Effect of Managed Care on Speech-Pathologists

The purpose of this paper is to examine how managed care affects the ability of speech-pathologists to practice, and the ensuing impact on patient services.

The trend in contemporary health care delivery is toward managed care. Opponents of managed care contend that managed care is a deceitful sham designed to maximize profits and minimize care. There has been an increasingly vocal criticism of managed care by health care providers, consumers, and some politicians.

Managed care, however, is becoming the Abackbone of health care delivery in the United States@ (Wells, et al, 1995, p. 57). Managed care has two major goals; one is to control health care costs and the second is to provide quality services that are sufficient enough to satisfy the enrollees. Several strategies based on direct control and care and indirect economic incentives are used. Payment incentives include capitation to encourage the provider to use fewer services, and co-payments and deductibles to discourage over-use of services by patients.

Managed care is part of the reform of the traditional health care system in the United States, and it is a volatile issue. Costs are the primary concern of funding providers, while 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 was supposed to satisfy these three groups. However, critics of the managed care concept conten

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cerebral palsy or autism often call for an ongoing, long term treatment plan, and the trained speech therapist, in consultation with the client, can be the best judge of what is needed. Unfortunately, caps stipulated by managed care and Medicare can too often mean that the speech-language pathologist cannot follow through on the designated treatment plan and vital treatment can be disrupted. An example is in the area of patients recovering from the debilitating effects of strokes. Of all the after effects of a stroke, Abeing unable to talk, read, write or understand those around you can be among the most upsetting@ (Speech After Stroke). Of the 500,000 Americans who suffer a stroke each year, between 25 and 40 percent of those who survive will have stroke related communications disorders (Speech After Stroke). The value of speech rehabilitation for stroke victims extends beyond restoring speech and language into the realm of psychology; the ability to communicate can often lessen the depression and alienation that follow a stroke. Speech rehabilitation is a time consuming process and putting caps on the allowed treatment can only be detrimental to the health and well-being of the patient. Of course, for wealthy clients, s

Category: Medical - E