Consequences of Managed Care for People with Disabilities and for Providers

2010

A close examination of the remaking of the health-care system and the consequences of this effort for people with disabilities and the profession of medicine. While still respected, some of the power the profession had to control its own destiny was lost to managed care plans as they came up with new ways of financing and organizing the health care delivery system in the United States. Managed care, as a way of paying doctors and other providers, is a kind of low-intensity war waged against the culture of private-practice, especially specialty providers, and the academic medical centers that depend on patient admissions from their affiliated physicians. It also has implications for people with disabilites, heavy users of the health care system. Managed care, through cost-shifting to plan participants, is a form of combat also against the indifference to cost displayed by consumers with insurance coverage but with no deductibles and co-payments in their policies. Putting off a visit now has its rewards, as well as settling for a generic drug. This wholesale effort to rein in costs has lead to serious inroads on the way medicine is practiced, how doctors relate to patients, and how much autonomy professionals are permitted in their work. Some of these changes will produce better health outcomes for patients, provided that carefully designed studies demonstrate that changes in clinical practice or health behaviors of patients produce better health outcomes.

Managed Care, People with Disabilities, Medical Profession

Performing Technical Assistance and/or Training, Performing Research or Evaluation

Health-Related Activities, Quality of Life

Students/Trainees (long or intermediate trainees), Professionals and Para-Professionals, Family Members/Caregivers, General Public

None

Mulit-County, State, National, International

N/A