Managed Care Managing Costs

Managed Care Managing Costs

Purpose: Comment the Discussion (Class 507 Unit 4 Topic 2 Comment 1 M)

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Thing to Remember:

Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

1 References, find resources that are 5 years or less

No errors with APA format 6 Edition

To Comment:

Managed Care Managing Costs

Managed care has grown rapidly since the 80s and is what we define healthcare as today. Managed care was designed as a way to cut healthcare costs and to provide more coverage. Through managed care, members are able to see approved providers and can be tested and treated at participating organizations. In the past payment was based on a fee for service (FFS) principle. FFS greatly encouraged the overutilization of medical tests and treatments. There was no regulation. By using managed care plans, the costs decrease as patients utilize their primary care physician (PCP) to guide more appropriate and effective care. Van Parys (2014) reports managed care plans reduce the number of unnecessary emergency room visits and hospitalizations because managed care plans provide better access to primary care. In addition to smarter care, managed care organizations are often able to negotiate better rates and lower prices.

Managed Care and Quality of Care

Managed care has been closely evaluated with its effect on quality of care for patients. Although there are several pros and cons listed one thing that is sure is that quality of care has not been compromised with the growth of managed care. Managed care has tightened many things up in this gray world of healthcare. Managed care has learned to spend healthcare money on a few other important topics that affect quality of care; instituted practice guidelines, monitor credentialing process, monitor actual patient outcomes, promote a collaborative care method, and care is streamlined based on necessity and recommendation of the PCP. Fabius (2000) states the managed care movement has not only influenced the care of the membership it has attracted over the years, but has also affect the care of all Americans through a multitude of healthcare delivery breakthroughs and applications.

References

Fabius, R. J. (2000). A dozen benefits from the managed care movement. (Managed

Care on Trial). Physician Executive, (5). 34.