Medicaid Managed Care - U.S. Senate Special Committee on Aging

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PREAMBLE
Over the past decade, managed care has
become the dominant force in the organization
and delivery of private health care
and is growing rapidly in publicly sponsored
health care. Although the term
encompasses a variety of arrangements
and techniques, the hallmark of managed
care is the use of financial and other incentives
to promote coordinated health care
and to reduce costs.
Ideally, managed care has the potential
to provide a more seamless continuum of
high quality care, expand access to care,
and control health care costs. So far, however,
managed care performance has been
uneven, with evidence indicating both
promise and problems. As with fee-forservice
health care, incentives for delivering
services are not-always properly
aligned with the needs of patients.
The issue of appropriate standards for
managed care - voluntary or mandatory
- is the subject of intense debate. Various
private entities have developed voluntary
standards for managed care. Many states
have adopted statutes imposing specific
requirements. The federal government has
for many years regulated managed care
entities participating in publicly sponsored
health care programs. As managed care
becomes a greater factor in the delivery of
health care, government is likely to take an
even more active role.
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