Question

Discuss the challenges of managed care.

Answer 1

Managed care is the healthcare delivery system organised to managed cost, utilisation, and quality. It is through contracting the managed care organisations.

Following are the challenges for managed care

1. Reaching to the medically underserved populations. Managed care is not able to cater demands of underserved population due to experienced staff shortages though they are in the communities where they can serve people.

2. Unstable enrollment and eligibility. Health plans are so designed that the beneficiaries could remain enrolled in the Medicare services and the eligibility for enrollment in the plan depends on the family income in most parts of states.

3. Conducting care coverage and developing effective pay incentives. It is challenging to ensure the coverage of care that is being provided. Coverage of care in private markets extend to value based. Deciding what to include in plan and what to take out in separately is major issue faced nowadays.

4. Aligining managed care with health nutrition, social services. Involving this services into managing care poses a great challenge as the acceptance of theses services are necessary.

5. Information technology it is difficult to store and manipulate data on such systems which are underfunded. There are care plans so designed to provide optimum services.