This website uses cookies to ensure you have the best experience. Learn more

Managed Care Essay

1402 words - 6 pages

Managed Care

To decide on whether or not an issue is considered ethical or moral we need the hard cold facts. Facts expose or explain what is to be decided upon—not what the outcome should be. Decisions regarding health care and mental health issues represent a major portion of ethical and moral choices. As individuals we are not always able to understand the justice, or fairness, behind the decisions supposedly based on hard cold facts.
Once upon a time being a therapist was considered a calling. The images of a counselor sitting back in their comfy cushioned chairs listening to hours and hours of patient's dilemmas, heartaches and mental health issues have been replaced with the hard cold facts that therapists today are fighting over customers while behaving according to appropriately mandated practices. HMOs (health maintenance organizations) and PPOs (preferred provider organizations) are the therapeutic callings today—managed care.
As therapists and patients it may be difficult to grasp the concept of "managed care" as this system becomes prevalent in the mental health areas. Managed care is any health care delivery system in which strategies are employed to optimize the value of provided services by controlling their cost, promoting their quality, and measuring performance to ensure cost-effectiveness. Managed care now dominates health care in the United States. A managed care system actively manages both the medical and financial aspects of a patient's care(Corcoran,1996).
Three concepts are at the origin of argument with managed care: control of the treatment plan, cost effectiveness, and quality of treatment. Current quality of care measurements focus on limited and tangible evidence. How do we measure evidence of mental health improvements? Who should make the decisions regarding mental health issues, the physician or the Chief Financial Officer? Health is an issue which needs be left to the physician while dollars and cents can remain with the financial officer. Managed care theoretically may seem appealing, but most view managed care practices as emphasizing cost control over quality.
The ethical arguments of managed care are dependent on the goals of the physician and the provider. If the primary goal is always doing the best for the patient within the limits of available resources and less interest for the bottom line then subjecting patients to unnecessary risks is minimal. However, if the patient is regarded as a secondary issue the physician and providers are ethically wrong. "It is the position of the National Academies of Practice that is unethical to compromise a patient's needs and quality care concerns to satisfy financial objectives" (Pope, K. S. & Vasquez, M. J. T., (1998) pg. 322).
The APA Ethical Principals of Psychologists and Code of Conduct (Section 4.09c) states, "Prior to termination for whatever reason, except where precluded by the patient's or client's conduct, the psychologist...

Find Another Essay On Managed Care

Managed Care and Utilization Management Essay

1780 words - 7 pages Utilization management is described as the implementation of guidelines which reduce unnecessary use of medical resources (Kongstvedt, 2007, p.190). There are a variety of methods used to ensure costs are kept at a minimum without compromising patient care. The use of utilization management (UM) are yielding financial benefits resulting in managed care organizations (MCOs) and facilities investing more into UM programs. Health

Managed Care: Pay for Performance Essay

832 words - 4 pages Francois S. DeBrantes and Guy D’Andrea provided a study from the American Journal of Managed Care in 2009 to determine at what extent to the size of financial incentive influences a physician’s decision to participate in a P4P program. Mr. DeBrantes is the CEO of Bridges to Excellence that was used in the study. Bridge to excellence is a non-profit multi-stake holder that has implemented incentives and rewards programs for more than five years

The Pros and Cons of Managed Mental Health Care

1456 words - 6 pages Abstract This paper will discuss the different effects managed care has on the quality of mental health care for its clients. On the positive, managed care has increased availability to a cliental that would otherwise not be able to afford mental health care. On the negative, there has been a reduction in quality in order for managed care corporations to keep costs low and still make money. Proper implementation of managed mental health care

Deliverance: A Study of Medicaid and Managed Care

4632 words - 19 pages Deliverance: A Study of Medicaid and Managed Care Since the inception of Medicaid in 1965, the program has seen extraordinary growth in expenditures and enrollment. From 1989 to 1992, the increases in Medicaid spending were the largest since the program began in. Enrollment in Medicaid by AFDC families grew from 3.8 million in 1990 to 4.4 million in 1992, almost a nine percent annual increase (Coughlin et al. 1994). During this period

Quality of Indemnity Vs. Managed Care Insurance System

3734 words - 15 pages INDEMNITY INSURANCE SYSTEM VERSUS THE MANAGED CARE SYSTEM 2005 Table of Contents Abstract Introduction Body 1 General Information about Healthcare systems 2 Types of Plans 2.1 Indemnity 2.2 Managed Care 2.2.1 Health Maintenance Organizations 2.2.2 Preferred Provider Organization 2.2.3 Point of Service 2.2.4 Table 1 3.3 Wellness Programs 3.4 Influences of managed care system on: 3.4.1 Institutions

The Pros and Cons of a Managed Health Care System

1679 words - 7 pages manner ever, and has expressed a mature effort to ensure the overall social welfare of the people of the society they serve. In respect of health management one interesting topic has emerged in US in the recent times. The same is Managed Care. We shall discuss about this part of the healthcare management in this discussion and in the succeeding paragraphs (Niles, 2011). (Source: Kadushin & Harkness, 2013). Managed Care – The ideology In the

What role do diseases and longevity play in policy development? What has been the role of managed care and attempts at reform in health policy?

948 words - 4 pages managed and well-planned care as a population.Until insurance companies started to pay for patients care, the idea of what constituted a disease was not something that was discussed as much in the public and political realm. But decisions about what should be covered by insurance, and exactly what kind of coverage citizens should receive has now become a major political debate. Largely this is due to the fact that there is inconsistency in the care

Nutrition

651 words - 3 pages Managed Care Organization A managed care organization is a collection of clinics, doctors, hospitals, pharmacies and other healthcare providers who come together to offer health care to persons who are sign up for the services. In many cases, managed care organizations operate and are referred to as networks of health care providers. Managed care organizations are comprised of health care experts from different fields who come under an

Medicaid managed health plans

677 words - 3 pages A Medi-Cal Managed Care Health Plan contracts with specific doctors, clinics, specialists, pharmacies, and hospitals. These providers make up the health plan’s “network. In 1972 and 1975, Legislation enacted a law allowing the State of California to license the Health Maintenance Organization (HMO) to enrolled Medical beneficiaries. It wasn’t till 1990 that California decided to enrolled Medical beneficiaries into managed care. Today, more that

Case management

602 words - 2 pages Case Management in Managed CareCase workers role has been influenced by managed care and new cost containment strategies which are creating competition and role conflict. Mental health care services theme has become an organized philosophy undergoing massive change. United States managed care leads in healthcare decisions, applying cost effectiveness, evaluation in reimbursement, pharmaceuticals, drug treatments, health maintenance organizations

Emergency Room Overutilization

1769 words - 7 pages Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved

Similar Essays

Managed Health Care Analyzed Essay

1843 words - 7 pages The health care industry in the United States is very diverse and dynamic. The continued growth of managed health care is influenced by the economy, the need, and the regulatory regulations set forth on the industry. If one of these forces changes, it can affect the entire group; this causes the managed health care industry to be at the mercy of its roots and the industry’s need for it. What started out as a simple idea has turned into a complex

Managed Health Care Essay

2284 words - 9 pages coverage over the course of the past two to three decades.One of these factors is the introduction and rapidly increasingenrollment in managed health care insurance plans. Managed carehealth insurance plans can, in most cases, help to alleviate therising costs of effective medical coverage. Another importantfactor that has affected health care costs is the invention andimplementation of new medical technologies. As prominentresearchers and

Managed Health Care Issues Essay

3241 words - 13 pages When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large

Managed Care And Quality Improvement Essay

1248 words - 5 pages Managed care is often seen primarily as a cost cutting initiative that is concerned with managing cost and cost only in the healthcare field. For this and a few more reasons managed care organizations face severe judging on the quality of care that they provide. When analyzed correctly, trends prove that managed care has in fact been very significant in determining and improving the quality of care. In this paper, elements such as the state and