Managed health care plans: sheep in wolves' clothing.
The gatekeeper is the ambassador of managed care, a cost-effective, quality advocate. The gatekeeper is one of the most effective management tools available to managed care organizations and patients today. However, there is little evidence proving this positive cost-benefit. Furthermore, managers lack the understanding and information about how gatekeepers operate and why certain decisions are made. The authors discuss what they believe is the real promise of managed care.
Kaplan
J G
JG
Blue Cross and Blue Shield of Western New York, Buffalo 14240.
Sneider
J S
JS
D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000592:standards; D017060:Patient Satisfaction; D012017:Referral and Consultation / Q000592:standards*; D014481:United States