Question

discuss the issues of the anti- managed care sentiment and explain the "gag clause" prohibitiin in an HMO contract

Answer 1

Managed care focus on anti-manged care sentiment. managed care problem is ethical problems that conflict values from patient-centered to population centered health care. It ensures high-quality patient care and improving clinical outcome for Medicaid beneficiaries. there is an issue in managed care in financial incentives access to electronic records, coverage appeal, and denials as a fundamental needs, that conflict the interest and confidentiality, anatomy and beneficence and available resources to provide health care delivered the system and to run managed care.
Gag clauce prohibition in managed care organization prohibits physicians' treatment options and action contracts signed by a physician including termination without cause clause. Gag clause informs that medical providers should not talk about themself to patient. it was prohibited by managed care as a managed care practice. it emphasizes that physician should do the best for the patient regardless. Managed care organizations focus on gag clause prohibition that physicians doing the best thing they should violate gag clause that should avoid the worst thing for the patient. It needs patient and physician strong relation and communication by open discussion as the best care to patients with informed decsion about patient care. MCO aligned incentives to physician work by avoiding gag clause and providing best medical treatment and cost concern and ensuring ethical values for patient care.