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Getting to go in managed care

G R Wolford1, M Brown, B P McCool

  • 1Alliant Health System, Louisville, KY.

Health Care Management Review
|January 1, 1993
PubMed
Summary
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Healthcare providers must actively manage care and utilization to control costs and share in rewards. Failing to do so risks financial sacrifice while intermediaries benefit.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Health Economics

Background:

  • Managed care strategies have been implemented to control rising healthcare expenditures.
  • The current healthcare landscape necessitates a re-evaluation of provider roles in cost containment.

Purpose of the Study:

  • To examine the imperative for healthcare providers to directly manage care and utilization.
  • To analyze the financial implications for providers engaging in cost-control measures versus those who do not.

Main Methods:

  • This study is a conceptual analysis and synthesis of current healthcare management trends.
  • It reviews literature on managed care, provider-based cost reduction, and economic incentives.

Main Results:

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  • Providers who actively manage care and utilization can achieve cost savings.
  • These providers are positioned to share in the financial rewards of cost containment.
  • Providers who do not engage in direct management risk financial detriment as intermediaries profit.

Conclusions:

  • Healthcare providers must assume greater responsibility for managing care and utilization to control costs effectively.
  • Proactive engagement in cost-saving measures offers financial benefits and sustainability for providers.
  • A failure to adapt to managed care principles may lead to unfavorable financial outcomes for providers.