Understanding the Future of Managed Care Saida Ali Holyfield Abstract At one point‚ managed care was the viewed as a resourceful tool in efforts to help assist employee‚ physicians and hospitals with quality health care‚ while controlling the cost of medical care in the United States. Over the past 30 years‚ managed care has been in the limelight of health insurance‚ as a dictator of how it will pay for medical bills. There have been many factors playing a role with managed care over the years. For
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Effectiveness Mental health care is something that everyone is affected by‚ whether it is being provided or being needed. Because of its vast reach‚ it is important to have access to mental health care when needed; Providing that care is no simple task. The article ‘The Managed Care Approach to Health Care Blocks Access to Mental Health Treatment’ (2008) uses pathos‚ logos and ethos as methods of persuasion‚ respectively‚ they elicit: emotion‚ logic and authority. Combined in this situation
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Managed care is any arrangement in health care in which an organization like HMO or another type of doctor-hospital network or an insurance company acts as intermediate with the individual that is seeking care and the physician. The intention of managed care is to eliminate facilities and services that are no longer needed or useful and also to reduce costs. In managed healthcare their insurance plans are very different from the fee- for-service‚ or FFS‚ insurance plans. In the
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For the past several years‚ the health care and insurance industries in America have been undergoing significant reform in order to rein in the high cost of delivering health care services. Managed care has become a cornerstone of this process (Strickland‚ 1995). The case management industry (with its focus on cost containment‚ managed competition‚ and quality care) is playing an increasingly important role in the managed care environment (Owens‚ 1996). According to Mullahy (1995a)‚ the number of
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profit because a fee-for-service was still the predominant form of payment (Zuckerman‚ 2011‚ p. 6). However‚ during the 1990s many medical facilities faced foreclosure and buyouts because of the rise of the managed care industry (Zuckerman‚ 2011‚ p. 6). More recently‚ the Affordable Health Care Act (ACA) has caused many healthcare organizations to reevaluate their strategic plans and missions statements‚ so that they may survive on making less of a profit while still offering a variety of medical
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Differences between Managed Cares Verletta Williams Everest University Online Managed care has been formed since the 1930 and evolved over the last ten years. Since the evolving of managed care there are three types of managed care plans. People that are enrolled in private health insurance are subscribed to a type of managed care plan. There are many differences between the three types of managed care plans and they also have similarities. The involvement of managed care plans are between the
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Achieving and Maintaining Accreditation in Managed Care Accreditation is a process by which an impartial organization (URAC) will review a company’s operations to ensure that the company is conducting business in a manner consistent with national standards. For a physician and a nurse after they receive their degree they have to do continuing education courses every year to maintain their licensing with that particular state. These classes are generally known as CME’s (Continuing medical education)
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Describe the effects of managed care on physician’s practices. Do you see these effects as positive or negative? Why? Some effects are negatively affecting the care that physicians are able to provide their patients. In some patients are being denied health care coverage for health services by health plan providers because the provider does not believe that a severity of an illness is noticeable. For example: A teen tells his/her physician that they feel suicidal‚ but the mental health patient
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The managed care delivery model was intended to decrease unneeded health care costs‚ by controlling the level of service along with the type of service that was being provided. This model came in a response to the rocket costs of the unrestricted fee-for-service plans in the 1980s. (PBS.org) Managed care plans are a type of health insurance. There are several ways the managed care model is expressed one particular way is the Health Maintenance Organization or better known as HMO. HMOs have their
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author mainly concentrated on differences between managed care and public health and he mostly talked about the disadvantages to public health departments due to managed care systems such as‚ decline in grants . Whereas 2nd editorial clearly explains about the advantages of collaboration between Managed Care and Public Health. It also clearly explains how managed care world and public health antagonize each other. The fact is that managed care and public health are co-dependent in the most straight
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