Managed Care
Brooke McMichael
University of Scranton

Abstract
This paper examines the benefits and issues with managed care. The benefits include patients receiving preventative care, lower premiums, lower costs of prescriptions, fewer, unnecessary procedures, and less paper work. Some issues with managed care include limitation on doctors that patients can choose from, restricted coverage, the possibility of under treatment, and compromised privacy. Managed care effects nursing by causing significantly few jobs for registered nurses, more opportunities in non-acute health care settings, and more use of advanced practice nursing.

Managed Care With the economy in shambles and the rising cost of health care, many people are turning to managed care programs for health care coverage. The number of patients participating in “discounted” managed care programs is presently at a shocking all-time high. Over 150 million people are currently enrolled in some kind of managed care program, which attributes to about 60 percent of the population (Bertrand, 1996-2007). The main purpose of managed care is to provide high quality care at an affordable low cost. Managed care programs are said to have the best of both worlds. However, it is hard to find an even balance between the two. With such drastic restraints on spending and cost, the question of whether or not the quality of care is up to par comes into play.
What is Managed Care? Managed care is a type of health care program provided by a corporation that both finances and delivers health care services of high quality at a low price by focusing on prevention, health promotion, and primary care (Huntington, Health care in Chaos: Will We Ever See Real Managed Care?, 1997). In these programs, groups of doctors, hospitals, and health care providers join together to provide affordable health insurance to the public (Cohen, 2008). Providing preventative care helps keep costs down for insurance companies because it



References: Bertrand, C. A. (1996-2007). Managed Care- Solution or Problem? Retrieved Novemeber 2, 2009, from Medicine Up to the Minute: http://www.medicineuptotheminute.com/mgdcare.htm Burns, M Chitty, K. K., & Black, B. P. (2007). Professional Nursing: Concepts and Challenges. St. Louis: Saunders, Inc. Cohen, D. (2008, February 19). Health Insurance Types- HMO and PPO- Pros and Cons. Retrieved September 9, 2009, from Ezine Articles: http://wzinearticles.com/?Health-Insurance-Types--- HMO-And-PPO---Pros and Cons&id... Fang, H., & Rizzo, J. (2008). The changing effect of managed care on physician financial incentives. American Journal of Managed Care , 653-660. Hansen-Turton, T., Ritter, A., & Torgan, R. (2008). Insurer 's Contracting Policies on Nurse Practitioners as Primary Care Providers. Policy, Politics, & Nursing Practice , 241-248. Huntington, J. A. (1997). Glossary For Managed Care. The Online Journal of Issues in Nursing . Huntington, J. A. (1997). Health care in Chaos: Will We Ever See Real Managed Care? The Online Journal of Issues in Nursing . LaTourette, S. C. (1997). Managed Care: A Legislator 's Viewpoint. The Online Journal of Issues in Nursing . Mental Health America. (2009). Dealing with Treatment Denials. Retrieved November 1, 2009, from Mental Health America: http://www.mentalhealthamerica.net/go/help/how-to-pay-for- treatment/dealing-with-treat... Outlining the Pros and Cons of Managed Care. (1997). Retrieved September 9, 2009, from Surviving Managed Care: http://www.ecnnews.com/hlth/man3.htm Tufts Managed Care Institute Wenzel, J., & Steeves, R. H. (2008). Experiencing Breast Cancer in Managed Care. Qualitative Health Research , 1477-1488.

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