This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gold, M. Articles by Berenson, R. Search for Related Content PubMed PubMed Citation Articles by Gold, M. Articles by Berenson, R. Social Bookmarking                   What's this?

Behind the Curve: A Critical Assessment of How Little is Known about Arrangements between Managed Care Plans and Physicians

Mathematica Policy Research, Inc.

Lyle Nelson

Mathematica Policy Research, Inc.

Timothy Lake

Mathematica Policy Research, Inc.

Robert Hurley

Medical College of Virginia

Robert Berenson

RWJF IMPACS Program/CHPS, Georgetown University

Extraordinary growth in managed care arrangements over the past decade has been both widely praised and criticized. Proponents and critics agree that the nature of medical practice is being profoundly altered by this growth, even if they cannot articulate the direction and consequences of this change. We explore the roots of this uncertainty by examining the available evidence on critical features of the arrangements managed care plans currently have with affiliated physicians. Our approach is to review and synthesize the literature in several key substantive areas from a broad range of sources. We found that existing knowledge is dated, derived from a limited subset of plans, inattentive to important structural diferences between plans, and responsive to a very naorow set of issues poorly rflecting the range of medical practice and change introduced by managed care We highlight key questions of interest and the knowledge gaps critical to address so that policy and management decisions can both reflect and be informed on these issues that define the arrangements managed care plans make with physicians and ultimately influence medical practice.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. A. Hall, E. Dugan, R. Balkrishnan, and D. Bradley How Disclosing HMO Physician Incentives Affects Trust Health Aff., March 1, 2002; 21(2): 197 - 206. [Abstract] [Full Text] [PDF]

				C. Brach, L. Sanches, D. Young, J. Rodgers, H. Harvey, T. McLemore, and I. Fraser Wrestling with Typology: Penetrating the "Black Box" of Managed Care by Focusing on Health Care System Characteristics Med Care Res Rev, November 1, 2000; 57(3_suppl): 93 - 115. [Abstract] [PDF]

				C. A. Pedersen, E. C. Rich, J. Kralewski, R. Feldman, B. Dowd, and T. S. Bernhardt Primary Care Physician Incentives in Medical Group Practices Arch Fam Med, May 1, 2000; 9(5): 458 - 462. [Abstract] [Full Text] [PDF]

				S. M. Shortell, T. M. Waters, K. W. B. Clarke, and P. P. Budetti Physicians as Double Agents: Maintaining Trust in an Era of Multiple Accountabilities JAMA, September 23, 1998; 280(12): 1102 - 1108. [Full Text] [PDF]

				D. E. Grembowski, K. Cook, D. L. Patrick, and A. E. Roussel Managed Care and Physician Referral Med Care Res Rev, March 1, 1998; 55(1): 3 - 31. [Abstract] [PDF]

				D. B. Smith Addressing Racial Inequities in Health Care: Civil Rights Monitoring and Report Cards Journal of Health Politics Policy and Law, January 1, 1998; 23(1): 75 - 105. [Abstract] [PDF]

				J. B. Christianson, D. Wholey, and M. S. Peterson Strategies for Managing Service Delivery in HMOs: An Application to Mental Health Care Med Care Res Rev, June 1, 1997; 54(2): 200 - 222. [Abstract] [PDF]

				F. J. Hellinger The Impact of Financial Incentives on Physician Behavior in Managed Care Plans: A Review of the Evidence Med Care Res Rev, September 1, 1996; 53(3): 294 - 314. [Abstract] [PDF]