title: Managed care and the public health challenge of TB.
abstract: Managed care is fast becoming the dominant form of medical care delivery and financing in the United States, yet its effects on public health practice remain largely unknown. Tuberculosis (TB) is a classic example of a disease with both public health and medical care implications, and as such it provides an opportunity for examining the impact on public health of the shift towards managed care in the medical marketplace. The authors approach the role of managed care in TB control by first considering the need for interorganizational coordination at the community level. The authors identify four basic models of how managed care organizations may fit into TB control efforts in local communities, using observations from 12 local public health jurisdictions to illustrate these models. These TB control models provide insight into the general mechanisms through which managed care organizations may affect other areas of public health practice.
authors.affiliation: School of Public Health, University of North Carolina at Chapel Hill 27599-7400, USA. paul_halverson@unc.edu
authors.forename: P K
authors.initials: PK
authors.lastname: Halverson
authors.forename: G P
authors.initials: GP
authors.lastname: Mays
authors.forename: C A
authors.initials: CA
authors.lastname: Miller
authors.forename: A D
authors.initials: AD
authors.lastname: Kaluzny
authors.forename: T B
authors.initials: TB
authors.lastname: Richards
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D005376:Financial Management; D006301:Health Services Needs and Demand; D006801:Humans; D007373:Interinstitutional Relations; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D017146:Models, Organizational; D011635:Public Health Administration; D014376:Tuberculosis / Q000517:prevention & control*; D014481:United States