TO TELL THE TRUTH - DISCLOSING THE INCENTIVES AND LIMITS OF MANAGED CARE

As managed care becomes more prevalent in the United States, concerns have arisen over the business practices of managed care companies. A p articular concern is whether patients should be made aware of the fina ncial incentives and treatment limits of their healthcare plan. At pre sent, managed care organizations are not legally required to make such disclosures. However, such disclosures would be advisable for reasons of ethical fidelity, contractual clarity, and practical prudence. Phy sicians themselves may also have a fiduciary responsibility to discuss incentives and limits with their patients. Once the decision to discl ose has been made, the managed care organization must draft a document that explains, clearly and honestly, limits of care in the plan and p hysician incentives that might restrict the care a patient receives.