Releasing managed care's chokehold on healthcare providers.

Managed care mythology: supply-side dreams die hard.

As managed care gains increasing influence over the American health financing system, economic pressures and emerging market realities have created a fertile climate for wishful thinking on the part of hospital executives and physicians. Rather than accept the inevitability of reducing excess capacity and incomes, providers cling to self-serving myths about managed care's strategic direction. H...

Regulatory restrictions on selective contracting: an empirical analysis of "any-willing-provider" regulations.

"Any-willing-provider" (AWP) laws compel managed care plans to accept any provider willing to accept the plan's terms and conditions, potentially undermining managed care's ability to constrain spending. However. AWP laws potentially respond to inefficient risk-selection by providers of managed care. With risk selection, observed reductions in expenditures in the managed care sector may be offs...

Home care's unique challenges.

Interregional Patient Mobility in the Italian NHS: A Case of Badly-Managed Decentralization; Comment on “Regional Incentives and Patient Cross-Border Mobility: Evidence From the Italian Experience”

The article by Brenna and Spandonaro on interregional mobility for acute hospital care in Italy raises important issues concerning social and territorial equity in a healthcare system. Based on Regions and private providers’ strategic behavior, the hypothesis adopted to explain patient cross-border mobility (CBM), demonstrated by statistical analysis, may be further explored using qualitative m...

Patient-centric care management.

OBJECTIVE To review managed care's current cost management trends and the consumerism movement; to elucidate the pros and cons of key issues; and to describe the philosophy of focusing on the patient, also called patient-centric care, while improving the patient's care through value-based purchasing and plan design. SUMMARY Managed care is sometimes practiced using a silo approach with little...