Cost Effects of Managed Care
The influence of managed care on the cost of care is difficult to assess. Only few studies compare the entire cost of MCOs with those of the traditional fee-for-service insurances. Often only certain aspects are investigated, since the complexity would otherwise be impossible to address. Thus, the expenses of hospital services, the use of service providers and the influence on the prices of health services are examined. Due to higher economic efficiency and lower purchasing prices it is also difficult to separate the cost reductions in managed care from the selection effects. At least a portion of the cost advantages of MCOs seems to be due to the more favourable risks in the structure of insured persons in HMOs (Kühn 1997). Shimada et al. (2009) found similar results in their study. They identified that the insured in MCOs demonstrate a better state of health than those in fee-for-service insurances. However, this effect is put into perspective in regions with more competition. In general it must be stated that there is still a lack of established studies (see Sullivan 2000) and, to be fair, it must be assumed that such studies will not be available in the near future.
- Baumberger, J., & Künzi, M. (2010). 20 Jahre HMO und Managed Care in der Schweiz: Managed Care – Erfolgsgeschichte ohne Wirkung? clinicum 1–10.Google Scholar
- Berchtold, P., & Hess, K. (2006). Evidenz für Managed Care: Europäische Literaturanalyse unter besonderer Berücksichtigung der Schweiz: Wirkung von Versorgungssteuerung auf Qualität und Kosteneffektivität, Arbeitsdokument des Obsan 16. Neuchatel: Schweizer Gesundheitsobservatorium.Google Scholar
- Kühn, H. (1997). Managed care. Medizin zwischen kommerzieller Bürokratie und integrierter Versorgung. Am Beispiel USA, Veröffentlichungsreihe der Arbeitsgruppe Public Health des Wissenschaftszentrums Berlin.Google Scholar
- Robinson, R., & Steiner, A. (1998). Managed health care. US evidence and lessons for the National Health Service. Buckingham: Open University Press.Google Scholar