Use of preventive services by managed care enrollees: An updated perspective

We examined whether enrollees in managed care plans received more preventiv e services than enrollees in non-managed care plans did, by conducting an u pdated literature synthesis of studies published between 1990 and 1998, We found that 37 percent of comparisons indicated that managed care enrollees were significantly more likely to obtain preventive services; 3 percent ind icated that they were significantly less likely to do so; and 60 percent fo und no difference. Enrollees in group/staff-model health maintenance organi zations (HMOs) were more likely to receive preventive services, but there w as little evidence, outside of Medicaid managed ca re, that managed care pl ans are worse at providing preventive services, However, most of the eviden ce is equivocal: Provision of preventive services was neither better nor wo rse in managed versus non-managed care plans. Because of the blurred distin ctions among types of health plans, more research is needed to identify whi ch plan characteristics are most likely to encourage appropriate utilizatio n.