Preview

Health Care Reform Project Part 2

Good Essays
Open Document
Open Document
727 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Health Care Reform Project Part 2
Running head: Health Care Reform Project Part 2

Health Care Reform Project Part 2
Kelly Jones
HCS/440
May 25, 2015
Lori Geddes One solution to managed care in health care is the keeping the cost of the health care down. According to "Health Care Cost Control: Getting on the Right Track" (2002), “A real solution will, of necessity, involve pain for all players in health care: employers, government, providers, insurers, pharmaceutical and medical technology companies, and consumers.” To regain control over the heath care crisis the purchasers and the consumers need to come together and decide what the best resolution would be best for them. They will also need to determine what it is that they are willing to sacrifice in order to reduce the high rate of the health care cost. If this doesn’t work the only other alternative would be for the government to step in and decide what needs to mandated, nobody wants this to happen. Another solution to managed care in health care is access to affordable health care. According to “Health Care in Chaos: Will We Ever See Real Managed Care“ ”Lack of insurance coverage causes people not only to avoid preventive care, but to delay seeking illness care until later into the episode of illness.” The underinsured or uninsured will wait until they absolutely have to or need to be seen and end up going to the Emergency room costing themselves and other a lot more money out of pocket. If managed care was more affordable then there would be a lot less people needing insurance along with better health for those individuals. There are an increased number of uninsured people in the United States to roughly around 45.6 million people (Health Care in Chaos: Will We Ever See Real Managed Care). Quality of care in managed care is another issue that is happening. “Medicare HMO enrollees with chronic conditions showed worse quality of care.”(Miller, 2015). The quality of care with HMO’s can be considered poorly done. Most people



References: Health Care Cost Control: Getting on the Right Track. (2002). Retrieved from http://www.managedcaremag.com/archives/0202/0202.edge.html Huntington, J., (Jan. 6, 1997) "Health Care in Chaos: Will We Ever See Real Managed Care?" Online Journal of Issues in Nursing Vol. 2, No. 1, Manuscript 1.  Managed Care: Get Used to It. (2010). Retrieved from http://www.nytimes.com/2010/03/14/business/14views.html?_r=0 Miller, R.H. (2015). Does managed care lead to better or worse quality of care? Retrieved from http://content.healthaffairs.org/content/16/5/7.short

You May Also Find These Documents Helpful

  • Best Essays

    A few years ago, some opined that managed care was either dead or nearly dead. Years later, managed care seems stronger than ever, or is it? After reading the background information, conduct additional research and respond to the below questions.…

    • 1477 Words
    • 5 Pages
    Best Essays
  • Satisfactory Essays

    Assignment1 Copy

    • 4284 Words
    • 13 Pages

    Insurance acts as intermediary between buyer and provider and has no incentive to provide a better price or higher quality. This is especially true in the movement from the medical model to the business model of health care. “The United States spends more on healthcare than any other country in the world, in 2008 US healthcare costs were 2.3 trillion or 7,000 per capita. The US per capita cost is 45% greater than our northern neighbor Canada, and 33% greater than Norway”. (Organization for Economic Co-operation and Development (OECD), 2011). The business model is profit based. Requiring a profit almost always includes streamlining of services and mandating cost controls. Both of which limit the insured’s access to services, drugs, and new technology.…

    • 4284 Words
    • 13 Pages
    Satisfactory Essays
  • Good Essays

    Escape Fire Paper

    • 1432 Words
    • 4 Pages

    Dr. Don Berwick, Head of Medicare/Medicaid 2010-2011 whom talks about how unsustainable the healthcare system is. We’re spending almost twice as much in America as any other country on earth. Yearly, we have been spending $2.7 trillion in healthcare. The average per capita cost of healthcare in the developed world is about $3,000, but in the United States, it was around $8,000 annually, more than double. Due to these astronomical amounts, healthcare has not become affordable anymore. Insurance companies are raising their rates they are charging for premiums, covering less on patient care, which in turns takes even more money out of our pockets because we now not only have to pay the premiums, but are now left with the portion of the care given that we must pay for out of our pockets.…

    • 1432 Words
    • 4 Pages
    Good Essays
  • Good Essays

    One solution is providing universal access and increasing financial affordability. Having physical accessibility, meaning health services within reasonable reach providing adequate health care. As well as financial affordability, the people’s ability to pay for services without financial hardship. Lastly, acceptability, when in the environment of different social and cultural factors such as age, sex, or ethnicity. Sadly, universal access is not always ample. The goal in having health insurance or health care coverage is to lighten the financial hardship from unaffordable out of pocket payments. Universal health care is not possible without universal access. Depending on the insurance you possess, different coverage is provided. Medicare, a…

    • 119 Words
    • 1 Page
    Good Essays
  • Powerful Essays

    Managed Care plans are “health insurance plans that contract with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network” (Medline Plus, 2013). We have all had to choose at one point with HMO’s (health Maintenance Organization) and PPO’s(Preferred Provider Organizations), and each person will have a difference in opinion on what they consider the best. Physicians want to work with the one that will help them get more business in their specific area. If there are large businesses in the area, they typically want to use an HMO. So once the physician has decided on their area and picked which way they would like to go, they must now become a part of the managed care systems.…

    • 2141 Words
    • 9 Pages
    Powerful Essays
  • Good Essays

    The health care system in the United States has been growing and changing for years and will continue to do so for years to come. The one constant in the Unite States health care system is change and evolution through evaluations of those changes. If there had not been unrest with the level and provisions of care in the early 1970s Managed Care may have never been introduced. President Nixon signed legislation in 1973 termed, Health Maintenance Organization (HMO) Act of 1973. This pivotal event in the health care system allowed for a change from the fee for service model to a comprehensive range of medical or health care services in a single organization. (Mueller, 1974) Although there had been prior prototypes, such as Kaiser Foundation health plan, this legislation was documentation of the governments support and the beginning of Managed Care. The impact of managed care is both historic and immutable, yet even today, with the early growth of consumer-driven healthcare, managed care continues to morph(Navarro et al, 2009).…

    • 792 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    Davis, S.R., & Meier, S.T. (2001). The elements of managed care: a guide for helping professionals. Belmont, CA: Brooks/Cole, Cengage Learning.…

    • 2280 Words
    • 10 Pages
    Powerful Essays
  • Powerful Essays

    Mainly, as a result of managed care in the 1990's, the healthcare system is perceived to be on the decline, i.e. increased cost, poor quality care, increased number of uninsured, mistrust of the providers and insurers, unethical behavior by both insurers and providers, etc (Fottler & Malvey, 2004). On the macro level, insurers shaped these perceptions by high insurance premiums and those that are out of reach for many Americans (who remain uninsured). Unethical behavior by insurers hasn't helped the matter either. Healthcare executives should develop better leadership and public relations savvy. Many institutions have incurred a world of trouble when they were perceived as violating fundamental values. The introduction of managed care resulted in the eroding of public trust and perceptions of a steady decline (due to medical errors, increased workload, eroding physician-patient relationship, less people insured, etc.) in the healthcare system (Teixeira, 2005). Low levels of trust amongst providers and insurers also lead to mistrust, low level care, etc. The level of trust in the industry has dipped to a critical level. Nurses distrust doctors. Doctors hate insurers andmanaged…

    • 1492 Words
    • 6 Pages
    Powerful Essays
  • Better Essays

    For some time now, Americans have been wanting to switch to a universal health care system. A healthcare system where all Americans will have access to the proper health care that is affordable and fits their needs. Some solutions that can be implemented are replacing for-profit insurance companies, reforming the health care system, and hiring insurance companies that have slow cost growths. These are excellent solutions because there are a substantial number of Americans who do not have health insurance and desperately need it. However, we should not put a national health care system into effect because our current health care system is in a corrupt state and has to be addressed before we can move forward.…

    • 1215 Words
    • 5 Pages
    Better Essays
  • Good Essays

    Presently in the United States there are several different health care plans and the decision to accept Managed Health care plans become difficult. Managed care is the most utilized form of health insurance in the United States for it provides cost that is efficient versus paying for services rendered in one lump sum. However like everything in life, there are pros and cons to consider when it comes to managed care versus traditional insurance.…

    • 785 Words
    • 4 Pages
    Good Essays
  • Better Essays

    Evolution of Managed Care

    • 1519 Words
    • 7 Pages

    References: Davis, K., Collins, K., & Morris, C. (2006). Managed Care: Promise and Concerns. Retrieved on August 25, 2010, from http://content.healthaffairs.org/cgi/reprint/13/4/178.pdf…

    • 1519 Words
    • 7 Pages
    Better Essays
  • Better Essays

    Health care reform has been a budding issue within the United States this past year, and problems continue to surface. At the beginning of this process, Americans wanted the government to ensure that all citizens would be able to have affordable and good health care, no matter what their financial situation. The price for health care was increasing at a rate that people could no longer afford it and a lot of people desperately wanted a universal health care systems like some of their neighboring countries. In a sense, change was needed, but how this change came about is the real issue…

    • 2608 Words
    • 11 Pages
    Better Essays
  • Good Essays

    Hospice Outline

    • 653 Words
    • 2 Pages

    While debate continues on both the success and the future of managed care, one cannot deny the increased emphasis on cost containment. The results of managed care and the continuing evolution of the American health care system are both quantitative and qualitative. They range from a reduction in hospital admissions and stays to an increase in ambulatory care, out-patient surgeries, and home care from an emphasis on prevention and better decisions by consumers about health-related behaviors to the sometimes limited choices by consumers in selecting practitioners and in utilizing benefits from increasing limitations in coverage with higher deductibles and co-pays to the reality of a still significant portion of the population among the disenfranchised or uninsured and from quality of care and treatment to issues and concerns around trust. Four of these areas will be addressed in greater detail below. The Institute for the Future in Health and Health Care 2010 described three tiers of coverage in todays evolving health care system and projected how individuals and families may experience this changing system based on which tier of health coverage describes their particular situation (2000). Their observations are summarized below Tier 1 The securely enfranchised. The first group represents 38 percent of the population. It consists of empowered consumers with considerable discretionary income, who are well educated and use technology, including the Internet,, to get information about their health. Usually they are able to make choices in their plans and coverages. They are able to educate themselves about health behaviors as well as health care issues and concerns. They are likely to engage in shared decision making with physicians and other allied health professionals. Because access and benefit/ coverage security are not issues for them, and because they are more likely to be politically active, their tier will be the most likely to influence changes in legislation…

    • 653 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Your discussion mentions that a risk of managed care to the payer is that physicians are paid a fixed amount for services on a monthly basis regardless of how much service is used. This risk is with hopes that physician will utilize the minimal amount of service ultimately decreasing health care costs. Physicians who participate in managed care plans also experience potential risk. In managed care plans, physicians can jeopardize relationships with patients (Chan Hong Kit, Abul Rasid, & Md Husin, 2016). Managed care has impacted the way that physicians and patients interact. Doctors are held more accountable with value-based requirements, and patients are engaging more in their healthcare decisions.…

    • 468 Words
    • 2 Pages
    Good Essays
  • Better Essays

    Health Care Utilization

    • 1132 Words
    • 5 Pages

    Orszag, P.R., & Emanuel, E.J. (2010, August). Health Care Reform and Cost Control. The New…

    • 1132 Words
    • 5 Pages
    Better Essays

Related Topics