Ethical Issues In Managed Care

Managed care is described as a variety of systems and arrangements for planning, managing, delivering and evaluating care (Linsley et al.,2014). In a well-functioning system of managed care, a defined group of people receive treatment services that are clinically necessary and appropriate, within defined benefit parameters, for a set amount of time, in compliance with quality standards, and measurable outcomes (Linsley et al.,2014). Managed health care has made an impact on patients and providers view of insurance and what care is necessary. It is also known as an initiative to cut cost in the healthcare sector. Due to this, many managed care organizations are judged on the quality of the services they provide. In this paper, I will examine
It does not mean managing the caregivers and administrative staff. Managed care controls what physicians, specialist, healthcare facilities that patients have access to. According to the article “The origins of Managed Care (2007) In 1973, Congress passed the Health Maintenance Organization Act, which encouraged rapid growth of Health Maintenance Organizations (HMOs), the first form of managed care. Patients are not able to see other physicians or even specialists within the managed care system without permission from a primary care physician. In other words, managed care is like a toolbox. Inside the “toolbox”, the tools include healthcare networks, second opinion requirements, and pre-approval requirements for treatment (Deom, Marie, et
Although managed care seems to have been effective in reducing the physician bias for overtreatment of patients, it has created conflict between physicians and patients, whether they are genuinely caring about the quality of service. Another issue where managed care can affect the quality is replacing highly trained health professionals with those that has less experience to save on cost (Tietze, 2003). According to the article “Impact of managed care on healthcare delivery practices”, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should collaborate to address issues of concern. Such as promoting trust and commitment on within the