Rise of Managed Care in the USA: Lessons for Dentistry
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First online:
Abstract
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.
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