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Full-Text Articles in Law
Using Managed Care Tools In Traditional Medicare — Should We? Could We?, Robert A. Berenson, Dean M. Harris
Using Managed Care Tools In Traditional Medicare — Should We? Could We?, Robert A. Berenson, Dean M. Harris
Law and Contemporary Problems
Berenson and Harris consider whether the most controversial tools of managed care, including selective contracting, gatekeeping, and prior authorization, should be adopted in the Medicare program. On policy and practical political grounds, they do not recommend selective contracting or gatekeeping. Nevertheless, Medicare should be granted the authority to have preferred providers and case management programs that could treat providers differently and could permit certain beneficiaries to receive additional, off-policy benefits.
How The Health Care Revolution Fell Short, Clark C. Havighurst
How The Health Care Revolution Fell Short, Clark C. Havighurst
Law and Contemporary Problems
Managed Care I proved itself a poor public servant was appropriately deposed in the counter-revolution it inspired. Managed Care II apparently believes that, by cultivating a more benevolent image than its predecessor, it will be able to hang onto power and ride out any "perfect storm" that may be brewing and that its members can survive as private functionaries in a market increasingly dominated and controlled by government.
The Quality Of Managed Care: Evidence From The Medical Literature, Joseph Gottfried, Frank A. Sloan
The Quality Of Managed Care: Evidence From The Medical Literature, Joseph Gottfried, Frank A. Sloan
Law and Contemporary Problems
Gottfried and Sloan examine the empirical evidence, drawn from the medical literature, pertaining to the safety of managed care practices. They seek to ground the ongoing debate on the medical merits of managed care organizations in the science of clinical research.
Back To The Future: The Managed Care Revolution, Gail B. Agrawal, Howard R. Veit
Back To The Future: The Managed Care Revolution, Gail B. Agrawal, Howard R. Veit
Law and Contemporary Problems
The evolution to a managed care system did not achieve the complete, fundamental change in the health care delivery system that was envisioned by some of its early proponents. As the managed care movement evolved beyond the prepaid group practice model, it focused primarily on methods used to spread the cost of health care services.
Market Failures And The Evolution Of State Regulation Of Managed Care, Frank A. Sloan, Mark A. Hall
Market Failures And The Evolution Of State Regulation Of Managed Care, Frank A. Sloan, Mark A. Hall
Law and Contemporary Problems
Sloan and Hall reflect on whether the market defects identified explain why the managed care revolution has stalled and whether patient protection laws can help put managed care back on track. From a perspective of reliance on market forces to achieve socially desirable outcomes, the fundamental failure of managed care is the failure to produce competing systems of health care delivery that force competitive processes and consumer choice to focus on trade-offs between the cost and quality of care.