Contrary to popular belief, managed care health plans generally do not give their patients more preventive medical services than non-managed care plans, says a new study from researchers at the University of California, San Francisco. However, the researchers said, certain types of managed care plans score better than others, and have a clear advantage over non-managed care.
Most people, including those who study health care plans, take it for granted that managed care plans give customers greater access to preventive medicine, including immunizations, medical and nutrition counseling, and disease screening. Several previous studies including a 1994 survey by Harold Luft, PhD, Director of UCSF's Institute for Health Policy Studies, and Bob Miller, PhD, a UCSF associate professor at the Institute for Health and Aging, showed that HMO enrollees were consistently more likely to receive preventive services than people in non-managed care plans.
But managed care has changed dramatically during the last decade, said Kathryn Phillips, PhD, lead author of the new study and an associate professor of health economics and health services research at UCSF's School of Pharmacy and Institute for Health Policy Studies. A far smaller percentage of people enrolled in managed care today are members of a "group/staff" managed care plan - one in which patients almost exclusively see doctors within the HMO. In 1990, 40 percent were enrolled in this type of plan, whereas only 12 percent were in 1997. Today, most patients use more open types of managed care plans, which "tend to be much more loosely managed," and less centralized, Phillips said.
Phillips looked at the impact of these changes on use of preventive care. Working with other researchers, including Melanie Egorin, a UCSF doctoral student in sociology, she performed a meta-analysis of 18 studies from the 1990's that compared preventive services in managed care versus non-managed care health plans.
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Contact: Kevin Boyd
415-476-2557
University of California - San Francisco
9-Jan-2000