Summary Managed Care In the United States managed care is becoming
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Managed CareIn the United States, managed care is becoming an increasingly popular method of administering healthcare. It influences the clinical behavior of providers, as it combines the payment and delivery of healthcare into a single system, the purpose of which is to control the cost, quality, ...
managed care is becoming an increasingly popular method of administering healthcare it influences the clinical behavior of providers
as it combines the payment and de
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Managed Care
In the United States, managed care is becoming an increasingly popular method of
administering healthcare. It influences the clinical behavior of providers, as it combines
the payment and delivery of healthcare into a single system, the purpose of which is to
control the cost, quality, and access of healthcare services for a single bracket of health
plan enrollees (Scutchfield, Lee, & Patton, 1997).
Yet, managed care often evokes strong or negative reactions from healthcare providers
because they are paid a fixed amount for treating their patients, regardless of the actual
cost, which may influence their level of efficiency. This can challenge the relationships
between doctors and patients (Claxton, Rae, Panchal, Damico, & Lundy, 2012; Sekhri,
2000).
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: Summarize the history of when, how, and why managed care was developed.
Define and discuss each type of managed care organization (MCO)—health
maintenance organization (HMO), preferred provider organization (PPO), and point of
sale (POS). 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. 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. Offer your recommendations, to
accept or decline, for patients considering managed care health plans, with your
Answer:
Managed care development
Managed care development
, The beginnings of oversaw consideration can be followed back to no less than 1929
when ‘Michael Shadid’ a doctor in ‘Elk City’ ‘Oklahoma’ set up a health agreeable for
ranchers in a little group without medicinal experts or an adjacent general healing centre.
He sold shares to raise cash to build up a neighbourhood healing facility and made a
yearly charge calendar to take care of the expenses of giving consideration. By 1934’ six
hundred family participations were supporting a staff that included ‘Dr. Shadid’ four
recently enrolled authorities, and a dental practitioner. That same year two ‘Los Angeles’
doctors ‘Donald Ross’ and ‘Clifford Loos’ went into a prepaid contract to give far
reaching health administrations to two thousands representatives of a nearby water
organization.
Other major prepaid gathering practice arrangements were started somewhere around
‘1930’ and ‘1960’ including the Group ‘Health Association’ in ‘Washington’ in ‘1937’ the
Kaiser Permanente Medical Program in ‘1942’ the ‘Health Cooperative’ of Puget Sound
in Seattle in ‘1947’ the Health Insurance Plan of Greater ‘New York’ in ‘New York’ City in
‘1947’ and the Group Health Plan of Minneapolis in 1957. These arrangements
experienced solid resistance from the therapeutic foundation yet they likewise pulled in
countless.
Today, such prepaid wellbeing arrangements are normally alluded to as wellbeing
support associations. The expression health maintenance organization in any case was
not begat until ‘1970’ with the point of highlighting the significance that prepaid health
arrangements allocate to health advancement and counteractive action of disease.
Health maintenance organization are what most ‘American’ consider when the
expression oversaw consideration is utilized despite the fact that other oversaw
consideration models have raised in the course of recent years.
Managed care is a model in which a go between organizations gathers instalments from
Medicare and other medicinal wellbeing guarantors and afterward chooses the amount it
will pay the giving doctor and it keeps the distinction as benefit. Previously specialists
were paid specifically by wellbeing insurance agencies in this model wellbeing insurance
agencies pay the over saw care association which then pays the doctor. (Appendix B. A
Brief History of Managed Care )
Type of Managed Care Organization
Managed Care is a social insurance conveyance framework composed to oversee
expense, use, and quality. Medicaid Managed tend to the conveyance of Medicaid
medical advantages and extra administrations through contracted game plans between
state Medicaid offices and Managed care associations that acknowledge a set for every
part every month instalment for these administrations. By contracting with different sorts
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