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Managed Care


The growth in managed care in both the public and private sectors is having a significant impact on the U.S. health care system. To assist pediatricians and child advocates to respond to this growing trend effectively, the American Academy of Pediatrics offers various resources and publications through the Division of Health Care Finance and Quality Improvement and the Committee on Child Health Financing. The following resources, available through the AAP BookStore, can be seen as a toolbox of strategies and guidance materials to assist pediatricians and families in understanding and challenging the demands of managed care. With so many routes to take in managed care, these resources will help guide pediatricians and families in the right direction.

  • With over 200 pages of information, the manual " A Pediatrician's Guide to Managed Care"(2nd edition) supplies critical advice pediatricians can use immediately for negotiating contracts, evaluating capitation rates, assessing physician organization models, and clarifying legal issues. It includes the updated Model Managed Care Agreement and a series of issue briefs on managed care and children with special health care needs.

  • The brochure " How to Use Your Managed Care Plan Effectively: Questions and Answers for Families" (see full text) is designed to be used by pediatricians to help families understand the nuances of managed care. Using a question and answer format, the brochure provides easy-to-understand explanations on a variety of managed care policies and procedures.




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