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Centre for Policy on Ageing | |
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| Is managed care good or bad for geriatric medicine? | | Author(s) | Mark S Lachs, Hirsch S Ruchlin |
| Journal title | Journal of the American Geriatrics Society, vol 45, no 9, September 1997 |
| Pages | pp 1123-1127 |
| Keywords | Health services ; Medical care ; Private health services ; United States of America. |
| Annotation | Vignettes are used in this article to examine the simultaneous dangers and opportunities which managed care brings to geriatric medicine. While the complex multifactorial syndromes prevalent in older adults might at first glance seem poorly handled under capitation, the authors argue that the incentives provided under existing delivery systems can be equally perverse. These improper incentives have arisen from: the fee-for-service payment mechanism itself, which has spawned a subspecialty culture ill-equipped to deal with the primary care needs of older adults; and the fragmentation of funding sources for geriatric care into two major payers (Medicare and Medicaid), encouraging providers to focus on cost shifting rather than logical integration of services. The result has been a delivery system that provides little impetus to maximise functional status. Because doctors may assume financial risk under global capitation, and because the cost of caring for a frail older adult is inversely related to functional status, managed care offers the potential to align the goals of cost containment with the goals of modern geriatric medicine. Doctors should have a voice in the design and implementation of these systems. (RH). |
| Accession Number | CPA-981127210 A |
| Classmark | L: LK: LH: 7T |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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