A Study On Managed Care

Managed Care is a health care delivery system that integrates the financing and delivering of health care services. It came into being in the 1930s and developed in the 1970s. It has changed the traditional system in which the health care service provider and the health care insurers were not only separate but also opposite. This article is a study on the Managed Care through the theoretical and practical study. The mode of Managed Care is effective in reducing the medical cost and fee control.In China, the typical cases of Managed Care mode are Wuhan's Commercial Hospital's Health insurance and 413 Pattern put forward by Xiong Maoyou. Since China's market economy is still underdeveloped, the government still plays an important role in the resource distribution through intervention and monopoly of markets. There are some obstacles to develop Managed Care in China.There are four sections mainly concluded in this article:The first section studies the characteristics of the medical insurance.The second section is an introduction of the characteristics and development of Managed Care in foreign countries such as USA, UK and Mexico.The third section is an analysis and an evaluation of Managed Care. The analysis is based on the Principal-agent model. There are three indexes to evaluate the Managed Care: Efficiency Index, Merit Index, and Response Index.The fourth section discusses the reforms of China's medical insurance, the process of 413 Pattern, the obstacles of Managed Care's development in China, and its enlightenments on China.