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Managing costs and managing care.

P A Rivers1, K L Tsai

  • 1Graduate School of Health Administration and Policy, College of Business, Arizona State University, Tempe, Arizona, USA.

International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services
|December 4, 2001
PubMed
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Managed care offers a solution for equitable, standardized healthcare services and cost savings through capitation and utilization reviews. Continuous improvement and resource management are key to wider adoption and improved access for all Americans.

Area of Science:

  • Health Services Research
  • Healthcare Management

Background:

  • Managed care models aim to provide equitable, standardized, and prevention-oriented healthcare services.
  • Key components include defined populations, contracted providers, and integrated care delivery.

Purpose of the Study:

  • To present governmental strategies for managing healthcare and controlling costs.
  • To highlight the role of managed care in achieving cost savings and quality improvement.

Main Methods:

  • Analysis of federal government steps and measures in managed care.
  • Review of cost containment and utilization review techniques.
  • Identification of best practices for resource management.

Main Results:

  • Managed care demonstrates capacity for cost-saving and quality promotion.

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  • Federal initiatives focus on managing care and containing costs.
  • Managed care can lead to more equitable access to healthcare.

    • Conclusions:

    • Managed care offers a viable, though not perfect, solution for healthcare delivery.
    • Universal adoption of managed care may require time.
    • Americans could benefit from a standardized level of healthcare provided by managed care.