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Managed care: the next generation.

¹Sachs Group, Evanston, Il, USA.

Frontiers of Health Services Management

|March 3, 1998

Summary

This summary is machine-generated.

Managed care impacts most Americans, with 120 million in managed care settings. Future success requires focusing on consumer priorities like care quality and access, not just cost reduction.

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Area of Science:

Healthcare Management
Health Economics

Background:

Managed care significantly impacts American healthcare, with 120 million of 160 million employees covered enrolled in managed care settings.
Health Maintenance Organization (HMO) development has primarily focused on reducing employer healthcare benefit costs.

Purpose of the Study:

To analyze the current state of managed care and its impact on consumers.
To identify future strategies for managed care plans to ensure profitability and consumer satisfaction.

Main Methods:

Analysis of the current managed care landscape and consumer perceptions.
Examination of historical drivers of HMO development (cost reduction).

Main Results:

Consumers perceive a conflict between quality care and plan profitability.

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Current profitability models rely on utilization reduction and retaining savings.

Market pressures necessitate new profitability strategies for health plans.

Conclusions:

Future managed care success hinges on prioritizing consumer needs such as care quality and access.
The next generation of healthcare will likely involve integrated systems offering both open-access and point-of-service benefits.
Adapting to consumer demands is crucial for the survival and success of managed care plans.