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Invited Commentary
Health Care Reform
October 2017

Social and Behavioral Determinants of Spending

Author Affiliations
  • 1Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 3now with Washington University School of Medicine, St Louis, Missouri
JAMA Intern Med. 2017;177(10):1431-1432. doi:10.1001/jamainternmed.2017.3325

A growing proportion of state and federal health care dollars are spent via managed care, in which government pays private companies to administer insurance coverage on its behalf. Recent reports suggest that as many as 77% of Medicaid beneficiaries are enrolled in some type of managed care plan,1 and Medicare Advantage, which is Medicare’s managed care option, now enrolls nearly a third of Medicare beneficiaries.2

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