Cost and quality under managed care: irreconcilable differences?

The quality of care under a managed-care program for dual eligibles.

PURPOSE Our objective in this study was to compare the quality of care provided under the Minnesota Senior Health Options (MSHO), a special program designed to serve dually eligible older persons, to care provided to controls who received fee-for-service Medicare and Medicaid managed care. DESIGN AND METHODS Two control groups were used; one was drawn from nonenrollees living in the same area...

Unconstitutional or impossible: the irreconcilable gap between managed care and due process in Medicaid and Medicare.

All payer, single payer, managed care, no payer: patients' perspectives in three nations.

We present data on patients' experiences with access to and cost and quality of health services in the United States, Canada, and Germany. In general, patients report favorably about their care. U.S. respondents report more problems with access to care, even controlling for the severe problems of the uninsured. Differences in managed care versus fee-for-service plans in the United States mirror...

Improving cost-effectiveness of and outcomes from drug therapy in patients with atrial fibrillation in managed care: role of the pharmacist.

BACKGROUND The medical care costs for procedures, medications, and testing associated with atrial fibrillation (AF) in the United States are high and projected to increase markedly in the future as the number of Americans affected grows. The burden on patient quality of life, the health care system, and society are pharmacoeconomic considerations in managing AF. OBJECTIVES To identify key pha...

Managed care fundamentals: implications for health care organizations and health care professionals.

Managed care is changing our health care delivery system as radically as the computer chip has changed telecommunications. Health care professionals and organizations that do not understand managed care's implications will not be prepared for the future. For example, one implication of managed care is payment capitation, which is the transfer of financial risk from the insurer to the provider. ...