Business Law

Business Law News 2015, Issue 2

The Abyss of Managed Care and its 40-Year Impact on Payer/Provider Relations

Craig B. Garner1

Craig Garner is an attorney and health care consultant, specializing in issues surrounding modern American health care in its current climate of reform. Between 2002 and 2011, Craig was the Chief Executive Officer at Coast Plaza Hospital. Craig is also a Fellow with the American College of Healthcare Executives.

"God hates violence. He has ordained that all men fairly possess their property, not seize it."2

Modern American health care affords every hospital patient the inalienable right to emergency treatment,3 although this same system has yet to create any parallel infrastructure beyond the clinical delivery of such care. While today’s emergency department physicians across the nation have access to cutting-edge, integrated technology-based tools4 designed to improve patient outcomes by combining advances in medicine with evidence-based clinical guidelines,5 the science of overseeing managed care patients often appears to be light years removed from the era in which it was born.6 As a result, American health care has become a system of fundamental brilliance that finds itself limited by gross inefficiencies,7 a combination that has led to a symbolic, if not actual, nationwide revolution.8

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