Managed Care

“Managed care” refers to systems for delivering medical care that attempt to control costs and improve quality by monitoring how clinicians treat illnesses, limiting referrals to specialists, and requiring payors' authorization prior to hospitalization and other specialized treatments. These systems have grown since the 1960s, when the US federal government launched the Medicaid and Medicare programs. The term may be considered a rhetorical ideograph, for it describes an ideology of healthcare organization, operating as a slogan as much as a descriptor. Commonly recognized organizational forms associated with managed care include health maintenance organization, preferred provider organizations, and accountable care organizations. Health and organizational communication researchers have studied how managed care changed the ways that clinicians worked together and communicated with each other. Researchers have also documented how managed care organizations have come to dominate the healthcare landscape of the United States while failing to limit cost increases, compared to other countries. Both clinicians and nurses have expressed various degrees of dissatisfaction with working under managed care rules. Managed care has not facilitated access to care by members of lower socioeconomic groups. The entry discusses future directions for research.