Managed care as a public cost-containment mechanism.

Must we choose between quality and cost containment?

Accepted for publication 10 September 1996 Introduction For the past few years, the United States has been engaged in a public policy debate about how to reform the healthcare system to assure access to care while cost containment. Underlying the deliberations is a concern that quality and cost containment are a trade off that is, that efforts to contain costs inevitably result in lower quality...

Letter to the Editor: Recognizing and Preventing Burnout among Orthopaedic Leaders

Dear Sir: The article by Saleh et al. regarding surgeon burnout is particularly interesting during this time of managed care [1]. In the past, surgeons experienced pressures primarily from issues related to quality of care, quality of their surgery, and results obtained. Managed care introduced increasing pressure from hospital managers, the financial industry including insurance companies, mar...

Managed mental health care in the public sector.

Due to strong market forces and payor concerns, first in the private and now in the public sector, the mental health field is changing. The survivors and leaders will be the innovators and risk takers. They must have the ability to look critically at themselves and make needed changes. This new environment creates great opportunity to provide better mental health care. Capitated mental health p...

Value based insurance design: maintaining a focus on health in an era of cost containment.

HEALTH LAW AND ETHICS ERISA Litigation and Physician Autonomy

THE FEDERAL EMPLOYEE RETIREMENT INCOME SECUrity Act (ERISA) looms like a colossus over the managed care environment. Originally enacted to regulate employer-sponsored pension plans, the statute also covers health care benefits established by self-insured employers (with few exceptions, such as for governmental employees). According to recent Department of Labor estimates, ERISA applies to appro...