Question description
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.
References:
Claxton, G., Rae, M., Panchal, N., Damico, A., & Lundy, J. (2012). Employer Health
Benefits Annual 2012 Survey. Retrieved from http://ehbs.kff.org/pdf/2012/
8345.pdf
Sekhri, N. K. (2000). Managed care: The US experience. Retrieved from https://monkessays.com/write-my-essay/
who.int/bulletin/archives/78%286%29830.pdf
Scutchfield F. D., Lee, J., & Patton, D. (1997). Managed care in the United States.
Journal of Public Health Medicine, 19(3), 251–254. Retrieved from http://
jpubhealth.oxfordjournals.org/content/19/3/251.full.pdf
Support your responses with examples.
Cite any sources in Help write my thesis – APA format.
Submission Details
Assignment 2 Grading Criteria
Maximum Points
Summarized the history of factors (when, how, and why) that contributed to the development of MCOs.
20
Defined the three main types of MCOs (HMO, PPO, and POS) plans.
20
Explained
the positive and negative aspects of MCOs from a provider, physician
and healthcare facility, and a patient point of view.
60
Explained the three types of incentives for providers for efficiency in healthcare delivery and who bears the financial risk.
60
Offered recommendations to accept or decline each type of MC plan with rationales.
40
Written components.
50
Total:
250
