[New models in the model (Managerial challenges in the Hungarian managed care model)].

The Hungarian managed care model integrates the different levels of health care services. Its goal is a more efficient resource allocation within the health care system, quality improvement of services, developing incentives and financing methods. The basic concept of the model is to introduce the benefits of the American managed care and the British fundholding system. The managed care model brought a new approach in the Hungarian health care system and meets a lot of expectation in both professional and political context. The model has certain problems, but these are handled at macro level. Without an integrated approach of macro, meso and micro levels is hardly believable the efficient and effective functioning of the model. Such macro level problems are the cost-efficiency versus high quality health services, financing incentives, and risk taking. At meso and micro level we are facing with questionable efficiency and effectiveness of the MCOs other health care organisations, which are based on strong bureaucratic paradigms and are convicted to a long lasting crisis in their changing environment. The integrated use of Mintzberg's management models (machine model, network model, performance-control model, virtual government model and normative-control model) adapted by us for the Hungarian managed care model could resolve certain problems or make them at least more solvable. In the changing environment of the health cares organisations the top management has to frame the change-scenario, to initiate, realise and sustain organisational changes. Achieving this, the proposed management models are a useful support. Their practical application could contribute to the efficient and effective functioning of the Hungarian managed care model at macro, meso and micro levels, as well.