Posting date: May 19, 2004

This Article Reprint (PDF) HTML Version Related Papers Submit a response to this article Comments: View responses Alert me when this article is cited Alert me when Comments are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Robinson, J. C. Articles by Yegian, J. M. Search for Related Content PubMed PubMed Citation Articles by Robinson, J. C. Articles by Yegian, J. M. Related Collections Insurance Coverage Managed Care Managed Care - Consumers Managed Care - Physicians Managed Care - Quality Business Of Health Quality Of Care Consumer Issues

Health Affairs, 10.1377/hlthaff.w4.269
Copyright © 2004 by Project HOPE

Web Exclusives

Medical Management After Managed Care

¹ James Robinson is a professor of health economics at the University of California, Berkeley, School of Public Health.
² Jill Yegian is director, health insurance, at the California HealthCare Foundation in Oakland.

^*Corresponding author.

Abstract

Health insurers are under conflicting pressures to improve the quality and moderate the costs of health care yet to refrain from interfering with decision making by physicians and patients. This paper examines the contemporary evolution of medical management, drawing on examples from UnitedHealth Group, WellPoint Health Networks, and Active Health Management. It highlights the role of claims data, predictive modeling, notification requirements, and online enrollee self-assessments; the choice between focusing on behavior change among patients or among physicians; and the manner in which medical management is packaged and priced to accommodate the diversity in willingness to pay for quality initiatives in health care.

Key Words: Business of Health, Consumer Issues, Managed Care, Managed Care - Consumers, Managed Care - Physicians, Managed Care - Quality, Insurance Coverage, Quality of Care

                      What's this?

Comments: