The impact of managed care contracting on physicians
Related Experiment Video
Updated: May 8, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
1Department of Medicine, Massachusetts General Hospital, 10 Emerson Place, Rm. 10G, Boston, MA, 02114, USA, dply@partners.org.
Insights
Physician contracting with more managed care plans offers benefits like higher income but increases administrative tasks. Simplifying contracting processes could improve physician efficiency and patient care.
Area of Science:
- Health Services Research
- Physician Practice Management
- Healthcare Administration
Background:
- The U.S. healthcare system's fragmentation creates significant administrative burdens for physicians.
- The impact of physician contracting practices on this administrative burden is not well understood.
Purpose of the Study:
- To determine how physician practice outcomes are affected by the number of managed care contracts.
- To assess the relationship between contract availability and physician practice outcomes.
Main Methods:
- Secondary data analysis of the Community Tracking Study Physician Survey (1996-2005).
- Included 36,340 physicians: 21,567 primary care physicians (PCPs) and 14,773 specialists.
- Measured patient care hours, non-patient care hours, time adequacy, career satisfaction, and income.
Main Results:
- More contracts correlated with increased patient care time (20-30 min/week per 11 contracts).
- Increased time outside patient care (approx. 10 min/week per 11 contracts).
- Slightly higher odds of inadequate patient time (OR 1.005 per contract for PCPs) and higher incomes (approx. 3% more/year for specialists per 11 contracts).
Conclusions:
- Managed care contracting provides tangible benefits to physicians, including increased income.
- Contracting involves modest trade-offs: more administrative time and reduced patient time adequacy.
- Streamlining contracting administration could optimize physician effort and potentially enhance patient care.
Background:
Prior literature suggests that the fragmented U.S. health care system places a large administrative burden on physicians. Less is known about how this burden varies with physician contracting practices.
Objective:
To assess the extent to which physician practice outcomes vary with the number of managed care contracts held or the availability of such contracts.
Design, Participants, And Main Measures:
We perform secondary data analyses of the first four rounds of the nationally representative Community Tracking Study Physician Survey (1996-2005), which includes 36,340 physicians (21,567 PCPs [primary care physicians] and 14,773 specialists) across the four survey periods. Our measures include reported hours in patient care, share of hours outside patient care, adequacy of time with patients, career satisfaction, and income.
Results:
Doctors who contract with more plans report spending more time in patient care (per 11 additional contracts, about 30 min per week for PCPs and 20 min per week for specialists), report spending a modestly larger share of their time outside patient care (per 11 additional contracts, about 10 min per week for PCPs and specialists), are slightly more likely to report inadequate time with patients (odds ratio 1.005 per additional contract for PCPs), and earn higher incomes (per 11 additional contracts, about 3 % more per year for specialists).
Conclusions:
Contracting opportunities confer significant benefits on physicians, although they do add modest costs in terms of time spent outside patient care and lower adequacy of time with patients. Simplifications that reduce the administrative burden of contracting may improve care by optimizing allocation of physician effort.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:22Standards of Care I