Introduction
Health care services are the most essential as they cater to the health conditions of the individuals in society. There is a need for proper management of the health centers to ensure that the services delivered are of the best quality and the most reasonable costs.
Managed care
Managed care refers to any system which handles healthcare delivery and whose aim is to monitor the costs. It is depended upon the physician who is considered as the gatekeeper as all those seeking medical attention have to go through him to obtain the services. Managed care entails diverse techniques which are intended to minimize the cost of health benefits and boost the quality of care for the concerned organizations. These mechanisms include programs to review some medical necessities for specified services, increasing cost-sharing for the beneficiaries, financial inducement of the health officers and patients to opt for less expensive forms of care, or control of the number of admitted patients. These and some other techniques should be considered to ensure well-managed health care. This is also facilitated by consumer-driven health care which involves creating awareness to the consumers about information relating to their health centers and letting them control the costs of the services offered thus they can improve the quality of health services they receive (Scandlen, 2005).
Managed care originated from the US back in the early 19th Century in response to a health care that was not suitable to the patients in terms of the quality of services offered and their costs. It was developed by the Health Maintenance Organization Act of 1973 and the techniques implemented are currently used by various nongovernmental health benefit programs. Since its origin, the unnecessary cost of hospitalization and medication reduced forcing the providers to discount their charges and improving the quality of their services to survive in the competition.
In the US the development of managed care was incited by the empowerment of the Health Maintenance Organization. This has made the process of managed care almost ubiquitous although it is blamed for the failure of the overall role of controlling medical costs hence there are many critics on the general effects of managed health care delivery in the US. Despite the implementation of managed health care services to reduce the cost of services delivered, the health expenditures of the US have recently increased to outstrip the general national income to approximately 2.4% more than the yearly GDP since the 1970s (Tietze & Sinha, 2003).
The potential impact of health care reform initiatives on managed care in the U.S.
The health care reforms have had positive effects on managed care in the US since the conditions have improved. The standards are set to be achieved by any organization offering the health services and the prices approximated to avoid exaggerations. This is effectively achieved by forming organizations such as Utilization Review Accreditation Commission whose auditors move from one organization to the other ensuring that quality services under regulated prices are offered. This ensures that the objectives of the managed care are achieved since no health organization is permitted to operate without registering with the standardizing organizations. Any organization whose operations meet the set standards can seek accreditation or approval from the concerned organization
The reforms may help to reduce the economic crisis since the medical expenses will not outweigh the general income of the nation and the costs of importing materials and machines will be regulated by these organizations. The managed health care will be able to reach all the targeted groups through the standardizing organizations (Gitterman, 2000).
Conclusion
To have well-managed health care with an equal value of services, standards should be set to determine the value of services offered by an organization. This also helps the management of the health organizations to know the best decisions to consider for proper management.
Reference List
Gitterman, D. P. (2000). The president and the power of the purchaser: Consumer protection and managed care in the United States. Public Health Policy Unit. 43 (1); 103.
Scandlen, G. (2005). Consumer-driven health care: Just a tweak or a revolution? Health Affairs 24(6).
Tietze, M. F. and Sinha, S. K. (2003). Impact of managed care on healthcare delivery practices: The perception of healthcare administrators and clinical practitioners. Journal of Healthcare Management 48 (5); pg. 311.