Can the NHS learn from US managed care organisations?

doi:10.1136/bmj.328.7433.223

BMJ 2004;328:223-225 (24 January), doi:10.1136/bmj.328.7433.223

Education and debate

Can the NHS learn from US managed care organisations?

Jennifer Dixon, director¹, Richard Lewis, visiting fellow¹, Rebecca Rosen, fellow¹, Belinda Finlayson, research officer¹, Diane Gray, visiting fellow¹

¹ Health Policy, King's Fund, London W1G 0AN

Correspondence to: J Dixon jdixon@kingsfund.org.uk

A new King's Fund study identifies factors associated with efficientmanagement of chronic disease in the United States

The first 150 words of the full text of this article appear below.

Managed care organisations in the United States have some parallelswith primary care trusts in the NHS. A key aim of both is toimprove health so that avoidable use of health care is reduced.Managed care organisations have strong inbuilt incentives tomanage the care of enrolled patients proactively (box 1). Twostudies recently reported that hospital admissions and use ofday beds for the population of one managed care organisation,Kaiser Permanente North California, were less than that fora comparable population in the NHS.^2
3 The findings raised hotdebate, and the study by Feachem et al was criticised mainlybecause of the methods of comparing the US and NHS populationsserved and costs.⁴ On the assumption that the reduction is real,we examine what factors might contribute and whether the NHScould adopt them.

The Department of Health is already funding two pilot projectsmodelled on Kaiser . . . [Full text of this article]

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