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The Journal of Bone and Joint Surgery 79:125-36 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Current Concepts Review - Managed Care: Form, Function, and Evolution*

SCOTT GOTTLIEB, B.A.{dagger} and THOMAS A. EINHORN, M.D.{dagger}, NEW YORK, N.Y.

Investigation performed at the Department of Orthopaedics, Mount Sinai School of Medicine, New York City


   Introduction
 
During the last decade, health care in the United States has become a cost-conscious and, in some instances, a cost-driven industry. To a large measure, this focus on price explains the reasons behind the phenomenal growth of managed-care companies in the last ten years. These arrangements are now an integral component of the nation's health-care-delivery system, and many experienced observers believe that they have the potential to reduce or eliminate much of the inefficiency in the current system. Health-care plans such as those offered by health-maintenance organizations (HMOs) are thought to provide comprehensive coverage for enrollees at a lower cost than is associated with the episodic care that people receive under traditional indemnity policies.

An HMO delivers comprehensive, coordinated medical services to voluntarily enrolled members on a prepaid basis. The risks and costs are frequently borne by the provider (the independent clinical professionals and institutions that furnish services to the . . . [Full Text of this Article]


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