The Five Stages of Managed Care

There are five stages of managed care, with quite predictable market events and strategic responses. At every stage, a new set of relationships evolves among the major players, including physicians and hospitals, HMOs and insurers, employers and government. That is, at each higher level of managed care penetration, providers, payers, and purchasers restructure their relationships, as the players seek to control their market and their destiny. The key to the variance in the stages is HMO enrollment. The higher the stage number, the higher the HMO enrollment percentage. The purpose of this book is to inform the health field about the predictable pattern of HMO growth and managed care development and to outline sustainable strategies for coping with each stage of managed care. Providers, HMOs, and suppliers will need successful integration strategies, or they will be isolated as,vendors" and struggle to survive