Rise of Managed Care in the USA: Lessons for Dentistry
Since the 1960s, the USA has experienced rapid growth in national health care expenditures, outpacing growth in other sectors of the economy. As a result, the late 1970s experienced a rise in the use of mechanisms designed to control the cost and utilization of health care. These mechanisms have come to be known as managed care. Various models of managed care have used different approaches to contain costs and improve health care quality, including capitation payments, restricted provider networks, and, more recently, financial incentives to reduce cost and improve health outcomes. In dentistry during the past two decades, the majority of the payment system has moved from primarily fee-for-service to one model of managed care called Dental Preferred Provider Organizations (DPPOs), which now accounts for more than 80 % of the market share for commercial plans. Despite a lack of recent growth in national expenditures for dental care, dentistry will need to become increasingly involved in new types of managed care due to emphasis on reducing costs and improving health care quality in the US health care system as a whole.