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...

Elders who are frail because of disability, multiple chronic conditions, and other factors account for a growing share of the population, yet they are often poorly served by a health care system that is focused on acute care episodes. This report for the California HealthCare Foundation examines...

This study systematically identified and profiled the content and use of AHRQ’s grant funded research on health care costs, productivity, organization, and market forces. The report provides evidence that the research findings have had an impact on policy debates, although much of that impact...

Examines the California experience from year-end 1997 through the beginning of 2002 to identify lessons that can be applied to the national M+C environment. California enrollees account for about one-quarter of the national enrollment in the M+C program, and the state has a much higher market...

Reductions in the fees paid by Medicare to physicians have raised concerns that beneficiaries in some areas may have problems obtaining needed care in a timely manner. This report suggests that these reductions have not led to marked restrictions in access to care, even though the study examined...

Despite strong interest in improving care for high-risk elders, demonstration projects typically show negative results. This paper examines a large foundation-sponsored initiative to gain insight into why success can be so elusive. The findings indicate that flaws in concept, design, and...

Provides a timely profile of how managed care plans—especially those at financial risk—structure their networks and pay providers, finding that contractual arrangements between plans and providers are complex and diverse across and within networks. Furthermore, HMO contracts with...