Managed Care: Made in America

About the Book

This book focuses on how a distinctly American product—managed care—got its start, how it works, and what needs to be adjusted in the future. As Birenbaum makes clear, this book is about social change. It is about doctors contracting with health maintenance organizations (HMOs) and being subject to their rules; about the limited access to specialty care; and about the frugal use of hospital admissions and stays. Consumers and providers have had mixed experiences in these health-delivery systems. Birenbaum, a health-policy analyst, has created a synthesis of research studies and analyses of trends to chronicle these developments and to suggest remedies to correct the most unjust aspects of managed care.

This book is about social change. It is about doctors contracting with HMOs and being subject to their rules; about the limited access to specialty care; and about the frugal use of hospital admissions and stays. Consumers and providers have had mixed experiences with HMOs. Birenbaum, a health-policy analyst, has created a synthesis of research studies and analyses of trends to chronicle these developments and to suggest remedies to correct the most unjust aspects of managed care. This is important reading for anyone concerned with contemporary health care in America.

Table of Contents:

Preface
Introduction: Retrenchment and the Remaking of the Health-Care System
What Is Managed Care?
American Business Falls in Love with Managed Care
Medicaid Managed Care
Healthy and Unhealthy People at the HMO
How HMOs Assure Quality
Consumer Satisfaction
Professional Autonomy and Managed Care
Protecting Consumers and Providers through Legislation
The Growing Business of HMOs
Unresolved Issues Regarding Managed Care
Bibliographical Essay
Index

About the Author :
ARNOLD BIRENBAUM, a health-care policy analyst, medical sociologist, and health services researcher, is Professor of Pediatrics at Albert Einstein College of Medicine and Associate Director of the University Affiliated Program for People with Developmental Disabilities, Rose F. Kennedy Center./e He has authored or edited 11 earlier books and monographs, including Putting Health Care on the National Agenda (Praeger, 1995), recipient of the American Medical Writers Association First Place Award-Allied Health Category.

Review :
?[B]irenbaum's text is a primer for those seeking to understand how managed care programs differ from traditional health insurance plans and why those differences matter.?-Administrative Science Quarterly ?Arnold Birenbaum's Managed Care is an organized and balanced assessment of managed care in the post-Clinton reform period. His book leads the reader through the complexities of employer sponsorship, the Employee Retirement Income Security Act, changes in Medicare and Medicaid, and the alphabet soup of alternative managed care arrangements....Birenbaum's Managed Care would be good reading for congressmen prior to the upcoming debates on the president's most recent proposals.?-Inquiry ?Birenbaum describes in a lively, interesting, and very readable book how the process of managed care started, how it works, the strengths and weaknesses of this approach to health care, and what needs to be changed in the future to make this model of health care function better for patients. ...Valuable reading for all who are interested in what is happening to health care in the US.?-Choice ?His target audience included both payers and providers. He also attempted to write for "consumers." He succeeded: this book is suitable for a lay audience.?-Australian Health Review "ÝB¨irenbaum's text is a primer for those seeking to understand how managed care programs differ from traditional health insurance plans and why those differences matter."-Administrative Science Quarterly "[B]irenbaum's text is a primer for those seeking to understand how managed care programs differ from traditional health insurance plans and why those differences matter."-Administrative Science Quarterly "Birenbaum describes in a lively, interesting, and very readable book how the process of managed care started, how it works, the strengths and weaknesses of this approach to health care, and what needs to be changed in the future to make this model of health care function better for patients. ...Valuable reading for all who are interested in what is happening to health care in the US."-Choice "His target audience included both payers and providers. He also attempted to write for "consumers." He succeeded: this book is suitable for a lay audience."-Australian Health Review "Arnold Birenbaum's Managed Care is an organized and balanced assessment of managed care in the post-Clinton reform period. His book leads the reader through the complexities of employer sponsorship, the Employee Retirement Income Security Act, changes in Medicare and Medicaid, and the alphabet soup of alternative managed care arrangements....Birenbaum's Managed Care would be good reading for congressmen prior to the upcoming debates on the president's most recent proposals."-Inquiry