Managed Care and Modernization: A Practitioner's Guide

Managed Care and Modernization: A Practitioner's Guide

Managed Care and Modernization: A Practitioner's Guide

Managed Care and Modernization: A Practitioner's Guide

Synopsis

Offering a handbook for healthcare managers and practitioners, this book aims to give practical guidance on applying managed care techniques as part of the modernization of health services. This book seeks to contextualize managed care, reviewing contemporary policy and practice, and exploring the major challenges facing health services.

Excerpt

In 1997, the Labour government in the United Kingdom (UK) embarked on an ambitious programme of National Health Service (NHS) modernization. There was substantial structural change proposed by the 1997 White Paper, The NHS: Modern, Dependable, the dozen or so major policy documents which have followed and not least the historic nhs National Plan for the service’s second millennium. in the past, governments have often been accused of using structural change as a smokescreen to mask inadequate investment in the nhs. Historically the uk has undoubtedly had its healthcare on the cheap relative to oecd comparator nations while the nhs has shouldered more than its fair share of reorganizations. At last, however, we appear to have a government (and now seemingly an all-party consensus) determined to reverse chronic under-investment in the nhs. Whereas the United States (US) has been reining in healthcare expenditure growth from 12 per cent annually a few years ago to only 3 per cent at the end of the Clinton administration, the nhs is to get 30 per cent growth in real terms over only four years.

As we argue in this book, both the Labour modernization agenda and those Tory reforms which it retained owe much to the experience of us managed care organizations (MCOs). Historically this is only fitting since the founders of the Health Maintenance Organizations in California, the home of modem managed care, were inspired, in part at least, by three key elements of the nhs - the pooling of financial risk against a fixed budget, the removal of financial barriers to access and a delivery system based in primary care acting as gatekeeper to secondary care.

In the mid-1990s, however, us managed care systems had developed to a point where they had much to offer back in return. the British authors in this book first became interested in this experience as members of a 1994 study tour with Manchester University to fhp Healthcare in Southern California, then the second largest hmo in the us and subsequently . . .

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