Healthcare Economics
managed care
In the United States, managed care is becoming an
increasingly popular method of administering healthcare. It influences the
clinical behavior of providers, as it combines the payment and delivery of
healthcare into a single system, the purpose of which is to control the cost,
quality, and access of healthcare services for a single bracket of health plan
enrollees (Scutchfield, Lee, & Patton, 1997).
Yet, managed care often evokes strong or negative reactions
from healthcare providers because they are paid a fixed amount for treating
their patients, regardless of the actual cost, which may influence their level
of efficiency. This can challenge the relationships between doctors and
patients (Claxton, Rae, Panchal, Damico, & Lundy, 2012; Sekhri, 2000).
Research managed care's inception and study some examples.
Be sure to investigate the perspectives about managed care from the vantage of
both healthcare providers and patients. You can use the following keywords for
your research—United States managed care, history of managed care, and managed
care timeline.
Based on your research, answer the following questions in a
8- to 10-page Microsoft Word document: •What are the positive and negative
aspects of managed care? Analyze the benefits and the risks for both providers
and patients, and how providers should choose among managed care contracts.
Conclude with your analysis and recommendations for managed care health plans.
Your response should include answers to the following questions: ◦Summarize the
history of when, how, and why managed care was developed. ◦Define and discuss
each type of managed care organization (MCO)—health maintenance organization
(HMO), preferred provider organization (PPO), and point of sale (POS). ◦Explain
the positive and negative aspects, respectively, of managed care organization
from the provider's point of view—a physician and a healthcare facility—and
from a patient's point of view. ◦Explain the three types of incentives for
providers for efficiency in the delivery of healthcare services. Explain who
bears the financial risk—the provider, the patient, or the managed care
organization. ◦Offer your recommendations, to accept or decline, for patients
considering managed care health plans, with your rationale for each
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