Managed Care

* With the spectacles of FPA’s collapse last summer and MedPartners’ collapse this month (March 13), the chickens are coming home to roost on managed care in general and physician practice management companies in particular. Except a better metaphor would be Hitchcock’s “The Birds.”

In 1995, the mantra of the administrators of health care was that the providers (physicians and hospitals) would continue to be squeezed financially until “quality or access was affected.” We are about to find out what that looks like. In the past few years there has been no room for quality initiatives or real improvements in information systems. The easier way was to cut reimbursements ever further. Now that hardly anyone is left standing after this price war, absolutely everything in health care delivery will need to be reconsidered.

RICHARD ZALAR MD

Rancho Palos Verdes