Managed care finds itself in dire straits

Area of Science:

• Health Services Research
• Healthcare Management

Background:

• Managed health care models, such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), have been prevalent for over a decade nationwide.
• Significant time has passed, suggesting sufficient opportunity for these models to demonstrate their value and effectiveness.

Purpose of the Study:

• To evaluate the overall success and impact of managed health care systems.
• To assess whether managed care has fulfilled its initial promises of quality care and cost reduction.

Main Methods:

• Qualitative assessment based on expert opinions from various industry stakeholders.
• Analysis of the perceived outcomes and effectiveness of managed care over its implementation period.

Main Results:

• A consensus among consultants, economists, and industry executives indicates a failure of managed care to meet expectations.
• Managed care is perceived as having fallen short on delivering both quality care and cost savings.

Conclusions:

• Managed care is facing significant challenges and potential decline due to unmet promises and perceived excesses.
• The current trajectory suggests a crisis point for the managed care model in the United States.