The Sloan Foundation: Managed Care

The dizzying pace of change in the emerging health care market poses significant challenges for practitioners and public policy decision makers alike.

The Managed Care Industry Research Center at Harvard University undertakes research with an "inside the industry" focus to provide accurate, in-depth information that describes and characterizes the emerging industry and its components. For instance, the Center helped redesign and field the American Association of Health Plans national survey for the most systematic look to date at the organization, medical management, and use of financial incentives by health plans. This major survey is of immediate benefit to the managed care industry, government, and purchaser and provider groups with an

interest in health plans, since the resulting data focus on quality assurance and improvement efforts, marketing and access to care, and contracting practices as they exist in the industry.

The Center has also produced findings from its study of industry components in California, where managed care has advanced most rapidly. Based on relationships with PacifiCare, a large HMO; Pacific Business Group on Health, a coalition of purchasers; the California Medical Association; independent practice and trade associations; and consumer advocacy groups, the Center compiled the first in-depth study to characterize the incentives used by medical groups and independent practice associations that affect the behavior of individual physicians. This study is expected to influence the course of legislation affecting financial incentives and physician compensation. Center research is influencing how two national plans, 10 large employers, and the state of Massachusetts contract for managed behavioral health services.

The Center is studying the effect of varying consumer incentives on use of health care services, the shifts in labor relations and human resources issues in health care, the role of provider-sponsored organizations as physicians seek greater control and a larger share of the premium dollar in the managed care environment, and the relationship between information systems and organizational performance as the structure of the health care industry undergoes dramatic change.