Question

How has the growth of managed care affected the performance of the medical sector ? ( 300 words Un Plagiarised )

Answer 1

The managed care is a health care delivery system which is organised to manage cost, utilization and quality of health services. Managed care plans are a type of health insurance which have contract with the health care providers and medical facilities to provide care for its members at reduced costs. The United States pay a huge amount in the healthcare industry but still the quality of care is not that satisfactory. Therefor the use of managed care was evolved to influence the use of medical care by improving outcomes and efficiency. This system is employer based and fee for service health care. It means that the patients need to pay only for the services provided to them which is proved benefial. This put forward a cut of in the income of the doctors who would earn more than delivered services and also the expenditure on unnecessary procedures and test by the patient. It gave The constraints and controls imposed by the managed care outraged the doctors and patients.

Managed care reduced the unnecessary health care costs through various mechanisms including economic incentives for physicians and patients to select less costly forms of care,programs to analyze the necessity of a specific services, control on inpatient admissions and length of hospital stay, selective contracting with the health care providers. The various managed care techniques includes disease managements, case managements, wellness incentives,patient education and utilization management.

With the implementation of managed care, the consumers complained of denials of care and substandard quality of care for sake of cutting the cost that proved to be a negligence on the part off the health plans. Therefore United States passed laws for health sector to sue them for malpractice. This made the health professionals to be more vigilant in care and to avoid negligence in practices. Thus with the growth of managed care, the performance of the medical sector also improved. The shift of market power from the supply to the demand side,enabled the managed care industry to accomplish two task. First, the insurance carriers could extract price discounts from the providers of care. Second the insurance carriers could foist upon the doctors and hospitals that enable then to decide if the wanted to renew their contract with the particular physicians. Thus the annual increase of the premiums that the employers had to pay for the insurance coverage of their employees declined. This led to the gradual decrease in the annual expenditure on health care services in United States. Thus, the implementation of managed care was proved to be cost effective, with minimal utilization of resources and also improved the quality of care.