HSM 544 Managed Care Concept Week 3 Discussions 1

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HSM 544 Managed Care Concept Week 3 Discussions 1
Discuss the concept of managed care. Why was it created? What were its…

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HSM 544 Managed Care Concept Week 3 Discussions 1

HSM 544 Managed Care Concept Week 3 Discussions 1

Discuss the concept of managed care. Why was it created? What were its goals? Have these goals changed? Has it worked? How it can be improved?

Managed care, in theory, should address quality, cost and access concerns.  In practice, what are the limitations of managed care in achieving these goals?  What are the major obstacles to an MCO’s ability to control costs and provide access?  Managed care, in theory, should help control costs, but not all of healthcare has adopted this model.  Why is this the case?  Which managed care programs have been the most successful and why?

Managed care was created for a few reasons. First, the obvious it was a response to rising costs. This was partially due to the payment structure they had at the time (fee-for-service), in which providers were the major benefactors as they had every incentive to provide more care than what was needed increasing their profits. The second was to…