Managed care and cardiac pacing and electrophysiology.

Managed care is having an increasing impact on the administrative and clinical practices of cardiovascular specialists including physicians providing cardiac pacing and electrophysiology services. This article provides an overview of the five key areas where managed care is affecting cardiovascular practices including the following: (1) administrative burdens; (2) competitive/economic pressures; (3) cost/efficiency requirements; (4) interference in the physician-patient relationship; and (5) disruption in physician-physician relationships. The issues associated with each of these areas of concern are discussed in detail with specific examples that are relevant to cardiac pacing and electrophysiology.