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But P.P.O.'s may be even less successful in controlling costs and managing care, some analysts say.
Yet in today's upside down medical marketplace, insurers "managing" care make clinical decisions, while reimbursement adjustments force doctors to assume inappropriate kinds of risk.
It's not just technical expertise that's needed in healthcare but also expertise in areas such as managing care, or good communication in sensitive situations.
Jack Reichman, an analyst at Standard & Poor's, said Aetna would have to prove that it could make money with its new strategy of "managing costs by managing care".
It is unlike managed care, in which primary doctors act as gatekeepers to specialists and the overriding goal is not managing care but managing costs.
The managed care concept of the 1990's was about having an outside bean counter, usually an insurance company, looking over the shoulder of the doctor -- managing costs instead of managing care.
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Under managed care, they cannot.
These were the days before managed care.
The managed care industry disagrees.
And it is not just managed care.
"With managed care you almost have to.
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CEO of Professional Science Editing for Scientists @ prosciediting.com