Bumps on the managed care road: the search for an alternative model to reduce collisions between HMOs, physicians, and patients.
Managed care is experiencing political, litigious, and financial bumps on the road. There are various reasons for this bumpy ride: out-of-control costs, prescription drug expense, negative media reports, public revolt at denials of care or limited access to specialists, bad physician relations, patients' rights legislation, dropping health maintenance organization (HMO) stock prices, the ripple effect of the Harvard Pilgrim bankruptcy, and threat of massive litigation against HMOs. Two reasons not often mentioned, but explored in this article, are the orthodox managed care's flawed market model and lack of enough understanding of physician culture and emerging consumer trends to effectively address these two key constituencies.
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D003220:Conflict, Psychological; D003258:Consumer Behavior; D003363:Cost Control; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D017146:Models, Organizational; D020380:Needs Assessment; D010358:Patient Participation; D011369:Professional-Patient Relations; D011641:Public Relations; D014481:United States