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Health Plans & The Market

PROLOGUE

Health Plans And The Market

In the section’s lead paper Debra Draper and colleagues of the Washington, D.C.–based Center for Studying Health System Change draw on a rich data set from twelve urban areas to portray the "changing face of managed care." Pressures on managed care plans are finally starting to show up in the plans’ business strategies, their research finds, but the full impact on consumers has yet to be seen.

Next, Rob Cunningham and Doug Sherlock, a journalist and a securities analyst, report on the nation’s Blue Cross Blue Shield plans. They find that the backlash against managed care techniques has fueled a resurgence of interest in the Blues’ care delivery model. At the same time, some nonprofit Blues plans are being acquired by for-profit Blues-based organizations that are in pursuit of a greater share of the insurance market.

The third paper shines a spotlight on defined-contribution health insurance products, a coverage option that is gaining favor among some employers, analysts, and policymakers. Employers using a defined-contribution approach set aside a sum of money for their employees to use in making their own plan choices, while providing catastrophic coverage and tools to help them choose appropriately. Some of the newer defined-contribution options rely heavily on Internet technology; as the high-tech market has suffered serious setbacks, some wonder about the future of these e-health tools. But this paper by Jon Christianson and colleagues holds out hope that the model will continue to thrive, enabling consumers to control their own health plan destinies and their employers to cut benefits costs.

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