manage their ... The move to managed care started in 1995. ...www.state.nj.us/humanservices/dmahs/managedcare.html

U Managed Care - Affordable Health Care for Everyone!

What type of health insurance works best with U Managed Care? ... U Managed Care can significantly reduce your patient responsibility for out-of-network claims. ...www.umanagedcare.com/

Managed Health Care

Managed care is now a huge, and powerful, industry. ... Just try to get managed care providers to provide you with reasonable answers to ...www.burtonreport.com/InfHealthCare/ManagedHlthCare.htm

Managed Care Museum Welcome - the history of managed care and more.

The History of Managed Care: The Managed Care Museum provides historical information on HMOs, PPOs and other aspects of managed health care plans and organizations.www.managedcaremuseum.com/index.html

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News about Managed Care

Early Glance: Managed Care companies

INO News(AP:NEW YORK) Shares of some top managed care companies are mixed at 10 a.m.: Aetna fell $.66 or 1.8 percent, to $35.45. CIGNA fell $.29 or .9 percent, to $33.69.http://news.ino.com/headlines/?newsid=689372797781790

Investors, Analysts Bullish on Managed Care Investments, More at iiBIG Forum

Marketwire via Yahoo! Finance iiBIG presents the Investment and M&A Opportunities in Managed Care conference, scheduled for November 17-18, 2008, at the New York Marriott Marquis in New York City.http://biz.yahoo.com/iw/081001/0439219.html

Early Glance: Managed Care companies

INO News(AP:NEW YORK) Shares of some top managed care companies are mixed at 10 a.m.: Aetna rose $.67 or 1.9 percent, to $35.92. CIGNA fell $.02 or .1 percent, to $33.31.http://news.ino.com/headlines/?newsid=6893724658084

Managed Care Specialists Win Big for QHR Hospital Clients

PRWeb via Yahoo! News QHR managed care consultants are yielding big results for its hospital clients nationwide. Two South Carolina hospitals - a 248-bed facility and a 62-bed facility - are among the many seeing big changes in their bottom line as a result of QHR's expertise in negotiating/renegotiating managed care contracts.http://news.yahoo.com/s/prweb/20080930/bs_prweb/prweb1386324...

Final Glance: Managed Care companies

INO NewsAetna fell $1.10 or 2.9 percent, to $36.33. CIGNA fell $1.59 or 4.7 percent, to $32.17.http://news.ino.com/headlines/?newsid=68937375186790

News about Managed Care

Milestone for mental health treatment

Houston ChronicleA managed care company can refuse to pay for care, on the ground that it is not medically necessary or "clinically appropriate." But under the new law, insurers must disclose their criteria for determining medical necessity, as well as the reason for ... http://www.chron.com/disp/story.mpl/headline/nation/6041805....

Centene Corporation Names Patrick M. Healy As President and CEO of ...

PR InsideHis extensive knowledge of the managed care industry will be a great asset in delivering quality healthcare to the people of Georgia." Mr. Healy has more than 27 years of healthcare experience. Most recently, he was Executive Vice President of ... http://www.pr-inside.com/centene-corporation-names-patrick-m...

AmeriHealth Signs New Agreement with MultiPlan, Inc. to Provide ...

Businesswire.comThe company's managed care plan, AmeriHealth HMO Inc. of New Jersey, has received the highest possible accreditation by the National Committee for Quality Assurance (NCQA) by meeting NCQA's rigorous evaluation standards ... http://www.businesswire.com/news/home/20081006005877/en

How to die 'the Oregon way'

Guardian UnlimitedMost importantly, there were fears that no one would bother with palliative care any more, because patients could simply be ... if they even tell patients how they might access PAS, they'll be fired - though a few supporters of the legislation managed to ... http://www.guardian.co.uk/world/2008/oct/13/usa-healthandwel...

AREAWIDE: Flu-Shot Clinics To Open Soon

Hartford CourantPneumonia shots will also be available. Flu shots are available at no charge for anyone with Medicare Part B or Medicare managed-care plans. Residents must present the insurance card they use for doctor appointments at the clinic. Those who have non ... http://www.courant.com/news/local/hc-towndigbrf1006.art5oct0...

Search results for Managed Care

Managed Care Store

Store Resources... Featured Products... Welcome... Our Partners. Send us your questions @Store e-newsletter. Related Resourceshttps://www.managedcarestore.com/

Managed Care Digest SeriesĀ®

The sanofi-aventis Managed Care Digest SeriesĀ® is part of our continuing commitment to provide you with the latest, most essential information on the evolution of health care.http://www.managedcaredigest.com/

Managed Care magazine

Vol. 17, No. 9 September 2008. COVER STORY. Archimedes Lends Hippocrates a Hand David Eddy, MD, PhD, describes his predictive modeling program and what it can do for insurers ... http://www.managedcaremag.com/index.html

ManagedCare.com

We believe strongly in the role that managed care must play in containing medical cost inflation, and view physicians' access ... https://www.managedcare.com/

Managed Care magazine tables of contents

www managedcaremag.com http://www.managedcaremag.com/previous.html
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Answers for Managed Care

Tori C

Is managed health care effecient from an economic standpoint? What type of market structure does it represent?

Tori CYes, its efficient in theory. The type of market structure it represents is an oligopoly.
comradedata11

What is the motivation behind the cost-control features of managed care?

comradedata11C is the closest, but in truth it's about insurers making more and spending less in any way possible, even if it's to the detriment of the health of their insured.
studentafter30

What is a managed care? and how it is different from HMO and PPO?

studentafter30hmo is where you choose a primary provider or doctor, this doctor then refers you to other specialist doctors if needed. The primary provider doctor gets a monthly payment because you chose that docto...
valcus43

Why did several attempts at adding a layer of managed care to child care in Ohio fail?

valcus43it was the bureaucracy. they have no common sense and that was a real shame.
Wendy Z

What are some of the challenges to using a managed care approach in mental health care?

Wendy ZManaged care often places unreasonable limits on visits with mental health providers (if they include mental health coverage at all) . Most people with mental health problems, that need therapy and me...

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