Seeds of Innovation

Managing care in the 21st century

Our inaugural innovation issue!

Peter Wehrwein

Utilization review, formularies, medication—they are still the stuff of managed care. It’s the reason that managed and care, when together, are still dirty words in many circles.

But managing care in the still-young 21st century now also means managing people, not just their health care—and what they eat, where they live, and how they get around.

Managed care has left the hospital. And the doctor’s office. It has moved into the buzzy neighborhood of social determinants of health.

So, our inaugural issue about innovation includes a story about Geisinger treating diabetes with diet and a United- Healthcare Medicaid managed care plan that finances affordable housing.

Even something as existential as loneliness is now on the agenda.

Meanwhile, the medical care that has been in managed care’s tenuous, awkward, embrace has gone topsy-turvy: hospitals that have no beds and homes that have turned into ad hoc hospitals.

And the chronic disjointedness of American health care—of course, there is an app for that.

These innovations are at the pilot, project, skunkworks, and seed-and-seedling stage. You skeptics might be right about how viable they are and how much of a difference they might make.

And you cynics, you might have a point that they are distractions, the trendy folderol that American health care busies itself with while profits and prices climb. And there’s growing concern about what all the data might be used for.

But let’s give it a chance. Even if just one or two of these ideas take root and grows into something lasting and substantial, Americans and their health care will be better for it.


Our Yearlong Look: Emergency Care Examined
By Michael D. Dalzell
By Lola Butcher