Preview

The Positive Influence Of Managed Care Programs

Satisfactory Essays
Open Document
Open Document
142 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
The Positive Influence Of Managed Care Programs
The managed care program has had a positive influence on health care services. The physicians have the opportunity to coordinate care and deliver efficient services. According to Linsley & Morton (2014), the patient-centered approach implements strategies that will improve the experience of care, and enhance quality, safety and efficiency (p. 38). By given the consumers, various options for seeking care will attract more people to utilize the services. By focusing on delivering the best care and reducing the cost will help the managed care program to continue growing and continuously increasing their patient load. Health care is complex, and people will gravitate to programs that will offer them the best care to improve their overall health

You May Also Find These Documents Helpful

  • Good Essays

    Hsm 546 You Decide 1

    • 699 Words
    • 3 Pages

    Kongstvedt, P. (2007). Essential of Managed Health Care. 5th Edition. Jones and Bartlett: Sudbury, MA.…

    • 699 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Some of the pros for managed care are; Preventive care — HMOs pay for programs, they are set up and are intended at keeping one healthy (yearly checkups, gym memberships, etc.)The idea is, so they won 't have to pay for more costly services when and if one gets sick. Lower premiums — Because there are limits set as to which doctors one can see and when one can see them, HMOs charge a premium and usually they are lower premiums. Prescriptions — As part of their precautionary retreat, most prescriptions are covered by HMOs for a co-payment that also can be very low. Fewer unnecessary procedures —doctors are given financial incentives from HMOs , to provide only needed care, so doctors are less likely to order costly test or surgeries that one does not need. Limited paperwork — While healthcare professionals and facilities have more paperwork, under managed care, HMO members usually only has to show their membership card and pay a very low co-payment.…

    • 965 Words
    • 4 Pages
    Good Essays
  • Good Essays

    The pros of managed care are since the patient is limited to a specific caregiver the premium is lower. The patient only pays a monthly payment and a co-payment. The cons of managed care are that the patients are not allowed to see the doctor of their choice unless the doctor is in their network. The consumers perspective the pros and cons of managed care. The pros from the consumers perspective would be only paying monthly payments that is at a fixed rate. The other would be paying a small co-payment every time they see a doctor. The cons of managed care from a consumers perspective would be that they cannot see the doctor of their choice. The caregiver has to be affiliated with the managed care organization. The pros and cons from a caregivers perspective. The pros would be stability, fewer administrative duties, and better working hours. The cons would be less independence, and possibly a decrease in the income. There are more pros and cons these are just a few of them. From a caregivers perspective they would rather the patient have traditional insurance. The reason for this is because the caregiver is losing money by the patient having managed care. Caregivers get a percentage of the money when they see a patient with traditional insurance. Then there is also more stability and less working hours for the caregiver with managed care. It would be like flipping a coin for the caregiver what would they rather have more money or more time to spend with their family. The consumers perspective it would be in their best interest to have one of the managed care options (HMO,PPO). The reason for this answer is because for the most part most consumers…

    • 394 Words
    • 2 Pages
    Good Essays
  • Better Essays

    Greene, J. (2008, July). Members of Consumer-Driven Health Plans Choosing Less Care. Retrieved July 27, 2008, from Medical News Today Web site: http://www.medical.news.today.com…

    • 1094 Words
    • 5 Pages
    Better Essays
  • Powerful Essays

    Electronic Health Records

    • 3112 Words
    • 13 Pages

    A blend of socio-economic, technological and political factors has brought pressure to bear on healthcare providers to put measures in place that will promote efficient and quality healthcare delivery both at the federal and state levels. The purpose of this…

    • 3112 Words
    • 13 Pages
    Powerful Essays
  • Better Essays

    Evolution of Managed Care

    • 1519 Words
    • 7 Pages

    Managed care is a type of system that was formed to help control the costs and quality to health care services; this will give access to services to specific groups of covered patients. The system was created to help the patients (customers) to receive services without having the full financial burden (University of Washington, 1998). The managed care services’ goal is to be able to help individuals and their families by providing health care services that is affordable. This type of managed care will help employees or individuals by requiring a set fee to be paid to the physician for visits, a co-pay and monthly premium to be paid to the insurance company. This will lower the amount that the patient has to pay. There have been many demands that have been needed in the managed care system; changes have had to be made to keep improving the health care services to help it to continue to grow. This paper will cover how the managed care began, in addition to how the system has grown and the changes of the system.…

    • 1519 Words
    • 7 Pages
    Better Essays
  • Satisfactory Essays

    In spite of its impressive accomplishments, the U.S. health care system is fraught with problems and dilemmas. There is a growing concern that health care is a big, complex, unmanageable business. In this week…

    • 682 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    Managed Care of the U.S.

    • 512 Words
    • 3 Pages

    Commonly managed care describes a continuum of arrangements that integrate the financing and delivery of health care. It encompasses many different arrangements with particular doctors, hospitals and other providers to deliver services that make up networks of health care plans. Most managed care organizations offer a wide array of benefit designs that include HMO products, preferred provider organizations, and direct access products that allow patients to self-refer to specialists. (Sekhri, 1997)…

    • 512 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Managed care

    • 906 Words
    • 4 Pages

    Managed health care is a system of health care delivery managed by a company aiming mainly at quality/value cost effective services provided to patients. It has been introduced with an intention to avoid paying for unessential facilities and services directly to physicians. It helps in forming an intermediate between patients and physicians in such a way that health insurance organizations pay the physicians from the premiums paid by patients to insurers for the services provided. This helps in monitoring how cost effectively the services are utilized. It is not to be mistaken as health care delivery at discounted prices. It’s goal is to provide quality care at affordable prices by restricting patient’s choice of physicians and physicians limiting their fees. People who seek care in America are mostly enrolled in health care plans such as health maintenance organizations(HMOs) and preferred provider organizations(PPOs).The less common plan people are enrolled in is point-of-service(POS) which has features of both HMO and PPO.HMO provides integrated and preventive care services to voluntarily enrolled families with low premiums within the network of doctors and hospitals that belong to the organization. It requires to select a primary care physician(PCP) who serves as a personal doctor to provide all basic health care services. PCPs include family physicians and internal medicine physicians. Some HMOs consider pediatricians(for children), gynecologists(for women) as PCPs. Before seeing a specialist or for a diagnostic service, it is required to obtain a referral from PCP(“gatekeeper”). If an outside specialist is chosen or referral is not obtained before seeing a specialist, no coverage for services is rendered by HMO. All or most of the cost for the care must be taken care by the individual. In contrast to HMO, with a PPO it is not necessary to select a single doctor as policy holder’s PCP nor is it necessary to…

    • 906 Words
    • 4 Pages
    Good Essays
  • Better Essays

    Primary Care Physician

    • 1198 Words
    • 5 Pages

    Today, the United States is facing a shortage of about 16,000 primary care physicians and this number will continue to grow by 2025 (Amirault, 2014). Primary care physicians (PCPs) are the doctors who focus on overall health and offer the treatments and preventive screenings that save lives. A physician shortage is a situation in which there are not enough providers to treat all patients in need of medical care. The Association of American Medical Colleges (AAMC) has long pointed out that the shortage of primary care physicians will be a major setback for the American healthcare system advancing (Amirault, 2014). The shortage of primary care providers presents a serious problem for many healthcare organizations, and one that cannot be easily fixed. Throughout this paper, the contemporary health care issue of the shortage of primary care physicians will be further discussed, as well as its challenges and its impact on health care organizations from a business perspective.…

    • 1198 Words
    • 5 Pages
    Better Essays
  • Better Essays

    Managed Care

    • 1382 Words
    • 6 Pages

    Millions of individuals live in the United States of America, and they all need effective, affordable and accessible health care coverage and services. Within decades, the scope and cost of health care has changed dramatically with increased complexity and significance to the healthcare market. The purpose of this paper is to analyze the managed care industry and examine how organizations try to control costs.…

    • 1382 Words
    • 6 Pages
    Better Essays
  • Satisfactory Essays

    I am one of those patient who needs an epipen and my insurance only covers a portion of the cost, even after my insurance has paid I still have to pay $155 to get the prescription. Making medication affordable would allow all patients to ensure that they're getting the proper treatment for the health condition they have. Managed care makes some prescriptions more affordable for patients and even decreases the cost of the expensive ones. People who do not have prescription coverage pay around $314 for an epipen. That is crazy that it cost that much to obtain a medication that could save your life in anaphylaxis moment. You shouldn't not be able to take a medication simply because you can't afford it. Every medication out there should be affordable…

    • 149 Words
    • 1 Page
    Satisfactory Essays
  • Better Essays

    Managed Care

    • 1408 Words
    • 6 Pages

    Kleiner, B. H. (2012) Gives insight into conducted research to show how research of managed care has increasingly become a leading development in regards to the finances in managed health care. There have been many debates and, much confusion of the origins and, definition of managed care yet, the goals are to reduce costs, increase profits and, still provide quality services. The events that have led to managed care is due to constant changes within the health care management sectors as, all throughout history as, when the industries change there also is a need for change to meet the demands to finance managed care.…

    • 1408 Words
    • 6 Pages
    Better Essays
  • Better Essays

    Managed Care

    • 3374 Words
    • 14 Pages

    There are so many problems with our society's health care. Everyone wants to find a…

    • 3374 Words
    • 14 Pages
    Better Essays
  • Powerful Essays

    Individual payments for health care services received have undergone many changes over the past one hundred and fifty years in this country. For many years a fee for service system was in place. This was acceptable at the time because costs were low. However, as costs began to rise, changes in the system occurred as well. Private insurance companies started to form in the 1920s to help consumers afford medical care when needed. Through several evolutions over the years and due to increased costs of medical care, we saw new market oriented public policy initiatives starting to form by the 1980s. In 1970 health care spending represented 7% of the national income, but by 1993 it grew to 13.4% (White, 2004). Health care costs were starting to get out of hand and something needed to be done to address it. "In the public sector, important initiatives included the introduction of the Medicare Prospective Payment System, a range of state reform efforts, and the Clinton administration 's health reform initiative. At the same time, private insurers introduced changes that set in motion a fundamental restructuring of relationships in the health care market place, ultimately giving rise to managed care" (White, 2004). This paper will discuss the rationale, effectiveness, strengths, and weaknesses behind this relatively young reimbursement payment system called managed care.…

    • 1167 Words
    • 5 Pages
    Powerful Essays