Managed Health Care: U.S. Evidence and Lessons for the National Health Service (State of Health Series)

Healthcare in the United States has undergone a managed-care revolution, which has transformed the way in which health services are financed and delivered. Arising from this experience, techniques such as utilzation management, physician profiling and disease management are attracting attention in this field. Many management consultants, pharmaceutical companies and policy analysts advocate managed care as the way forward for improving the performance of healthcare systems. This is a systematic review of the research evidence on managed care in the US, assessing its performance in terms of its impact on utilization, costs, health promotion and screening, quality of care, and other key indicators. The authors then consider the development of managed care approaches in the NHS, with particular reference to the early research evidence on the primary care-based, total purchasing pilot projects.