Increasing healthcare expenditures and other economic pressures mandate fundamental reforms of the healthcare system in Germany. The overall goal is restraint of costs while at the same time maintaining a high standard of medical care. Among all options, managed care represents a potential...

This study evaluated the Medicaid Managed Care Program, an initiative launched by the 168 in 1995 to promote the delivery of high-quality health services for low-income people and those with special health care needs. The overview assesses the perspectives of states, Medicaid health plans, and...

Quality improvement collaboratives have become a common strategy for improving health care. This paper uses social network analysis to study the relationships among organizations participating in a large scale public–private collaboration among major health plans to reduce racial and...

This study evaluated the Medicaid Managed Care Program, an initiative launched by the 168 in 1995 to promote the delivery of high-quality health services for low-income people and those with special health care needs. The overview assesses the perspectives of states, Medicaid health plans, and...

More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage...

This study evaluated the Medicaid Managed Care Program, an initiative launched by the Robert Wood Johnson Foundation in 1995 to promote the delivery of high-quality health services for low-income people and those with special health care needs. The overview assesses the perspectives of states,...

This study evaluated the Medicaid Managed Care Program, an initiative launched by the Robert Wood Johnson Foundation in 1995 to promote the delivery of high-quality health services for low-income people and those with special health care needs. The overview assesses the perspectives of states,...

Rheumatoid arthritis (RA) is a prevalent condition associated with pain, joint destruction and morbidity. Direct healthcare costs are 2 to 3 times higher than average costs for individuals of similar age and gender. Furthermore, utilisation and costs rise with age and disease duration. Managed...

Managed care, with its restrictions on patient and provider autonomy, has dominated the delivery of healthcare in the US over the last decade. The latest model of managed care has focused on disease management programs, which outline optimal cost-effective processes for care, built on...

This article exposes and corrects some of the major myths about outsourcing disease management to a specialised expert vendor. Currently, a number of health plan medical directors feel that outsourcing costs more than building internally, will not provide a return on investment, and requires a...