Purchasers and the Impact of Managed Care on Physicians. (Value-Based Health Care)‪.‬

PHYSICIANS IN PRACTICE ARE INTENSELY AWARE THAT managed care represents a change in the way that medicine is practiced. Which patients physicians see, whether care is authorized, and how professional services are compensated are activities fundamental to modern medical practice, which is undergoing radical transformation along lines shaped by managed care organizations (MCOs). Based on this direct experience many physicians believe that the changes in American health care impacting their professional lives have been caused by MCOs. These physicians seek to understand the new health care environment and to limit its impact by controlling the way MCOs operate. (1) These physicians are mistaken in their belief that MCOs are the fundamental force changing the U.S. health care system: MCOs are only messengers. This error also serves to blind physicians to the greater marketplace dynamics--the real forces shaping U.S. health care. It can create an "us versus them" mentality in which progress or understanding is difficult. Finally, it leaves physicians on the sidelines at a time when their voices are critical to defining the emerging health care system in a way that can satisfy the needs of patients, physicians, and purchasers alike.