PMID: 9439948Jan 24, 1998Paper

Managed care. Evolution and distinguishing features

Gastroenterology Clinics of North America
J T Frakes

Abstract

Managed care as a system of health care delivery has grown tremendously in popularity in the United States during the past decade in response to demands by employers and government for cost containment, enhanced access, and improved quality. Managed care took root in the 1800s as prepaid health services provided by employers for immigrants coming to the United States to work. The forerunner of modern managed care, prepaid group practice, later was dwarfed by the unbridled development of FFS medicine under indemnity insurance in the post-World War II period and stunted by early reactions of organized medicine. The early health care reform years of the 1960s spawned HMO legislation in the 1970s, which prompted ever-escalating growth in HMO enrollment. Market-driven health reform has prompted the evolution of health care delivery to the modern-day version of managed care. In this system, health care is provided by a limited number of contracted providers at reduced rates of reimbursement. Patients are channeled to these contracted providers, and clinical decision making of these providers is influenced by the MCO through utilization management and quality assurance. Financial risk is shifted from payers and insurance companies to ...Continue Reading

References

Mar 27, 1996·JAMA : the Journal of the American Medical Association·E Friedman
Apr 1, 1996·Current Opinion in Pediatrics·S Shapiro
Jan 1, 1996·Health Affairs·L EtheredgeL Lewin

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Citations

Dec 22, 1999·Journal of Clinical Gastroenterology·M W RussoD A Drossman
Dec 4, 2001·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·P A Rivers, K L Tsai

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