Some of them reason this way even though they don't think very highly of managed care for a middle-class, employed population. At the very least, he said, managed care can only do better than the current system in ensuring that pregnant women get prenatal care and children get their vaccinations. All too often their care was defaulted to emergency rooms. That paradigm has to be turned on its head in a managed care environment. The emergency room cannot be a primary care provider.
Preventive services are essential in order for a managed care organization to be able to operate.
To date, however, that paradigm shift has not necessarily occurred. Under the traditional system, he said, no health care provider has had to take responsibility for the access and quality problems encountered by Medicaid beneficiaries. We all feel bad about it, but none of us is responsible for making it better, and no one is accountable for not making it better. ACP also sees some potential in improving Medicaid by drawing on the strengths of managed care. You just can't slash the money and say that solves the problem.