The Context of Health Care Management

Topics: Health care, Managed care, Centers for Medicare and Medicaid Services Pages: 3 (544 words) Published: March 2, 2011
Chapter 1 – The Context of Health Care Management


1. Define and describe the concept of managed care. Differentiate between managed care and health care in the past.
Managed care is the attempt to provide reasonable access to quality care at affordable cost. The primary care physician is the gatekeeper. Managed care will reduce insurance premium costs by limits on services, also increasing issues about denial of service or payment.

2.Identify two widespread effects of the managed-care movement. Describe how managed care affected these areas. When the “gatekeeper” was put into place only patients insurance would cover their costs if the primary care physician was the one that referred them to the specialist or a facility. This helped reduce health insurance premium costs to employers and subscribers. The managed-care movement has been good to the union for so long until the 2000’s now so many of the active participants in the managed care have been cutting there ties with it and making their own Deals with providers for both active employees and retirees. In the long run this is most have just accepted the changes and gone for less cost sharing for them all.

2. Identify the major laws and regulations that impact health care organizations in your state. What state-level agency issues licensure regulations for each type of health care facility in the state (e.g., hospitals, long-term care facilities)?

3. What are the primary strategies for initiating change in organizations?

Change in the organization as a whole, than you will receive resistance. You may learn many important things from resistance, which will make your implementation planning, go a lot smoother. The culture as a whole need to change themselves for the better.

4. Identify at least two strategies that have been utilized to ensure or at least enhance organizational survival. Give examples of each of the strategies and their impact on organizational...
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