Managed care: The changing environment for consumers and health care providers

“Managed care is the health law issue of 1999” (Leibold, 1999, p. 5). This chapter addresses changes in the health care system initiated by the managed care paradigm — which, in turn, has prompted many legal changes and challenges. Specifically, this chapter will describe the following: (a) an overview of the managed care system versus the traditional fee-for-service system; (b) a selected review of research literature on the strengths and limitations of the managed care system; and (c) a projection of the future trends of the managed care system for patients, consumers, health providers and society. The second area, the review of research literature, will include the impact of managed care on patients, consumers, physicians and nurses. In this chapter, the word patient, means someone who is ill; the word consumer, means someone who has health insurance and may become ill in the future and needs to utilize the health delivery system.