title: Managed care, medical technology, and the well-being of society.
abstract: The growth of managed care could have widespread effects on the structure and functioning of the health care delivery system, potentially influencing all patients, even those not enrolled in managed care plans. One important mechanism by which managed care could have such broad effects is by influencing technology development and adoption. This article examines available literature on the effects of managed care activity on technology adoption and the implications of any effects on patient care, outcomes, and health care costs. Existing literature supports the view that managed care has contributed to slowing the adoption of new technologies, particularly the high-cost, high-profile technologies that have been the focus of the most attention. The literature outlining the effects of managed-care-induced changes in technology adoption on patient care and outcomes is not large, but what literature there is tends not to find negative effects on patient care and outcomes. Specific evidence about costs also is somewhat sparse, but it suggests that managed care has contributed to some reduction in health care spending, although the extent to which savings will persist over time is unclear. Although evidence thus far does not suggest important detrimental effects of managed care on care or outcomes and even indicates some benefit through savings, it should be noted that existing literature has only explored a small number of the many technologies and services that might have been influenced, and there remain issues for the future that deserve vigilance.
authors.affiliation: Department of Health Research and Policy, Stanford University, Stanford, California, USA. laurence.baker@stanford.edu
authors.forename: Laurence
authors.initials: L
authors.lastname: Baker
mesh_terms: D020811:Biomedical Technology; D003363:Cost Control; D003695:Delivery of Health Care; D017048:Health Care Costs; D006801:Humans; D008329:Managed Care Programs; D014481:United States