The Impact of Managed Care on Physicians

Abstract

This article examines the forces that led to managed care and considers its two main thrusts: traditional indemnity, with controls and constraints through uti lization review, and controlled access and reimburse ment, as seen in the HMO model. The strategies avail able to the physician are discussed, suggesting how managed care can itself be managed. Finally, the evolution of managed care is shown to be in a final phase, wherein efficient and effective physicians are identified by computer data for selective contracting, leaving a sizeable minority of (potentially) unem ployed physicians.