A BROADER VISION FOR MANAGED CARE, PART-1 - MEASURING THE BENEFIT TO COMMUNITIES

Managed care plans are nicely positioned to influence communities in w ays that extend well beyond the provision of health care services. Wit h their vested interest in keeping populations healthy, they have cont ributed to a growing focus on addressing the social and economic facto rs that affect community health. This paper by Mark Schlesinger and Br ad Gray asks whether a community benefit standard should be imposed in the managed care industry as a measure of plans' contribution to loca l communities. The authors suggest that although there are a number of indications that managed care has embraced the concept of community b enefit, the future of plans' participation in communities-particularly their participation in providing safety-net services-is precarious. W ithout explicit incentives to make measurable contributions to the com munities in which they operate, managed care organizations will serve the health care needs of their enrollees but will not necessarily defi ne a broader community role for themselves. Schlesinger and Gray look at the evolution of the concept of community benefit and at the dynami cs that have contributed to its increasing importance and its increasi ng fragility as a health policy issue. Schlesinger, who holds a doctor ate in economics, is an associate professor of public health and a fel low of the Institution for Social and Policy Studies at Yale Universit y. Gray, who holds a doctorate in sociology, is director of the Divisi on of Health and Science Policy at the New York Academy of Medicine. T his is the first paper in a two-part series; the second part will be p ublished in Health Affairs later this year.