THE MERCK MANUAL OF GERIATRICS, Ch. 16, Managed Care

Section 1. Basics of Geriatric Care
Chapter 16. Managed Care
Topics: Introduction \| Medicare Managed Care Organizations \| Health Risk Appraisal \| Geriatric Care Management \| Disease Management

Introduction

A method of integrating the financing and delivery of health care to manage quality, costs, and access to care for an insured population.

Managed care and geriatrics share certain principles, priorities, and goals:

Both emphasize preventive health care

Both attempt to proactively identify persons who will require care management

Both attempt to offer a coordinated continuum of care

Both attempt to provide care at the most cost-effective site (preferably the home)

Managed care organizations (MCOs) attempt to balance individualized care with population-based care (see Figure 16-1), applying the principles of appropriate medical management to populations in an attempt to control costs and improve quality. Although some health policy experts are concerned that managed care's attention to reducing costs may undermine quality of care, others believe it can minimize unnecessary costs while improving quality.