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Trends in managed care and managed competition, 1993-1997
1RAND, Washington, D.C., USA.
Health Affairs (Project Hope)
|January 29, 2000
Summary
Employers are driving a managed care revolution by choosing plan types, limiting employee options. True managed competition principles are not guiding these choices when employees do have options.
Area of Science:
- Health Services Research
- Healthcare Policy
- Health Economics
Background:
- The healthcare landscape is undergoing a significant transformation, often termed a managed care revolution.
- Managed competition is gaining traction among policymakers in both private and public sectors.
- Understanding shifts in employment-based health plans is crucial for stakeholders.
Purpose of the Study:
- To analyze recent changes in employment-based health plans.
- To provide new estimates on the evolution of health insurance offerings by employers.
- To assess the role of managed competition in employer health plan choices.
Main Methods:
- Analysis of two large-scale employer health insurance surveys.
- Examination of enrollment shifts from indemnity to managed care plans.
- Evaluation of the extent of employee choice in health plan selection.
Main Results:
- Employers' decisions significantly influence the types of health plans offered.
- Enrollment has dramatically shifted from traditional indemnity plans to managed care options.
- When employees have choices, they are often not based on managed competition principles.
Conclusions:
- Employer preferences are the primary drivers of changes in health plan offerings.
- The current system does not fully align with managed competition ideals.
- Further research is needed to understand the implications of these employer-driven changes.
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