Behind the Curve: A Critical Assessment of How Little is Known about Arrangements between Managed Care Plans and Physicians

Author:

Gold Marsha1,Nelson Lyle1,Lake Timothy1,Hurley Robert2,Berenson Robert3

Affiliation:

1. Mathematica Policy Research, Inc.

2. Medical College of Virginia

3. RWJF IMPACS Program/CHPS, Georgetown University

Abstract

Extraordinary growth in managed care arrangements over the past decade has been both widely praised and criticized. Proponents and critics agree that the nature of medical practice is being profoundly altered by this growth, even if they cannot articulate the direction and consequences of this change. We explore the roots of this uncertainty by examining the available evidence on critical features of the arrangements managed care plans currently have with affiliated physicians. Our approach is to review and synthesize the literature in several key substantive areas from a broad range of sources. We found that existing knowledge is dated, derived from a limited subset of plans, inattentive to important structural diferences between plans, and responsive to a very naorow set of issues poorly rflecting the range of medical practice and change introduced by managed care We highlight key questions of interest and the knowledge gaps critical to address so that policy and management decisions can both reflect and be informed on these issues that define the arrangements managed care plans make with physicians and ultimately influence medical practice.

Publisher

SAGE Publications

Subject

Health Policy

Reference92 articles.

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