How mature is your organization's prevention effort? Four stages of managed care health promotion.

Rooted in prevention since the 1973 HMO Act, managed care has weathered seasons enough to put down roots in patient education and preventive services. Now it shows a readiness for re-potting. For health promotion to reach full maturity and realize its highest calling, its roots need to spread into the community. Analysts have posited four stages of managed care market penetration; similarly, I propose four stages of maturation in managed care-based prevention initiatives (Table 1). These stages of prevention are based on an analysis of more than 100 presentations from a series of "Managed Care to Managed Health" conferences sponsored by The Institute for Research and Education, Health-System Minnesota in Minneapolis. The following descriptions of the stages of maturation illustrate the development of prevention efforts--from patient education and preventive services in early stages to improving the health of enrollees and ultimately the community in later stages.