Kinder and gentler: physicians and managed care, 1997-2001

Area of Science:

• Health Services Research
• Medical Economics
• Physician Practice Management

Background:

• Despite a managed care backlash, most U.S. physicians maintain contracts with managed care health plans.
• Physician engagement with managed care has persisted despite criticisms.

Purpose of the Study:

• To analyze trends in physician participation in managed care from 1997 to 2001.
• To examine changes in the nature of physician-health plan relationships, including payment models and practice influences.

Main Methods:

• Analysis of data from a Center for Studying Health System Change (HSC) study.
• Examined changes in physician practice revenue from managed care contracts and the number of contracts held.

Main Results:

• Physicians reported a modest increase in managed care revenue and contract numbers between 1997 and 2001.
• A significant decrease in the use of capitation payment models by health plans was observed.
• Physician practices shifted away from direct financial incentives, with increased reliance on treatment guidelines.

Conclusions:

• Physician involvement with managed care remains high, with evolving contractual and financial dynamics.
• The influence of managed care practices, particularly treatment guidelines, has grown despite reduced reliance on capitation and direct financial incentives.