April 1997

Do We Understand the Effects of 'Managed Care' in Ophthalmology?A Review and Analysis

Author Affiliations

From the Health Sciences Program, RAND, Santa Monica, Calif (Drs Asch, Goldzweig, and Lee); the University of Southern California School of Medicine, Los Angeles (Dr Lee); the University of California, Los Angeles, School of Medicine (Drs Asch and Goldzweig) and the Department of Veterans Affairs, Los Angeles (Dr Asch). The authors have no proprietary interest related to the subject matter in this article.

Arch Ophthalmol. 1997;115(4):531-536. doi:10.1001/archopht.1997.01100150533016

Little has been published that directly assesses the effect of structures for providing managed care or the effects of capitated, prepaid financing on the cost and quality of eye care services. Managed care organizations use fewer ophthalmologists and may provide more screening for diabetic retinopathy. Studies of nonophthalmologic care show lower patient satisfaction with care, and mixed effects on cost, quality of care, and access to care, but are difficult to generalize to eye care. We reviewed the published peer-reviewed literature about this topic. Notable gaps exist in the knowledge of critical elements of the influence of managed care on providing eye care and on patient outcomes. Existing measures of quality, cost, satisfaction, and access could easily be adapted for use in evaluating the influence of managed care and guiding health care policy.