Managed care woes: industry trends and conflicts.

Although managed care plans have had success in controlling costs, they now face challenges on many fronts, including tighter profit margins, pressure for broader provider networks, increasing clout of hospitals and physicians and more demand for consumer protection regulation. Underlying these trends is a fundamental conflict between health plans and consumers, who are demanding--and, in many cases, getting--greater control over their health care delivery and services. This Issue Brief reports on a roundtable convened by the Center for Studying Health System Change to discuss these trends and conflicts and how they may play out over the next number of years. (1) Managed care challenges, (2) Redefining care delivery, (3) Investing in information systems, (4) Center survey findings about managed care, (5) Who's in control, (6) HCFA as a value purchaser, (7) Backlash fueled by many groups, (8) What about the future.