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 concern for the consumer. In this model, medical and pharmaceutical issues are addressed in silos, and value is narrowly defined. Increasingly, cost and responsibility is shared with or shifted to the patients. Patients may be unable or unwilling to assume these costs or responsibilities. Several studies have demonstrated that they may react with noncompliance. Managed care's definition of value must expand and integrate across silos to consider the needs and interests of the patient's overall care, in particular, addressing key cost drivers in terms of diseases that cause recurring costs. Using predictive modeling can result in cost savings. A case study (Pitney Bowes) is included in this article.