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Managed care and the poor

M D Smith1

  • 1Henry J. Kaiser Family Foundation, Menlo Park, CA 94205.

Journal of Health Care for the Poor and Underserved
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

Managed care offers potential improvements over fee-for-service for underserved communities. However, resolving issues like cost-sharing and preventive health is crucial for its successful implementation.

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Area of Science:

  • Health Services Research
  • Health Policy Analysis

Background:

  • Health care reform is often driven by middle-class concerns.
  • The fee-for-service model presents limitations for healthcare access and equity.
  • Managed care presents an alternative model with potential benefits.

Purpose of the Study:

  • To evaluate the potential of managed care as an improvement over fee-for-service systems.
  • To identify key issues that need resolution for managed care to benefit underserved populations.

Main Methods:

  • Conceptual analysis of healthcare systems.
  • Review of policy implications for managed care.

Main Results:

  • Managed care, ideally, offers advantages compared to fee-for-service.

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  • Significant challenges impede the realization of managed care's promise for the poor.

    • Conclusions:

    • Addressing cost-sharing, preventive care, and traditional provider integration is essential.
    • Policy adjustments are necessary to ensure equitable managed care for vulnerable populations.