Impact of managed care on health care delivery practices as perceived by health care administrators and practitioners
Managed care has had a significant impact on many components of the U.S. health care delivery system such as cost effectiveness, access to care, and quality of care. These changes have affected how administrators and practitioners perceive the impact of managed care on health care delivery practices. The problem of this study was to explore whether health care administrators and practitioners perceive the impact of managed care on health care delivery practices differently and to explore which organizational variables explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrator and practitioner health care professionals from high, moderate, and low managed care penetration markets. Two investigator-developed instruments, the Managed Care Perceptions Inventory (MCPJ) and the MCPI-D, and an intact centralization of decision-making assessment subscale were used for data collection. A study recruitment letter and the three instruments were mailed to their randomly selected places of employment followed by two reminder letters. Health care professional role (administrator versus practitioner), managed care market penetration, profit status, and centralization of decision making were the key study variables. Only health care professional role yielded a difference in managed care perception in that administrators had a statistically significant more positive perception of the impact of managed care on health care delivery~ however, none of the other three variables contributed to the difference. When distinction between administrator versus practitioner was not used as a grouping factor, managed care market penetration, not-for-profit status, and years in current employment position were statistically significantly associated with a more positive perception of managed care. To impact positive change in perceptions, organization administrators must become and remain aware of their own managed care environment by regularly monitoring the perceptions of administrators and practitioners and incorporating associated management interventions. Similarly, practitioners must monitor their own perceptions and seek to manage any negative perceptions. They should express all needs or concerns to their organization's administrators and work collaboratively to remain involved and well informed about issues of importance. Recommendations for further research also are provided.