Of the remaining quarter, most were in schemes that contained elements of managed care such as the requirement that, to be sure of reimbursement, patients obtain the insurer's permission before undergoing an expensive operation.
McKinsey and Company, a consultancy, reported in October that nearly 60% of health plans on the exchanges have elements of "managed care", a technique used by health-maintenance organisations (HMOs) in the 1990s that involves paying for care at only some clinics, rather than wherever the patient likes.
As managed care has grown in the U.S., industrialized countries also are adopting elements of managed care but for different reasons, mainly to improve system performance [ 1, 2].
Many countries have introduced elements of managed competition in their healthcare system with the aim to accomplish more efficient and demand-driven health care.
Following the introduction of elements of managed competition in the Netherlands in 2006, General Practitioners (GPs) and patients were given the role to select treatment hospital using public quality information.
In the subsidized regime, informants point to insufficient public funding and to elements of managed competition: added administrative costs and incentives to close non-profitable services (internal medicine) or to insurers not contracting high technology services (Table 5).
Within the context of chronic pain - which is very common - there is potential for eHealth to become a routine element of managing the condition.
Self-management actions by individuals with long-term conditions and the support they receive from primary care practitioners has been viewed as an essential element of managing and optimising positive health outcomes for long-term conditions (LTCs) generally and for type 2 diabetes in particular [ 1– 3].
In this quasi-experiment, we are interested in analyzing the impact of the adopted design method on three dependent variables: the effectiveness of the resulting managing element, the complexity of managing element's architecture, and the method's potential for promoting the acquisition of insights and refined experience about quality attributes trade-offs involved in SA systems design.
