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Efforts to control health care costs have led to significant shifts in the make-up of the healthcare market since 1980, including the wide-spread adoption of a variety of managed care practices including utilization management, concurrent review, case management, discharge planning, and disease management.
Such a phenomenon may also spill over to non-managed care enrollees, as prior studies have shown managed care practices influence and spill over onto other market constituents, including Medicare FFS enrollees [13, 14].
Molly Ball's article ("Is Managed Care Ill Managed?", March 4) presents Connecticut readers with a glimpse of managed care practices with which we health care providers have struggled for the past several years.
And they are still seeking court rulings on charges that managed care practices violate other laws.
Aetna has tried to improve relations with doctors, settling a lawsuit brought by the attorney general of Texas that challenged managed care practices.
Suits Are Dismissed in Part A federal judge partly dismissed lawsuits that challenged the managed care practices of six big health insurers but said he would allow plaintiffs to amend their cases.
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But fewer than half felt they had had adequate exposure to health care systems and practice, an area of study that extends to subjects like medical economics, managed care, practice management and medical record-keeping.
Previously, I was with a managed care practice and saw as many as eight patients an hour -- about six minutes a patient.
Another advantage is that the SEER areas have much higher penetration by Medicare HMOs than non-SEER areas [ 46], making them more useful for assessing whether there are significant managed care practice spillover effects, one of our main study questions.
This negative spillover result is consistent with findings in a recent paper by Schneider et al. [ 44] that Medicare managed care practice favors FOBT over endoscopy use for persons enrolled in Medicare managed care organizations, when compared to FFS Medicare enrollees.
We expect that manage care practices that promote use of preventive care services are more necessary in these markets, and thus we would expect to see a larger effect size on the spillover estimate in the unregulated markets.
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