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Managed care: a view from Europe.

Y Erdmann¹, R Wilson

¹Department of Social and Nursing Management, Alice-Salomon University of Applied Sciences, 12627 Berlin, Germany. yvserdmann@aol.com

Annual Review of Public Health

|March 29, 2001

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European countries are adopting US managed care concepts, shifting costs to consumers and using prospective budgets. While social insurance remains, these experiments may alter national health systems.

Area of Science:

Health Policy
Comparative Health Systems
Healthcare Management

Background:

European nations are integrating US managed care principles into their healthcare systems.
This involves significant restructuring of traditional health insurance and provider payment models.

Purpose of the Study:

To summarize recent developments in the UK, Netherlands, Switzerland, and Baltic states influenced by US managed care.
To analyze the impact of cost-shifting to consumers and prospective hospital budgeting.

Main Methods:

Comparative analysis of healthcare reforms in selected European countries.
Examination of changes in insurance mechanisms, cost-sharing, and provider management.

Main Results:

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Cost-shifting to consumers and prospective hospital budgets are key developments.

Social insurance and universal coverage remain central, limiting widespread for-profit managed care organizations (MCOs).

Increased provider competition is emerging due to new contracting rights for insurers.

Conclusions:

European healthcare systems are experimenting with US managed care elements, particularly cost containment strategies.
The long-term success and integration of these reforms into national systems remain uncertain.
Fundamental social insurance structures are likely to persist despite these changes.