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Insurer-provider integration, credible commitment, and managed-care backlash.

Nolan H Miller¹

¹John F. Kennedy School of Government, Harvard University, Cambridge, MA 02138, United States. Nolan_miller@ksg.harvard.edu <Nolan_miller@ksg.harvard.edu>

Journal of Health Economics

|May 23, 2006

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Managed care backlash stems from distrust in managed care organizations (MCOs) compared to traditional health plans. This study explores efficiency-promoting and efficiency-reducing motivations behind this backlash.

Area of Science:

Health economics
Healthcare management
Insurance studies

Background:

Managed care organizations (MCOs) face public distrust, a phenomenon termed 'managed-care backlash'.
Understanding the drivers of this backlash is crucial for healthcare system efficiency and patient satisfaction.

Purpose of the Study:

To identify and analyze the motivations behind managed-care backlash.
To evaluate the impact of these motivations on overall healthcare efficiency.

Main Methods:

Development of a theoretical model analyzing interactions between insurers, physicians, and patients.
Economic analysis of two distinct motivations for managed-care backlash.

Main Results:

Traditional health plans' superior commitment to non-least-cost care is an efficiency-promoting factor.

Related Experiment Videos

Patient 'doctor shopping' to obtain higher benefits by circumventing contracts can reduce efficiency.

Conclusions:

Managed-care backlash has complex drivers, with differing impacts on healthcare efficiency.
Policy and plan design should consider these motivations to improve healthcare delivery and patient trust.