Abstract
In this introduction, the development tendencies that aid and impede managed care will first be discussed and subsequently, a definition framework developed. This framework will address in more detail the instruments and organisational forms, as well as the consequences that result. The so-called called “managed care backlash” that first manifested itself almost 20 years ago after a period of significant growth will also be addressed.
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Literature
Amelung, V. E. (2012). Managed care: Neue Wege im Gesundheitsmanagement. Wiesbaden: Gabler Verlag.
Amelung, V. E., Weatherly, J. N., Deimel, D., Reuter, W., & Van Rooij, N. (2008). Managed care in Europa. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft.
Amelung, V. E., Eble, S., & Hildebrandt, H. (2011). Innovatives Versorgungsmanagement: Neue Versorgungsformen auf dem Prüfstand. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft.
Baker, L. (2011). Managed care. In S. Glied & P. C. Smith (Eds.), The Oxford handbook of health economics. Oxford: Oxford University Press.
Baumberger, J. (2001). So funktioniert Managed Care. Anspruch und Wirklichkeit der integrierten Gesundheitsversorgung in Europa. Stuttgart: Thieme.
Berchtold, P., & Hess, K. (2006). Evidenz für Managed Care – Europäische Literaturanalyse unter besonderer Berücksichtigung der Schweiz: Wirkung von Versorgungssteuerung auf Qualität und Kosteneffektivität (Arbeitsdokument 16). Schweizerisches Gesundheitsobservatorium (Obsan), Zollikofen.
Berchtold, P., & Huber, F. (2011). Schweizer Ärztenetze: ein Beitrag zur Integrierten Versorgung. In V. E. Amelung, S. Eble, & H. Hildebrandt (Eds.), Innovatives Versorgungsmanagement: Neue Versorgungsformen auf dem Prüfstand (pp. 91–99). Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft.
Binder, A. (2015). Die Wirkung des morbiditätsorientierten Risikostrukturausgleichs auf innovative Versorgungsformen im deutschen Gesundheitswesen (Gesundheits- und Qualitätsmanagement). Wiesbaden: Springer Gabler.
Brown, L. D., & Amelung, V. E. (1999). “Manacled” competition in the German health insurance market. Health Affairs, 18(3), 76–91.
Buchanan, A. (1998). Managed care: Rationing without justice, but not unjustly. Journal of Health Politics, Policy and Law, 23, 617–634.
Cafferky, M. E. (1997). Managed care and you – The consumer guide to managing your health care. Los Angeles: Practice Management Information Corporation.
Cambridge Advanced Learner’s Dictionary. (2013). Cambridge: Cambridge University Press.
CMS. (2016). Multiple chronic conditions. Last accessed March 13, 2018, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/MCC_Main.html
Cooper, P., Simon, K., & Vistness, J. (2006). A closer look at the managed care backlash. Medical Care, 44(5), I-4–I-11.
Cosgrove, T. (2013, September 24). Value-based healthcare is inevitable and that’s good. Harvard Business Review.
De Pietro, C., Camenzind, P., Sturny, I., Crivelli, L., Edwards-Garavoglia, S., Spranger, A., Wittenbecher, F., & Quentin, W. (2015). Switzerland: Health system review. Health Systems in Transition, 17(4), 1–288.
DeStatis. (2016). Studierende: Studienfach Medizin. Last accessed March 6, 2018, from https://www.destatis.de/DE/ZahlenFakten/Indikatoren/LangeReihen/Bildung/lrbil05.html
Draper, D., Hurley, R. E., Lesser, C. S., et al. (2002). The changing face of managed care. Health Affairs, 21(1), 11–23.
Fox, P., & Kongstvedt, P. R. (2013). An overview of managed care. In P. R. Kongstvedt (Ed.), The managed health care handbook (pp. 3–15). Gaithersburg: Aspen.
Gerlinger, T. (2003). Gesundheitsreform in der Schweiz – ein Modell für die Reform der Gesetzlichen Krankenversicherung (Vol. 38, pp. 10–30). Jahrbuch für kritische Medizin.
Glied, S. (1999). Managed care (NBER Working Paper Series). Cambridge: National Bureau of Economic Research.
Gruneir, A., Bronskill, S. E., Maxwell, C. J., Bai, Y. Q., Kone, A. J., Thavorn, K., et al. (2016). The association between multimorbidity and hospitalization is modified by individual demographics and physician continuity of care: A retrospective cohort study. BMC Health Services Research, 16, 154.
Harris, R. E. (2012). Epidemiology of chronic disease: Global perspectives. Burlington: Jones & Bartlett Learning.
Havighurst, C. (2001). Consumers versus managed care: The new class actions. Health Affairs, 20(4), 8–27.
Jérome-Forgot, M., White, J., & Wiener, J. (1995). Health care reform through internal markets. Montreal: Institute for Research on Public Policy.
Kaplan, R. S., & Porter, M. E. (2011). How to solve the cost crisis in health care. Harvard Business Review, 89(9), 47–64.
KFF [Kaiser Family Foundation]. (2016). Distribution of medical graduates by gender. Last accessed March 6, 2018, from http://kff.org/other/state-indicator/medical-school-graduates-by-gender/
Knight, W. (1998). Managed care: What it is and how it works. Gaithersburg: Aspen.
Kongstvedt, P. R. (2009). Managed care: What it is and how it works. Sudbury: Jones & Bartlett Publishers.
Kongstvedt, P. R. (2013). Essentials of managed health care (6th ed.). Burlington: Jones & Bartlett Learning.
Kühn, H. (1997). Managed care (Discussion Paper). Berlin: Wissenschaftszentrum.
Lehmann, H. (2003). Managed care. Kosten senken mit alternativen Versicherungsformen. Zürich: Rüegger.
Light, D. W. (1997). Gründe für den Kostenanstieg und Kostenkontrolle im Gesundheitswesen: Die Vereinigten Staaten. In M. Arnold, K. W. Lauterbach, & K.-J. Preuß (Eds.), Managed care. Stuttgart: DUV Gabler Edition Wissenschaft.
Mechanic, D. (2000). Managed care and the imperative for a new professional ethic. Health Affairs, 19(5), 100–111.
OECD [Organisation for Economic Cooperation and Development]. (2016a). OECD health data 2016. Data extracted on November 30, 2016, from http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT
OECD [Organisation for Economic Cooperation and Development]. (2016b). Health workforce policies in OECD countries – Right jobs, right skills, right places: Chart set. Published on March 15, 2016. Last accessed March 6, 2018, from http://www.slideshare.net/OECD_ELS/health-workforce-policies-in-oecd-countries-right-jobs-right-skills-right-places-chart-set
Payer, L. (1996). Medicine and culture (2nd ed.). New York: Holt.
Porter, M. E., & Lee, T. H. (2013, October). The strategy that will fix health care. Harvard Business Review.
Porter, M., & Teisberg, E. (2006). Redefining health care – Creating value-based competition on results. Boston: Harvard Business School Press.
Reschovsky, J., Hargraves, L., & Smith, A. (2002). Consumer beliefs and health plan performance: It is not whether you are in an HMO but whether you think you are. Journal of Health Politics, Policy and Law, 27(3), 353–377.
Scheidt-Nave, C., Richter, S., Fuchs, J., et al. (2010). Herausforderungen an die Gesundheitsforschung für eine alternde Gesellschaft am Beispiel “Multimorbidität”. Bundesgesundheitsblatt, 53, 441–450.
Schlette, S., Knieps, F., & Amelung, V. E. (2005). Versorgungsmanagement für chronisch Kranke. Bonn: Kompart.
Schumacher, H. (1996). Die Leistungsfähigkeit von Gesundheitssystemen im Vergleich. In Hamburger Jahrbuch für Wirtschafts- und Gesundheitspolitik (Vol. 41, pp. 189–215). Hamburg: Year.
Schwartz, F. W., & Wismar, M. (2003). Planung und Management. In F. W. Schwartz et al. (Eds.), Das Public Health Buch (2nd ed., pp. 558–573). Munich: Urban und Fischer.
SVR [Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen]. (2003). Finanzierung, Nutzerorientierung und Qualität. Gutachten 2003, Bonn.
SVR [Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen]. (2009). Coordination and integration – Health care in an ageing society. Special Report 2009 Abridged version.
Weatherly, J. N., Seiler, R., Meyer-Lutterloh, K., Schmid, E., Lägel, R., & Amelung, V. E. (2007). Leuchtturmprojekte Integrierter Versorgung und Medizinischer Versorgungszentren – Innovative Modelle der Praxis. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft.
WHO [World Health Organization]. (2008). The world health report 2008, primary health care, now more than ever. Last accessed March 6, 2018, from http://www.who.int/whr/2008/whr08_en.pdf
Zweifel, P. (2013). Managed care: Prescription for failure? Lessons from Switzerland. CESifo DICE Report 1/2013 (March).
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Amelung, V.E. (2019). Definitions and Concepts. In: Healthcare Management. Springer Texts in Business and Economics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59568-8_1
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