ACP position paper calls for reform to ensure managed care improves patient health
The College stresses that managed care strategies should be designed to improve health outcomes rather than focusing solely on reducing costs.
A new position paper from ACP, “Principles of Managed Care,” published Nov. 25 in Annals of Internal Medicine, stresses that managed care strategies should be designed to improve health outcomes rather than focusing solely on reducing costs.
As health care costs continue to rise in the U.S., the use and potential misuse of strategies like prior authorization and narrow clinician networks are likely to grow, ACP notes. These policies can lead to administrative burden for physician practices, delayed or forgone care, and worse health outcomes for patients.
The paper offers recommendations to safeguard the patient-physician relationship, prevent inappropriate barriers to care, and ensure that managed care supports high-value, medically necessary services. ACP calls for streamlined payment and administrative processes, greater transparency, and utilization management decisions grounded in evidence-based standards and current clinical guidelines.
ACP also mentions that collaboration among health plans, patient advocacy groups, physician organizations, policymakers, and other stakeholders is essential to ensure that managed care fulfills its primary purpose of connecting patients with timely, equitable, evidence-based care.