Medical Subject Headings (MeSH): Managed Competition

Managed competition is a healthcare reform concept that aims to create a more competitive marketplace for healthcare services, in order to control costs, improve quality and increase access to healthcare. It is based on the idea that competition among healthcare providers and insurance companies will lead to more efficient and effective use of resources, and that patients will have more choices and be more engaged in their own healthcare.

In a managed competition model, consumers are given a choice of private health plans, similar to the choices of plans available through the employer-based system. Insurers would compete for customers by offering different levels of coverage, co-payments, and benefit packages. The competition would be managed by an oversight entity that would ensure that all plans met certain standards, such as covering certain essential benefits, and providing access to quality care.

The oversight entity would also negotiate payments for services with healthcare providers, to ensure that the providers are reimbursed for services at a reasonable cost. This would create an incentive for providers to offer quality services at the lowest cost possible.

One example of the managed competition model is the health insurance exchanges created by the Affordable Care Act (ACA). These exchanges are state-based marketplaces where individuals and small business can purchase insurance plans. They allow consumers to compare different plans and their costs and make an informed decision on the one that better suit their needs.

Managed competition is an alternative approach to the traditional healthcare delivery system, which is often criticized as being overly bureaucratic and costly, and it aims to increase efficiency and improve the quality of care by encouraging competition among healthcare providers and insurers. However, implementing it effectively and fairly can be challenging, and there are many factors to be considered. It is important to have regulation in place to ensure that all citizens have access to quality care and that competition does not lead to a negative impact on certain population groups.