Managed Care

What does the term “managed care” mean with regard to health insurance?

The easiest way to define managed care is to compare it with traditional health care. Under traditional health care, doctors and hospitals are independent of each other. Doctors and hospitals set their own fees for services. You can go to any doctor you choose, and you are responsible for determining if your doctor is qualified to provide the care you need. Under managed care, doctors and hospitals, as well as other health care providers, agree to work together through health care networks.

What Is Managed Care?

Odds are you have managed care -- but do you understand it? At its core, managed care is about money.

What is Traditional vs. Managed Care?

Traditional health insurance allows you to select your health care providers, such as your favorite doctor or hospital. Managed Care, which combines the delivery and financing of health care services, has gained acceptance over the years. It may restrict your choice of doctors and hospitals, but in return you typically pay less for medical care compared to traditional coverage.

Where is Managed Care Now?

So the challenge of managed care today is not whether we should be for it or against it. The alternative - totally unmanaged care - comes with the price tag that neither the public sector, nor the private sector can afford.

For Managed Care, the Future Looks Rosy if...

Managed care can survive and may even thrive, experts say. But that will be in a world where public payers loom larger, provider prices are pushed down, the wellsprings of illness are addressed, and consumers aren’t quite so frustrated and angry.

First Report Managed Care

First Report®Managed Care (firstreportnow.com) is a managed markets print and online brand that circulates to more than 21,000 health plan CEOs, hospital formulary committee members, HMO pharmacists, health plan medical directors and pharmacy directors, large employer decision-makers, and state prison facility managers

Managed Care

After 28 years of publishing, our last issue of Managed Care was December 2019. While sad, we have much gratitude for the many writers, editors, researchers, reviewers, salespeople, and advertisers who kept us going and made Managed Care a standout publication. And not to be forgotten, we thank you for reading our publication and visiting our website.

Managed Care Matters

Joseph Paduda's weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers.

California Department of Managed Health Care

The California Department of Managed Health Care protects consumers’ health care rights and ensures a stable health care delivery system.