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Children and managed care: what research can, can't, and should tell us about impact
Insights
The impact of managed care on children varies significantly, depending on the specific type of managed care, the children involved, and the circumstances. Further research is needed to understand these nuances for child health outcomes.
Area of Science:
- Pediatric Health Services Research
- Health Policy and Management
Background:
- Rapid transition from fee-for-service to managed care models impacts pediatric healthcare.
- Understanding the effects of managed care on children's health and well-being is crucial.
Purpose of the Study:
- To examine the pace and context of managed care adoption for children.
- To identify opportunities and challenges associated with managed care for pediatric populations.
- To review existing research on the effects of managed care on children.
Main Methods:
- Comprehensive literature review of research on managed care and children.
- Analysis of the speed and context of managed care implementation in pediatrics.
- Synthesis of findings regarding the impact of different managed care approaches on child health.
Main Results:
- The effectiveness of managed care for children is not uniform; it is contingent on specific managed care characteristics, child populations, and contextual factors.
- Existing research indicates a complex relationship between managed care and pediatric health outcomes.
Conclusions:
- Future research should focus on specific managed care features and provider dynamics.
- Pediatric-specific research is essential, as adult research findings are not directly transferable.
- Prioritizing research on vulnerable groups, including poor and chronically ill children, is recommended.
Abstract:
The speed and ubiquity of the move from fee-for-service to managed care raises questions about how these changes affect children. This article examines (1) the pace and context of the move to managed care for children, (2) potential opportunities and challenges emerging from these changes, (3) research findings on how managed care affects children, and (4) next steps for learning more. The research review provides a consistent answer to whether managed care is good for children: it depends on what kind of managed care, which children, and under what circumstances. This finding suggests lessons for future research: (1) focus on particular features of managed care, (2) get inside the "black box" of managed care and examine providers, (3) expand the portfolio of research on children: research on adults cannot "trickle down" to children, (4) foster research partnerships and networks, and (5) focus on poor and chronically ill children.