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Managed Care Concept

Managed care programs are increasing in number with the goals of controlling health care costs and continuing to provide quality care. Questions exist, however, regarding the maintenance of quality assurance. The issue of managed care and quality of care is examined in this research. The specific question addressed in this research is as follows: "Have we sacrificed our health care quality for the bottom line?" The position of this researcher is that the quality of care in the United States has been sacrificed for profitability in the managed care system.

Managed Care and the Evolving Health Care Environment

Changing social structures are leading to evolving approaches to the delivery of health care. The roles of the various professional providers of health care also are in a state of transition. Societal changes also are occurring that impact the ethical bases of the functioning of health care delivery systems. Managed care is an evolving approach to the delivery of health care that affects each of these other factors (MacStravic, 1996).

Reform of the health care system in the United States is a volatile issue. Costs are the primary concern of funding providers, while a continuation of the opportunity to earn profits is the primary concern of the health insurance industry, and increased access to health care services is the primary concern of social activists. Managed care has been proposed as the concept that can satisfy each of these three groups (Hahn & Flood, 1995).

Managed care is a program type that proponents claim ensures appropriate care for a wide range of medical treatments through the application of techniques such as pre-admission certification, concurrent review, case management, utilization rules, and price limits (Gales, 1996). Opponents contend that managed care is a deceitful sham designed to maximize profits and minimize care (Merwin & Fox, 1992). While a reasoned assumption would be that the ...

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Managed Care Concept. (1969, December 31). In LotsofEssays.com. Retrieved 04:12, March 29, 2024, from https://www.lotsofessays.com/viewpaper/1695234.html