Managed care rapidly gained and quickly lost favor more than a decade ago, but even as it lost ground, it never fully lost a hold in the market. Now, it's an increasingly popular option among seniors enrolled in Medicare, and some managed-care tenets—care coordination led by primary care and capitation—have re-emerged under new models endorsed by the Patient Protection and Affordable Care Act.
Nonetheless, the debate continues over whether patients benefit when insurers, doctors and hospitals have more financial incentives to closely manage care. The sickest patients could lose if they are shunned by health plans or providers looking to avoid the higher costs of their care. But incentives may also provide financing for care coordination to prevent or better manage chronic diseases and their costs.
Answering the question is increasingly important as enrollment in Medicare Advantage grows, Congress debates Medicare policy and new payment models proliferate under health reform.