Figure 2-3 NIH awards to U.S. medical schools in different managed care markets, 1986 to 1995. Dollar amounts are relative. For instance, in 1995, markets with low levels of managed care penetration received 1.99 times more funding, markets with medium levels of managed care penetration received 2.03 times more funding, and markets with high levels of managed care penetration received 1.75 times more funding than they received in 1986. Source: Moy et al., 1997.

The modern-day structure of medical schools has evolved over time. In recent decades AHCs have provided medical education and research training, a research infrastructure, and care for the underserved. Today, however, AHCs are increasingly pressed to continue these obligations while assuming a greater proportion of their costs. As such, it has become harder to perform the type of large-scale, population-based research commonly required to control emerging infections. Managed care organizations, however, have the potential to assist in these efforts with their integrated, computerized database capabilities. These capabilities are discussed in the next section.


Presented by Frank DeStefano, M.D., M.P.H.

Medical Epidemiologist, Vaccine Safety and Development Activity, Centers for Disease Control and Prevention

Stimulated by the shift toward managed care, health care organizations in the United States are increasingly consolidating into integrated systems that

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