THE ROLE OF MANAGED CARE PRODUCTS IN MANAGED CARE PLANS

This paper presents information about the form and structure of manage d care products offered by group/staff health maintenance organization s (HMOs), network/independent practice association (IPA) HMOs, and pre ferred provider organizations (PPOs). The information comes from a 199 4 national survey of managed care plans and their arrangements with ph ysicians. The findings confirm that multiple product offerings are now common in managed care plans. The two reasons plans most often cite f or including these expanded offerings are to respond to customer inter est and to ease the transition to more traditional managed care. Thoug h plans commonly use a consistent provider network for different produ cts, they also vary some arrangements with physicians across their pro ducts and pay them in different ways. We discuss the implications of o ur findings-the most comprehensive study of these issues to date-to ai d in understanding the evolution of markets and of managed care, and a s a basis for the design of future research and the databases it will require.