MANAGED CARE - WHAT TO EXPECT AS MEDICARE-HMO ENROLLMENT GROWS .1.

Managed care is restructuring the American health care system and is b eginning to make inroads into the Medicare-eligible population. Advant ages of managed care for older patients include an emphasis on, preven tion, more flexibility in care delivery, and fewer restrictions and wi der coverage (eg, prescriptions) than Medicare fee-for-service, and op portunities to develop measures for quality of care. Disadvantages inc lude limitations on access and choice and a potential for professional conflict of interest. Early, managed cure enrollment favors the healt hy ''young-old;'' questions remain about whether HMOs can provide qual ity care to the frail elderly with complicated and expensive health ca re needs.