Special report. Integrating managed care. When managed care is a system.
In a comprehensive managed care system, all participants benefit from the improved quality and cost efficiency. When payers, beneficiaries, and providers communicate, share data, and participate in decision making, the result is more appropriate and more cost-efficient care. The following articles take a look at how each player in the health care system benefits from a comprehensive approach to health care. Payers (employers) benefit by being able to track the cost effectiveness of their health care through integrated data systems. Beneficiaries (employees and dependents) benefit by becoming more involved in the decisions being made by providers and third party payers about their care through patient education and advocacy programs. And health care providers benefit by gaining an increased leadership role in directing the management of their patients' care through practice guidelines. These guidelines will help doctors make decisions that lead to high quality care as well as build a foundation for standardized review criteria throughout the industry.
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D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D007221:Industry / Q000458:organization & administration*; D007256:Information Systems; D008329:Managed Care Programs / Q000458:organization & administration*; D014481:United States