[영문]OBJECTIVE: To review managed care’s current cost management trends and theconsumerism movement; to elucidate the pros and cons of key issues; and todescribe the philosophy of focusing on the patient, also called patient-centric care,while improving the patient’s care through value-based purchasing and plan design.SUMMARY: Managed care is sometimes practiced using a silo approach with littleconcern for the consumer. In this model, medical and pharmaceutical issues areaddressed in silos, and value is narrowly defined. Increasingly, cost and responsibilityis shared with or shifted to the patients. Patients may be unable or unwilling toassume these costs or responsibilities. Several studies have demonstrated that theymay react with noncompliance. Managed care’s definition of value must expand andintegrate across silos to consider the needs and interests of the patient’s overallcare, in particular, addressing key cost drivers in terms of diseases that causerecurring costs. Using predictive modeling can result in cost savings. A case study(Pitney Bowes) is included in this article.