Share
Explore BrainMass

Managed Care Issues

1. Review the following to articles about managed care.

(i) Positive and negative attitudes of managed care:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497554/pdf/12815085.pdf

(ii) Managed care quality, cost, and access issues:
http://www.biomedcentral.com/1472-6963/10/331

2. Evaluate the main points of the articles.

3. Write a summary for each topic.

4. Compare and contrast each article. Which of these articles do you find more relevant from a professional point of view and why?

Solution Preview

2. Evaluate the main points of the articles

What doctors think about the impact of managed care tools on quality of care, costs, autonomy, and relations with patient's article. Doctors responded favorably for the managed cost tools that they have control over such as: guidelines, gate-keeping, and health care networks. Also, the tools in control of the payer such as pay for performance, utilization review and selective contracting were rated the lowest.

Race and Trust in the Health Care System examines the trust in physicians, hospitals and health insurance providers based on survey respondent's race and age. I agree with the survey results. African Americans have a distrust of physicians and hospitals, which is based on history of discrimination and mistreatment. Also, I agree that African Americans would have a high opinion of health insurance plans because the administrators are viewed as being on their side and don't discriminate based on race. Whites do trust physicians and hospitals because they have not received any discrimination and have always had access to medical care. However, they do distrust medical insurance plans because they have second hand knowledge of someone that was denied coverage for a procedure based on the cost of the procedure only.

3. Write a summary for each topic

What doctors think about the impact of managed care tools on quality of care, costs, autonomy, and relations with patient's article. The survey examined the impact of eight managed tools, which are, use of guidelines, gate-keeping, health care networks, second opinion requirement, doctor payment by performance or salary, selective contracting and pre-approval of expensive treatments with four aspects of managed care, which are: quality of care, cost control, professional autonomy, and relations with patients. The survey respondents were contacted via mail. Also, the respondents received two follow up mailings to complete and return the survey. Every doctor working in Geneva, Switzerland was included in the survey. Therefore, a total of 2746 respondents were contacted to participate in the survey. There 1546 respondents that participated in the survey. There 56.3% of selected respondents participated in the survey. There were no correlations on the respondents based on age, setting of practice or source database. The respondents broken down into the following groups: gender, age, practice setting, specialty and managed care network.

The study examined managed care in Switzerland. Managed care is a universal term for reducing the cost of health care, while providing a high level of care. Managed care prevents doctors from unilaterally making all medical decisions and limits a doctor's ability to charge for services without the approval of the managed care provider or health insurance ...

Solution Summary

Managed care issues are examined. The expert evaluates the main points in the articles.

$2.19