Advocacy in the New World of Managed Care

Abstract

With the recent emergence of large-scale health care companies, advocacy's role within the system has been reduced. Already occupying only a minor role in case management (itself partly subsumed into the system), advocacy efforts to help individuals and to make structural changes at the system level run against the driving forces of managed care–cost containment and profit making. Practitioners within the managed-care system may be able to carry out some case-and-cause advocacy within the limits of company requirements and possible job jeopardy. Greater efforts will have to come from outside groups focusing on broad issues, including patients' rights; standards of care; consumer empowerment; outside evaluations; maldistribution of physicians and other personnel; protection against lowering of quantity, type, and quality of services; and training of managed care personnel.