Explain the positive and negative aspects of managed care.© BrainMass Inc. brainmass.com October 25, 2018, 10:00 am ad1c9bdddf
To answer this question, one has to define what is managed care. Managed care is referring "to a technique for influencing clinical behaviour of health care providers or patients by integrating the payment and delivery of health care. The overall aim of managed care is to place administrative control over cost of quality of, or access to health care services in specific population of covered enrollees. An example of managed care is capitation that involves paying physician a fixed, prospective amount for each patient regardless of cost of caring for patient. Another example of managed care include individual practice associations, health maintenance organizations, physician hospital associations, and exclusive provider organizations.
Capitation is one example of managed care practices that seek to control costs of health care. The ethical concern that managed care arise is that managed care create pressure to do more with less time per patient. It spent less costly medicines, and fewer costly ...
This is a discussion of the overall aim of managed care. It is to place administrative control over cost of quality of, or access to health care services in specific population of covered enrolees. An example of managed care is capitation that involves paying physician a fixed, prospective amount for each patient regardless of cost of caring for patient. Further details are discussed in the response.
Managed Healthcare Organizations
Research managed care's inception and study some examples. Be sure to investigate the perspectives about managed care from the vantage of both healthcare providers and patients. You can use the following keywords for your research—United States managed care, history of managed care, and managed care timeline.
Based on your research, answer the following questions in a 8- to 10-page Microsoft Word document:
• What are the positive and negative aspects of managed care? Analyze the benefits and the risks for both providers and patients, and how providers should choose among managed care contracts. Conclude with your analysis and recommendations for managed care health plans. Your response should include answers to the following questions:
o Summarize the history of when, how, and why managed care was developed.
o Define and discuss each type of managed care organization (MCO)—health maintenance organization (HMO), preferred provider organization (PPO), and point of sale (POS).
o Explain the positive and negative aspects, respectively, of managed care organization from the provider's point of view—a physician and a healthcare facility—and from a patient's point of view.
o Explain the three types of incentives for providers for efficiency in the delivery of healthcare services. Explain who bears the financial risk—the provider, the patient, or the managed care organization.
o Offer your recommendations, to accept or decline, for patients considering managed care health plans, with your rationale for each.
Claxton, G., Rae, M., Panchal, N., Damico, A., & Lundy, J. (2012). Employer Health
Benefits Annual 2012 Survey. Retrieved from http://ehbs.kff.org/pdf/2012/
Sekhri, N. K. (2000). Managed care: The US experience. Retrieved from http://www.
Scutchfield F. D., Lee, J., & Patton, D. (1997). Managed care in the United States.
Journal of Public Health Medicine, 19(3), 251-254. Retrieved from http://
Support your responses with examples.
Cite any sources in APA format.