Managed Care custom essay

Managed Care custom essay
Melissa Joseph

Healthcare cost has been drastically rising as time cause by. To hold down the rising
healthcare costs, managed care organizations have tried to prevent the indemnity insurance from
taking charge of the health care system. Health care providers have been ordering patients to
undergo various tests that result in exaggerated diagnosis leading to inflated care cost. According
to (Nickitas, Middaugh & Aries, 2016) having physicians as the gatekeepers who can seek
authorization before conducting any tests to the patients helps in keeping the cost down by
ensuring that patients have to go through the PCP before they are being referred for further care
from any specialist.
At times, patients are dissatisfied with healthcare services; therefore, managed care
organization are unable to managed health care spending. Proper interventions and policies need
to be developed and implemented to help in improving the quality of care that the patients
receive and at the same time, maintain the cost of care to enhance the accessibility of healthcare
services.

Jency Mathew

Managed care is an organization in which the patients get into an agreement with the
managed care organization to obtain their healthcare services from specific physicians and
particular hospital whereby the cost of the health care services are being controlled. The role of
managed health care organization is to control the cost of health services (Dugan, 2015).
Multiple choices that are obtained through managed care has caused deterioration of the quality
of care. Managed care organization uses different means of managing health care cost. Through
these various means, physicians are always paid partially with a particular speciality in many

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referrals. Besides, the physician acts as the gatekeepers to control the cost of care that every
patient incurs by sieving the number of referral that is made in a single day.

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References

Nickitas, D., Middaugh, D., & Aries, N. (2016). Policy and Politics for Nurses and Other

Health Professionals (2nd ed.). Burlington, MA: Jones & Bartlett.
Dugan, J., (2015). Trends in managed care cost containment: An analysis of the
Managed care backlash. Health Economics, 24(12), 1604–1618. Retrieved from:
https://doi.org/10.1002/hec.3115

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