Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Managed Care's No Panacea

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Our 1994 statement still rings true--"Managed care is not a panacea for two reasons: (1) it lacks a proven method of achieving results, and (2) it lacks a firm foundation of information about customers and service." What does it mean for health care reform?

One Cannot Measure What One Does Not Manage: Managed Care 101 in ”2010 (Part XIII) – Originally published Tuesday, March 17, 2009

Comprehensive payment systems need comprehensive, continuous and accurate risk-adjusted data.  For those trying to reform health care, get with the program!

The kind of information that can be used to improve the cost-effectiveness and quality of and access to health care is or could readily be available: this includes not only claims or encounter data, but also medical record data, sociologic, epidemiologic, genetic risk, and patient satisfaction data and comparative and normative statistics. 

I can hear the push back, already -- ‘This smacks of cookbook medicine.’  -- ’My patients are sicker.’  ‘The health plan does not practice medicine.’ Etc.

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