In: Operations Management
8. What is managed care, and what is being managed? What is the primary objective? Pros and cons?
In United States, managed care is defined as the group of activities worked towards reducing the cost of providing healthcare services and also working on improving the quality of service through improved manged care techniques. It was enacted in Health Maintenance Organization Act (1973) of US. It focus on managing the cost, utility and quality of medicals service in the state. It manages the delivery of health benefits as well as other additional medical services with the help of state and other organizations private and NGO working for health care improvement and medical services.
Their main purpose is to deliver best healthcare services to the beneficiaries who are poor and cannot afford high cost of medical services but deserves best. The objective is to improve healthcare plan performance, quality and the outcome of the plans. This is done through coordination and care beyond the traditional healthcare. Its pros are lower cost healthcare facility with best quality healthcare services. One of the most beneficial is the health care befits to the working employees.
Some cons are the rigidity of service providers in rules. Suppose, a member is not fully satisfied with the service and wanted to consult another doctor, he has to pay the expenses in full. These kind of restrictions results in bad responses from members.