Using Managed Care Tools in Traditional Medicare — Should We? Could We?

Berenson and Harris consider whether the most controversial tools of managed care, including selective contracting, gatekeeping, and prior authorization, should be adopted in the Medicare program. On policy and practical political grounds, they do not recommend selective contracting or gatekeeping. Nevertheless, Medicare should be granted the authority to have preferred providers and case management programs that could treat providers differently and could permit certain beneficiaries to receive additional, off-policy benefits.