Consumer Voice and Representation in Managed Healthcare
54 Pages Posted: 31 Mar 2007 Last revised: 19 Apr 2013
The author examines the potential role for the public and, more specifically, for plan participants, in making managed care organizations (MCOs) respond to their wishes by means other than market exit. Market exit, or simply choosing an alternative means of procuring healthcare, is not an option for most plan participants -- and even when available, sends a message that is muted at best. Moreover, the author reasons that MCOs are imbued with a variety of quasigovernmental qualities; thus, it is appropriate that they should be more responsive to the requirements of their customers than, say, a retailer. Professor Rodwin describes and analyzes various ways that public policy and law could enhance the ability of consumers to help shape the policies of MCOs and discusses the pros and cons of differing means by which Consumer Voice can be represented.
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