The coming third health care revolution: personal empowerment

The financing and organization of health care in the United States has been rapidly evolving in the last 30 years. Managed care and capitation have largely replaced fee-for-service as a way to pay providers. Cost-control initiatives were developed by payers. These crude cost-control methods proved insufficient and new approaches were developed. These might be referred to as disease management that includes evidence-based medicine and outcomes measurement. It is proposed that a third revolution, patient empowerment, is just starting. The potential far-reaching consequences are described, discussed, and analyzed here, including their cost consequences.