This research examines the application of the concept of managed care in the health care delivery environment in the United States. Historical information relative to managed care is reviewed. Advantages and disadvantages associated with the delivery of health care services in managed care environments are discussed. The application of the concept of managed care in the area of mental health also is addressed. Managed care services in the State of Arizona are discussed.
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 preadmission certification, concurrent review, case management, utilization rules, and price limits. Opponents contend that managed care is a deceitful sham designed to maximize profits and minimize care. The truth about managed care likely lies at some point along the continuum of opinion. The intent of the application of the managed care concept is to balance access to services, service quality, and the cost of services in relation to health care in the United States. The concept of managed care derived from the cost containment crisis in the delivery of health care services in the United States.
Dynamic change characterizes the American health care environment in the 1990s. Within such an environment, care providers and support organizations must develop and implement new and effective strategies if they are to remain viable entities.
The changes in the health care environment result from a combination of factors increasing costs of health care, changing societal values, advances in treatment therapies, technological innovation, changing demographics, and many others. Cost is a major factor involved in changes in the delivery of health care delivery and support services. It is, therefore, imperative for health care delivery and support...