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2022 | OriginalPaper | Chapter

5. Versicherungsorientierte Managed-Care-Organisationen und -Produkte

Author: Volker Eric Amelung

Published in: Managed Care

Publisher: Springer Fachmedien Wiesbaden

Zusammenfassung

Häufig werden Versicherungen als Ursprung von MCOs betrachtet. Auch wenn dies für die Wiederbelebung von Managed Care seit Mitte der 70er Jahre durchaus zutrifft, liegen die Ursprünge in den USA eher bei der Risikoübernahme durch die Leistungsersteller in den 20er Jahren in Form der sogenannten Prepaid Group-Pratices (PGP).

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Der folgende Teil wurde initial von Prof. Dr. Mirella Cacace geschrieben und anschließend überarbeitet und erweitert.

Hervorzuheben ist, dass es sich bei CDHP lediglich um eine rudimentäre Form der Versicherung handelt, bei der nur in geringem Maße zu einer kollektiven Umverteilung kommt. Dennoch, so argumentiert beispielsweise Schreyögg (2003), kann berechtigt von einer Versicherung gesprochen werden, da es sich auch bei einer Ansparung um eine Form der Risikoabdeckung handelt.

Dies veranlasste Uwe E. Reinhardt von der Princeton University zu einer amüsanten (aber doch wohl eher fiktiven) Anekdote im Economix Blog der New York Times. Er beschreibt, wie ihn seine Frau kurz vor dem Weihnachtsabend für eine Koloskopie anmeldet, um das Restguthaben in seinem FSA nicht verfallen zu lassen (siehe U.E. Reinhardt: The Trouble with (In)flexible Spending Accounts: http://economix.blogs.nytimes.com/2009/05/29/the-trouble-with-flexible-spending-accounts/).

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Title: Versicherungsorientierte Managed-Care-Organisationen und -Produkte
Author: Volker Eric Amelung
Publisher: Springer Fachmedien Wiesbaden
Book: Managed Care
Print ISBN: 978-3-658-12526-4

Electronic ISBN: 978-3-658-12527-1

Copyright Year: 2022
DOI: https://doi.org/10.1007/978-3-658-12527-1_5

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5. Versicherungsorientierte Managed-Care-Organisationen und -Produkte

Zusammenfassung

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