The concept of managed care is one that is primarily applied to the United States, and focuses on providing patients with high-quality medical care at a decreased cost. Managed care focuses on a number of different business models, ranging from individual physicians existing as part of a network to entire medical facilities comprised of specialists in an array of areas. In terms of the care provided to patients, managed care focuses on preventive care first and foremost, establishing a series of suggestions and guidelines for patients to follow to maintain the highest quality of life possible. Paper Masters can compose a custom written research paper on Managed Care that follows your guidelines.
The Focus of Managed Care
According to Medicaid.gov, when the focus of managed care moves beyond preventive care, there are several key factors that come into play. Managed care works to provide forms of treatment that are less costly; this can be done through monitoring and managing the facility in which the patient receives treatment.
However, there are some drawbacks to using managed care, primarily rooted in the program’s desire to save as much money as possible. This can result in the following issues with Managed Care:
- Panels of physicians that meet to determine the medical necessity of a given procedure, using little more than a primary care physician’s notes to make such a determination.
- Patient concerns are often given little consideration in these decisions, causing frustrations for many.
- Patients are less likely to be admitted to the hospital for “routine” concerns, something that can have drawbacks in the long term.
- A patient has a basic symptom, for example, it could be a sign of a more serious health complication to come, one that could have been avoided had the patient been admitted to a hospital.
While the theory behind managed care is positive, that of providing high-quality care at a decreased cost, the practical application of this principle can result in a series of negative repercussions, all in an attempt to reduce the patient’s impact on the facility’s bottom line.