Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
To the Editor: The American Heritage Dictionary1 defines the word managed
as "to exert control over." I propose that Medicare fee-for-service (FFS)
medicine is not only managed care, but managed care's best model.
Fee-for-service Medicare may appear unmanaged: patients go to whatever
clinician they want, who then bills for each service rendered or diagnosis
treated; the bill is then paid by Medicare. "Unmanaged" may have described
yesterday's Medicare, but not today's. Medicare is a managed care system,
although differently managed compared with preferred provider organizations
and health maintenance organizations. Were it not, Part A would already be
bankrupt, and the Part B premium would have escalated precipitously.
Olds JW. Medicare Fee for Service: A Model of Managed Care?. JAMA. 1999;282(11):1037. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-11-jac90008