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Managed care and cost reductions for entitlements.

¹Bedford Health Associates, Inc., Asheville, NC, USA.

Managed Care Quarterly

|March 3, 1997

Summary

Managed care plans for Medicare and Medicaid beneficiaries show mixed results, often increasing public sector costs. Health reform requires broader strategies beyond micromanaging benefits for effective healthcare system improvements.

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Area of Science:

Health Policy
Public Health
Healthcare Management

Background:

Managed care plans are increasingly utilized by Medicare and Medicaid beneficiaries.
Existing data on the effectiveness and cost-efficiency of these plans present a mixed picture.
Concerns exist regarding the impact on public sector costs and overall healthcare reform.

Purpose of the Study:

To evaluate the mixed results of managed care plans for Medicare and Medicaid beneficiaries.
To analyze the implications of managed care on public sector costs.
To contextualize managed care within broader health reform initiatives.

Main Methods:

Analysis of existing data on managed care plan performance for Medicare and Medicaid.
Review of cost implications for the public sector.
Assessment of managed care as an interim step in health reform.

Main Results:

Managed care plans yield mixed outcomes for Medicare and Medicaid beneficiaries.
Implementation often leads to higher costs for the public sector.
Current approaches may be insufficient for comprehensive healthcare reform.

Conclusions:

Managed care's focus on micromanaging benefits is likely an interim solution.
Broader health reform, such as Medicaid block grants, is necessary.
Addressing issues like covering the uninsured and provider choice restrictions is crucial for future healthcare strategies.

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