Managed care in four managed competition OECD health systems

Health Policy
Amir ShmueliMaria Trottmann

Abstract

Managed care emerged in the American health system in the 1980s as a way to manage suppliers' induced demand and to contain insurers' costs. While in Israel the health insurers have always been managed care organizations, owning health care facilities, employing medical personnel or contracting selectively with independent providers, European insurers have been much more passive, submitting themselves to collective agreements between insurers' and providers' associations, accompanied by extensive government regulation of prices, quantities, and budgets. With the 1990s reforms, and the introduction of risk-adjusted "managed competition", a growing pressure to allow the European insurers to manage their own care - including selective contracting with providers - has emerged, with varying speed of the introduction of policy changes across the individual countries. This paper compares experiences with managed care in Israel, The Netherlands, Germany and Switzerland since the 1990s. After a brief description of the health insurance markets in the four countries, we focus comparatively on the emergence of managed care in the markets for ambulatory care and inpatient market care. We conclude with an evaluation of the current situation...Continue Reading

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Citations

Feb 10, 2016·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·K P M van WinssenW P M M van de Ven
Apr 9, 2016·Health Policy·Daniëlle Duijmelinck, Wynand van de Ven
Feb 1, 2005·Australia and New Zealand Health Policy·Jeff Rj Richardson
Aug 4, 2016·Social Science & Medicine·Domino DetermannG Ardine de Wit
Aug 12, 2016·Health Economics·Lukas Kauer
May 11, 2016·Perspectives in Public Health·Bethany Brown
Mar 30, 2017·International Psychogeriatrics·Eamon O'Shea, Christine Monaghan
Apr 8, 2018·Applied Health Economics and Health Policy·Paul E Orzechowski
Apr 25, 2021·Health and Quality of Life Outcomes·Si ZhengPeigang Wang
Jul 13, 2021·Australasian Psychiatry : Bulletin of Royal Australian and New Zealand College of Psychiatrists·Jeffrey Cl LooiStephen Allison

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