Current and future developments in managed care in the United States and implications for Europe

Abstract

The paper reviews and evaluates current and future approaches to cost containment in the United States. Managed care was once seen as an effective approach to supporting health care quality while containing costs in the USA. In recent years payors started to look in other directions, since prospects for limiting expenses faded. Nowadays consumer driven health plans seem to be on the rise. The reasons for the decline of managed care, the growing popularity of the consumer driven health plans and the implications for Europe are discussed.

Figure 1

Annual percent change per capita health care spending United States 1991 – 2002.

Figure 2

Annual percent change per capita spending for private health insurance United States 1988 – 2002.

Figure 3

Participants in consumer drive health plans United States 2001 – 2004.

Figure 4

Percent of employees adopting consumer driven health plans United States 2003.