LECTURE+8+-+Managed+care

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

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Lecture 8: Managed Care Health Economics 01:220:316 Prof. Derek DeLia, Ph.D.
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Managed care in theory
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Managed care concept (ideal form) Respond to problems w/”traditional indemnity insurance” Moral hazard Fee-for-service (FFS) Managed care Emphasis on population health Statistical measures Provider/system performance
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Distribution of blood pressure in population w/homogeneous salt intake (hypothetical) 0 .005 .01 .015 Probability density 50 100 150 200 Blood pressure
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Distribution of blood pressure in populations w/ high & low salt intake (hypothetical) 0 .005 .01 .015 Probability density 50 100 150 200 Blood pressure High salt intake Low salt intake
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Percentage of patients w/high blood pressure by physician (hypothetical) Patient group Physician 1 Physician 2 Overall 10% 5% Low-income 15% 17% High-income 3% 4%
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Managed care in practice
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Brief history of managed care Prepaid health service plans 1920’s Ex: Kaiser Permanente, Group Heath Coop Unpopular w/med societies
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LECTURE+8+-+Managed+care - Lecture 8: Managed Care Health...

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