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

Managed Health Care. Essay

2284 words - 9 pages

Of the approximately 257.8 million individuals currently living inthe United States of America, every one of them has a need foreffective, affordable and accessible health care coverage andservices. Within the past thirty to forty years, the scope andcost of health care coverage and services has drastically changed,altering the manner in which health care was previously managed.There are several factors that have affected the cost of healthcare 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 economic analysts have discovered, there is adistinct and direct correlat! ion between advancing medicaltechnologies and rising health care costs. Medical innovation has beenproven time and again to be an important determinant of health carecost growth. It would appear that managed care health insurance plans,which attempt to lower health care costs, and highly expensive newmedical innovations and procedures are at cross purposes, pullingagainst one another in very different directions. Market-levelcomparisons have found the cost growth of health care in markets withgreater managed care penetration to be generally slower than that ofnon-managed care health insurance markets. However, managed care isunlikely to prevent the share of gross domestic product spent on healthcare from rising unless the cost-increasing nature of new medicaltechnologies changes.Managed care health insurance plans differ greatly fromindemnity fee-for-service, or FFS, insurance plans. Since theearly 1970's, rapidly growing enrollment in managed care healthinsurance plans has transformed the health insurance market inthe United States. Virtually nonexistent in most markets threedecades ago, managed care health plans covered 63 percent ofthe nation's employees by 1994. Managed care incorporates arange of features that allow the insurer greater influence inthe process of care delivery. Managed care plans aggressivelycontract for lower prices from physicians and hospitals andattempt to constrain the use of health care services bymonitoring providers and changing provider incentives. Healthinsurance providers that operate under the fee-for-serviceconcept grant the consumer much more freedom of choiceconcerning doctors and treatment programs, thus freeing theconsumer of any feelings of discontent with "interfering"insurance companies. Consumers of indemnity plans, however,pay a price for that freedom by way of drastically higher rates andlittle knowledgeable input on doctors, specialists and nearby hospitalsthat will fit their particular needs. Many of today's health insuranceconsumers choose to place...

Find Another Essay On Managed Health Care.

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 ). Additionally, efforts towards preventative care could help reform health policy, as both of these changes in the United State's view on healthcare would be much more progressive. The major challenge that affects reform appears to be long-held ideas and feelings towards the way that healthcare has been managed in the past, and the inability of citizen's and policy makers to stray from such thoughts.Mental health is probably the most misunderstood

Nutrition Essay

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

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

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

Managed Care

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

The need for healthcare reformation in America

2101 words - 8 pages Of the approximately 257.8 million individuals currently living in the United States of America, every one of them has a need for effective, affordable and accessible health care coverage and services. Within the past thirty to forty years, the scope and cost of health care coverage and services has drastically changed, altering the manner in which health care was previously managed. There are several factors that have affected the cost of

Obesity and Metabolic Syndrome

1277 words - 5 pages The Center of Disease Control and Prevention (2013) reported that, more than 35% of U.S. adults are obese and suffer metabolic syndrome which can include heart disease, stroke, type 2 diabetes and a variety of cancers, causing the US more than hundreds of billion dollars for their medical care. It makes some wonder whether the health care Americans have chosen to support our country was the right choice. A managed health care system might not be

Deliverance: A Study of Medicaid and Managed Care

4632 words - 19 pages also be taken into account. Health maintenance organizations (HMOs) are one of the most popular delivery methods of managed care for Medicaid clients. Operating best when in competition with other HMOs, they are more likely to be concentrated in urban areas where it is not uncommon to find multiple organizations. Managed care would be less beneficial in rural areas since there is often only one hospital or sometimes only one physician from which

Government’s Role in Long-Term Healthcare Delivery

904 words - 4 pages The history of long-term health care is just one part of HealthCare. “The Past Present and Future of Managed Long Term Care" website entails a view that has gained acceptance in the country and the states have a responsibility for making sure certain primary social goods are present. Political parts of health care are quality, cost, expenditures, and access to care economic security for the elderly, and that it is available to all. In the past

Medical Care

2716 words - 11 pages care has primarily focused on providing health care for the patients on a "Fee-for-Service" type payment system. Now that the country has entered in the information and services markets, health care has developed a method to transitions into the information and services markets as well. Today, health care providers have added an additional option to their clients. This option is known as Managed Care. Both of these health care payment types are

Emergency Room Overutilization

1769 words - 7 pages contracting with capitated health maintenance organizations (HMOs) to provide services, the quality of care would improve for Medicaid populations and costs would decrease. It was also hoped that the number of uninsured people would dramatically decrease by offering Medicaid managed care coverage to low-income families and individuals that were not Medicaid eligible. These services and coverage could be delivered through the Medicaid managed care carriers

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 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

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

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