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Managed care and chronic illness: an overview.

P D Fox1, T Fama

  • 1PDF Incorporated, Chevy Chase, MD, USA.

Managed Care Quarterly
|January 2, 1997
PubMed
Summary
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Managed care growth presents challenges for individuals with chronic illness. Key concerns include equitable enrollment in Health Maintenance Organizations (HMOs) and addressing patient fears regarding mandatory managed care participation.

Area of Science:

  • Health Services Research
  • Public Health Policy

Background:

  • The expansion of managed care systems impacts individuals with chronic health conditions.
  • Concerns exist regarding the equitable distribution of chronically ill enrollees within managed care plans.

Purpose of the Study:

  • To examine the implications of managed care growth for individuals with chronic illnesses.
  • To investigate enrollment equity of chronically ill patients in Health Maintenance Organizations (HMOs).
  • To explore strategies for mitigating fears associated with mandatory managed care enrollment for those with chronic conditions or disabilities.

Main Methods:

  • Qualitative analysis of existing literature and policy documents.
  • Review of enrollment data and demographic trends.
  • Examination of patient advocacy group concerns and proposed solutions.

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Main Results:

  • Preliminary findings suggest potential disparities in the enrollment of chronically ill individuals in certain managed care plans.
  • Patient apprehension regarding loss of autonomy and provider choice is a significant barrier.
  • The need for tailored approaches to address diverse chronic conditions and disabilities is evident.

Conclusions:

  • Managed care policies must actively ensure equitable access for all individuals, particularly those with chronic illnesses.
  • Addressing patient and caregiver fears through transparent communication and patient-centered options is crucial.
  • Further research is needed to develop and evaluate specific interventions within managed care settings for chronic disease management.