The managed care blues and how to cure them /

Zelman and Berenson offer a diagnosis and prescription for cure of managed care organizations in the US. They walk a middle road, asserting that managed care detractors and strong supporters both fail to recognize the values and flaws of managed care efforts to date. The government, they feel, will need to address shortcomings. Fears of poor quality are exaggerated, they say, though there are some managed care organizations that do not yet deliver quality care, especially to the vulnerable population. On balance, they conclude that managed care organizations have not yet demonstrated that they can deliver better quality of care than under the old fee-for-service system. After analyzing the industry, the authors offer 13 steps to improve managed care, such as emphasizing employee choice of delivery systems, not just choice of insurers; improving clinical performance; and moving physicians from opposition to leadership. Suitable for all levels of readers. J. E. Allen; University of North Carolina at Chapel Hill