Managed care, health and medicine homework help

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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 1- to 2-page Microsoft Word document: INCLUDE REFERENCES

  • 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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Explanation & Answer

Hello, attached is the answer. In case of any clarification please let me know.Thank you,Jerry.

Running head: MANAGED CARE

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Managed Care

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Professor

University

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MANAGED CARE
Managed Care

We can trace the roots of the managed care back to at least the year 1929. This was
when a physician in Elk City, Oklahoma known as Michael Shadid, came up with a health
cooperative for the farmers in a very small community which had no medical specialists and
even nearby hospital. Michael sold shares to get money for establishing a local hospital as
well as for the creation of a yearly fee schedule for covering the costs incurred in care
provision. By the year 1934, there were 600 family memberships who were in support of a
staff which included Michael, one dentist and four fresh employed specialists. In the same
year, other two physicians from Los Angeles, Clifford Loos and Donald Ross, joined a
prepaid contract to offer comprehensive health care services to 2,000 workers in a water
company.

Types of managed care organizations

HMO (Health Maintenance Organization)-These a type of plan where one has to use
the health care facilities and providers within the Health Maintenance Organization network
to be able to be covered, unless an emergency occurs. The Health Maintenance Organization
gives one a doctors list from which he or she should to choose his or her primary ...


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