Robert E. Hurley, Ph.D.
Department of Health Administration
Virginia Commonwealth University
December 2000
Paper prepared for the Office of the Assistant Secretary for Planning and Evaluation of DHHS.
TABLE OF CONTENTS
II. Turbulence in general health care market
A. Multi-party relationships
B. Financial pressures for plans and providers
III. Current concerns in public sector managed care
A. Medicaid
B. Medicare
C. The public sector challenge
IV. General trends in the managed care sector
A. Industry composition
B. Market Structure
C. Products diversification
D. Provider networks
E. Care management practices
V. Contemporary environmental pressures facing managed care organizations
A. Purchaser
B. Consumer
C. Provider
D. Regulatory—public and private
VI. Longer term challenges for managed care organizations
A. Looser models/products
B. HMO as niche-product
C. Clinical and administrative technology challenges
D. Purchaser preference changes
E. Lack of provider organization and sophistication
F. MCO lack of legitimacy
VII. Implications of trends for future managed care markets
A. Cost containment
B. Outcome improvement
C. Consumer acceptance
D. Provider cooperation
E. Public sector purchasing
VIII. Areas to Track for Policy Monitoring and Development
A. Industry Trends
B. Public Sector Trends
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