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  1. Medicare managed care : How physicians can make it better.

    Article - En anglais

    The federal government is attempting to control anticipated, increased Medicare health care costs by providing the senior population with incentives to encourage their movement into managed care programs.

    For-profit corporate HMOs that currently dominate the managed care arena are coming under increased competitive pressure at a time when their perception of profiteering is undergoing increased public scrutiny.

    If physicians are to take advantage of this window of opportunity and successfully enter the Medicare managed care marketplace, they must identify the major deficiencies existing in the current model, and fashion a new product that divests itself of the profit orientation of current corporate HMOs.

    A nonprofit version of a highly integrated, multispecialty provider service organization (PSO) provides an appropriate model to effectively compete with the corporate HMO.

    The ideal physician-controlled managed care model must :

    • develop a responsive policy board structure ;

    • create practice guidelines that decrease variation in physician practice ;

    • achieve an appropriate balance between primary and specialty medical care ;

    • and adopt a quality-assurance program that effectively addresses both process and outcome data.

    Mots-clés Pascal : Soin santé primaire, Evolution, Soin intégré, Amélioration, Rendement, Instruction, Mise au point, Etude critique, Homme, Etats Unis, Amérique du Nord, Amérique, Economie santé

    Mots-clés Pascal anglais : Primary health care, Evolution, Managed care, Improvement, Yield, Instruction, Perfecting, Critical study, Human, United States, North America, America, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0094158

    Code Inist : 002B30A06A. Création : 14/05/1998.