In the paper the topic to be discussed is a significant healthcare event. There are many events that have an impact on healthcare. The significant event that will be discussed in more detail is managed care. The main points to be discussed in further details are how managed care relates to the changes in health care, has managed care impacted the historical evolution of health care, and based on beliefs and values do I agree with managed care’s significance.
To fully understand the significant health care event managed care first needs to be defined. According to Shi, L. , & Singh, D. (2012), “Managed care is a system of health care delivery that seeks to achieve efficiencies by integrating the four functions of health care delivery discussed earlier, employs mechanisms to control (managed) utilization of medical services, and determines the price at which the services are purchased and, consequently, how much the provides get paid” (P. 8). Managed Care Relating to the Changes in Health Care
Health care costs are rising significantly throughout the years. In the 1990s rising cost in managed care grew rapidly resulting in consumers to keep up with these rising costs. Individuals who are paying health care insurance out of pocket are struggling to pay these costs. Conklin, T. stated, “Managed care-on the other hand-reflects a significant change in doing business that gradually reached most areas of the health care arena” (2002). With the changes in health care costs hospital admissions are reducing, increase of ambulatory care, out-patient surgeries, and home care (Conklin, T, 2012).
Individuals’ deductibles and co-pays are increasing in result of managed care. There are many struggles that health providers face when working in managed care. Raiz, I. A. (2006), “The experiences of mental health providers working in managed care settings have paralleled those of providers working in the general health care field, as both are affected by market place trends” (P. 2). Different health providers are affected by the changes in managed care in one way or the other. Managed Care’s impact on Historical Evolution of Health Care
I believe that that managed care impacted the historical evolution of health care. When managed care was developed in the United States the main purpose was to improve medical care outcomes as well as efficiency. Westert, G. P. , “During the second half of the twentieth century, managed care developed in the United States as a mechanism for constraining the growth of health care costs by controlling the delivery system” (2005). The federal government decided to offer managed care options through Medicare because of the growing expenses that the elderly have to through Medicare.
Westert, “Reductions in health care utilization brought about by managed care in the western United States have been adopted in other areas of the nation and the world” (2005). After the increase of managed care through the 1980’s and 1990’s as well as the twentieth century managed care began to decline. The association between the plans and the health care providers began to weaken in the United States when dealing with managed care. Once managed care began rising in cost consumers and providers decided to look elsewhere. Managed care began to change so that the health care providers and consumers come back to use the plans.
When managed care began to decline the increase of insurance deductibles for employee offered by the employers. Agreeing with Managed Care’s Significance based on beliefs and values Based on my beliefs and values I personally agree on managed care’s significance. Managed care has had up and downs throughout the years. The federal government has changed managed care to help the consumers and providers to ensure efficiency and effectiveness for the patient’s. Managed care offers employers the chance to raise deductibles in order to lower insurance premiums. Conclusion
Managed care has made an impact on the evolution of health care beginning with the decline of health care cost to the increase in these costs. Managed care has been changed over the years to better improve the plans for consumers and providers. The federal government is working to find way to improve health care costs for the consumers so that the costs are affordable.