To
help our customers identify issues and trends in managed care
contracting and manage profitability, Evergreen Re first introduced
the Managed
Care Indicator five years ago. This is our fifth annual
study on capitation and managed care issues of interest to providers
and payors.
The past few
years have been challenging for every person in this country and
the healthcare industry in particular. The events of September
11 and the overall economic environment have impacted all healthcare
entities. While the attacks in New York and Washington, D.C. did
not result in large-scale medical expenditures for injured individuals,
an increase in utilization due to stress-related symptoms did
occur. In addition, the increase in office visits and emergency-room
treatments for flu-like symptoms and antibiotic prescriptions
in the wake of the anthrax scare hit healthcare’s bottom
line. Now, several years later, carriers' exposure in property
casualty lines continue to cause further hardening in the reinsurance
market.
In the five
years we have conducted this study, physician groups, IPAs and
hospitals have shown they are learning to better manage the potential
profits and underlying risks associated with managed-care contracts.
Managed care continues to be Darwinian. Larger provider organizations
can negotiate more effectively with health plans and have more
resources to manage their contracts and streamline operations.
The study findings indicate there is room for additional profit
as organizations gain a clearer understanding of the costs and
frequency associated with each service they provide, know the
level of risk they should retain and are aware of the role of
reinsurance in enhancing predictability and protecting financial
stability.
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the Full Report Now
If you would
like to participate in our next survey, please email abischoff@evergreenre.com.
Managed
Care Indicator
