APPROACHES TO PROSTATE-CANCER BY MANAGED CARE ORGANIZATIONS

Objectives. Managed care organizations (MCOs) are developing populatio n-based approaches to illnesses with large numbers of patients, wide v ariations in care and outcomes, and high costs. This is the first surv ey that evaluates current prostate cancer approaches by MCOs. Methods. Case studies and a survey of corporate medical directors at large MCO s were conducted. Results. Two approaches, broadly based on disease ma nagement strategies for men with prostate cancer, have been implemente d in managed care settings on the West Coast. While both have provided comprehensive approaches to the disease, assessment of improvement in outcomes will require longer follow-up. A survey of corporate medical directors of MCOs indicates that population-based disease approaches nationwide for malignant prostate disease lag behind more well-develop ed efforts for nonmalignant illnesses such as diabetes and asthma. Con clusions. Prostate cancer may be a feasible area for development and e valuation of population-based approaches. MCOs have the potential to i mprove clinical care and outcomes for large numbers of men with prosta te cancer. While limitations exist related to specific managed care co nsiderations of data needs and lack of medical and surgical consensus on disease management, programs based on shared decision making have t he potential to improve patient care and outcomes. (C) 1997, Elsevier Science Inc. All rights reserved.