Managed care, school health programs, and adolescent health services: Opportunities for health promotion

The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed ca re organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emp hasis on prevention. cost-effectiveness, and quality of care - and a willin gness to explore innovative approaches to health promotion and disease prev ention. However, MCOs often face conflicting challenges, balancing the goal s of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the e ffectiveness of services in improving health and/or reducing medical expend itures. Mechanisms for improving prevention efforts within MCOs include qua lity assurance systems to monitor the performance of health plans. practice guidelines from professional organizations, and the contracting process be tween payers and health care providers. Development of partnerships between MCOs and schools, will be a challenge given competing priorities, variatio n in managed care arrangements. structural differences between MCOs and sch ools, and variability in services provided by school health programs.