The End of an Era: What Became of the "Managed Care Revolution" in 2001?

Feb. 21, 2003
Health Services Research, 38:1, Part II (February 2003), pp. 337-355
Cara S. Lesser, Paul B. Ginsburg, Kelly Devers

Since the mid-1990s, managed care has developed differently than expected in local health care markets nationally. Three key developments shaped health care markets between 1999 and 2001: (1) unprecedented, sustained economic growth that resulted in extremely tight labor markets and made employers highly responsive to employee demands for even fewer restrictions on access to care; (2) health plans increasingly moved away from core strategies in the "managed care toolbox"; and (3) providers gained leverage relative to managed care plans and reverted to more traditional strategies of competing for patients based on services and amenities.

Changes in local health care markets have contributed to rising costs and created new access problems for consumers. Moreover, the trajectory of change promises to make the goals of cost-control and quality improvement more difficult to achieve in the future.

Click here for a PDF of the article.