Managed care: What to expect as medicare-HMO enrollment grows: Part 1 of a two-part roundtable discussion

Managed care is restructuring the American health care system and is beginning to make inroads into the Medicareeligible population. Advantages of managed care for older patients include an emphasis on prevention, more flexibility in care delivery, and fewer restrictions and wider coverage (eg, prescriptions) than Medicare fee-for-service, and opportunities to develop measures for quality of care. Disadvantages include limitations on access and choice and a potential for professional conflict of interest. Early managed care enrollment favors the healthy "young-old;" questions remain about whether HMOs can provide quality care to the-frail elderly with complicated and expensive health care needs.