Study: Medicare managed care plans may not control costs

A new study by a Texas physician challenges the notion that Medicare managed-care plans cut down on unnecessary surgeries.

The study, by UT Southwestern Medical Center chief of medicine Dr. Ethan Halm, examines differences in care for 11,400 Medicare patients who received a carotid endarterectomy over a 10 year period. This is a common, costly procedure for which managed care plans typically require pre-certification.

Halm, whose research was published in the American Journal of Medical Quality, found that while most of these procedures are done appropriately, about 9 percent aren't needed. He suggests that health plans should make more aggressive use of pre-approval protocols and existing clinical guidelines to avoid unneeded procedures.

To learn more about the study:
- read this piece in The Dallas Morning News