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LECTURE+8+-+Managed+care

LECTURE+8+-+Managed+care - Lecture 8 Managed Care Health...

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Unformatted text preview: Lecture 8: Managed Care Health Economics 01:220:316 Prof. Derek DeLia, Ph.D. Managed care concept • FFS indemnity insurance – Disconnected providers, patients, & payers – Inflationary • Managed care – Integration of HC financing & delivery – Prudent payer • Basic goals – Cost containment – Supply-side incentives – Care coordination – Population health (statistical measures) Brief history of managed care • Prepaid health service plans 1920’s – Ex: Kaiser Permanente, Group Heath Coop – Unpopular w/med societies • HC cost inflation in 1960’s, 70’s, 80’s • New name : Health Maintenance Organization (HMO) • HMO Act 1973 – Loan guarantees & grants for start-ups – ESI groups w/>25 enrollees had to offer an HMO option if available – Federal qualification/standards • Federal changes in 1980’s – Investor guides/conferences – Rise of for-profit & regional/national HMO chains Growth in HMO membership in the U.S....
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LECTURE+8+-+Managed+care - Lecture 8 Managed Care Health...

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