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The Trust Crisis in HealthcareCauses, Consequences, and Cures$
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David A. Shore

Print publication date: 2006

Print ISBN-13: 9780195176360

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780195176360.001.0001

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The Changing Relationship between Health Plans and Their Members

The Changing Relationship between Health Plans and Their Members

Chapter:
(p.160) 16 The Changing Relationship between Health Plans and Their Members
Source:
The Trust Crisis in Healthcare
Author(s):

Charles M. Cutler

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195176360.003.16

Managed care organizations (MCOs) provide a unique service by monitoring and assessing areas for improvement in healthcare. A brief historical account of the development of health insurance in the U.S. contextualizes the development of MCOs. MCOs attempt to keep healthcare affordable by holding providers accountable. Employers embraced health plans in the 1990s with the expectation that they would help save money. However, critics and the public started to believe that health plans' primary interest was in saving money instead of coordinating care, improving access, and providing preventative medicine. This chapter argues that consumers are unaware of how MCOs have brought a new emphasis on transparency and accountability to the healthcare system. Instead, consumer misunderstandings about their health plan choices, the care that is covered, and the cost and quality of MCOs, have led to significant trust issues. The chapter concludes by offering suggestions of how these trust issues can be addressed by increasing communication and responsiveness between MCOs, patients, and providers.

Keywords:   managed care organizations, MCOs, health plan, history of health insurance, trust in managed care

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