Question

• Provide a thorough analysis of managed care, and discuss how it, as a delivery method, has facilitated the transfer of health services to outpatient and other nontraditional settings of care.
• Discuss the impact managed care has on the access, financing, and delivery of health care in the United States.
• Discuss managed care’s role in promoting health.

Answer 1

                                                   Managed care or rather managed healthcare refers to a system of healthcare in the US, implemented from 1980’s that focus on development of insurance plans for the patients thereby improving the healthcare of them. It was spurred by the Health Maintenance Organization Act of 1973. The managed care system includes a network of healthcare providers in order to provide care for the enrolees. The provider network consists of designated doctors and healthcare facilities, quality improvement programmes like disease management and case management, and preventive care emphasis including wellness initiative and patient education.

                                    In a manage healthcare system, the healthcare insurance provider provides the opportunity to chose a relatively cheaper provider or share costs so that a particular amount is born by the insurance firm and the rest would be taken by the people. Using the utilisation review method, the payers can manage the cost of healthcare benefits and is provided with a chance to assess the appropriateness before it is actually provided. The managed care system consists of a group of organisations consisting of doctors, physicians and other providers in order to transfer the benefits to the payee. The Health Maintenance Organisation, Independent Practise association, Preferred Provider Organisation etc are some of these.

                                    According to the reports of the WHO, managed healthcare, in the US has helped its citizens to have more access to the healthcare delivery system of the country. It further says that the growth of healthcare spending has expanded without having a negative effect on its quality. The US system of healthcare is employee-based and depends on the private financing of healthcare delivery. The managed care principle focus on providing high quality and cost effective healthcare to the citizens. An analysis shows that managed care has had an impact on stemming the escalating growth of US healthcare costs. But an overall analysis shows that its impacts are declining.

                                    Managed care is an important healthcare initiative which can help the healthcare functionaries to focus on the patient and make more evident decisions on the healthcare delivery. Although it has an impact on the cost benefit analysis, a thorough study reveals that while the impact on public health delivery is being analysed, it is having a positive impact as it has been able to contain the rising needs of the patients.