MANAGED CARE March 2007. ©MediMedia USA
The promise of managed care has always had a lot to do with what its advocates hoped would be the ability to provide care for populations, not just individuals. This was a radical concept to many people, and still one that is not too easy to explain to people outside the industry.
Early commercial HMOs especially were not too adept at delivering, and no wonder. Just getting their systems to hang together in the face of skeptical providers and the public was a big order. But as time goes on, and information technology advances, plans' ability to deliver on this promise gets better and better.
One example is the cover story, which emphasizes a new commitment to prevention on the part of many insurers [1]. Prevention is an activity that produces long-term economic gains, which can be a problem for businesses struggling with this year's bottom line. Yet in cancer care, prevention as a strategy is taking hold, and as with other prevention activities, all will eventually benefit. Plus, in the short term, to be able to show that you have leading-edge cancer prevention and management programs has to be attractive to employers (who also have to think long-term) and to members.
One place I wouldn't have expected to see managed care involved in is intimate partner violence, but in an article by Therese Zink, MD, et al, we find that by using the Planned Care Model, plans can collaborate with other institutions (e.g., domestic violence agencies) to reduce the incidence of IPV [2], which may afflict one third of women over their lifetimes and is more common than many actual diseases that health plans screen for and treat.
To care for populations is to care for individuals, and they benefit, even when, as is surely the case, they are not even aware that it is happening.