Accountable Managed Care: Should We Be Careful What We Wish For?

Managed care is exceedingly unpopular of late. Many people believe that the problem is managed care organizations (MCOs) are unaccountable. Indeed, for many people, the creation of tort-based accountability for MCOs is the touchstone for assessing legislative “reform.” The case for tort-based accountability is actually quite complex, and the merits of tort-based accountability cannot be resolved with sound bites and bad anecdotes. Tort-based accountability has both costs and benefits, and little attention has been paid to the extent to which alternatives to tort-based accountability are found in existing institutional arrangements.

This Article systematically considers the extent to which alternatives to the tort system have become widely accepted parts of the commercial landscape, and the trade-offs associated with the use of the tort system to deliver accountability. The Article concludes with ten suggestions for regulating managed care if the goal is actually to improve the care provided.