The independent physician groups and hospitals provide services under the organization's guidelines, but they may also care for patients who are not members. (1997)
While managed care does offer employers more control in choosing the specifics of the health care plan provision at the same time the insurance companies and the profit-drive health-care organizations possess a strong role. Opponents of the government having a primary role in health care financing state that managed care "raises the specter of rationing, lower quality, less freedom to choose physicians, interference with physicians' clinical autonomy, reduced access to specialty care and teaching hospitals, and increased government regulation." (Gottlieb and Einhorn, 1997) Further criticism has been stated in relation to the financial mechanisms employed by managed-care plans geared toward efficiency due to the risk of providers relating to penalties or rewards based on some measures of efficiency.
While health care providers are expected "to provide a wide range of services, recommend the best treatments, and improve the patient's quality of life. However, to keep costs down, they must limit the use of diagnostic services and specialty care, increase efficiency, and shorten the time spent with each patient." (Gottlieb and Einhorn, 1997) According to the American Medical Association there are ethical implications relating to the managed care financial arrangements. Also stated to be fundamental issues in this debate is the fact that "...academic medical centers do not fit naturally within managed-care systems because their missions are so different from those of largely service-oriented managed-care institutions." (Gottlieb and Einhorn, 1997) in fact, the expenses associated with maintaining research and education quality has resulted in many academic medical centers selling the hospital segment of their business.
LITERATURE REVIEW
The David and Lucille Packard Foundation journal 'The Future of Children' Vol. 8, No. 2 states that managed care has "...revolutionized the health care system in America." (1998) Managed care is described as a "vast array of financing and health care delivery practices that are designed to limit costs and ration care." (David and Lucille Packard Foundation, 1998) it is additionally related that healthcare providers and insurers have "created cost0conscious health insurance plans and employers and individuals are subscribing to them at unprecedented rates." (Ibid, 1998) Characteristics common to managed health care plans are inclusive of those as follows:
1) Strong financial incentives for members to obtain health care from only selected providers and hospitals that follow the rules established by the plan.
2) Reliance on gatekeepers, preauthorization, and other techniques to control access to specialty care, diagnostic tests, and hospitalization.
3) Shared financial risk among doctors, the health plan, and other health care professionals through the use of capitated payment methods or bonuses and penalties. (David and Lucille Packard Foundation, 1998)
According to this study reported in 1998, managed care has the potential of improving "delivery, quality and financing of health care services..." (Ibid) Additionally provider networks have served to improve both access to and coordination of care and in addition "the use of financial incentives to providers and members may promote preventive health care." (Ibid, 1998) the information systems which are very sophisticated have the potential to bring about improvement to accountability to customers through costs and services being monitored as well as the health of the managed care system members. Managed care has served to:
1) Reduce overall health care costs;
2) Stimulate the growth of for-profit health care;
3) Stimulate the growth of 'for-profit' health care;
4) Improve the access to preventive health and specifically for children who are privately insured;
5) Decrease access to preventive health care for children enrolled in Medicaid; and 6) Reduce access to specialty care for all insured children with an illness that is 'chronic or disabling'. (Ibid, 1998) critical feature of the revolutionary managed care system is the opportunity that presents in the creation of a managed care system that 'works for children'. The features of such a system are stated as follows:
1) a "medical home" that provides accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care for all children.
2) a defined benefit package that is crafted around children's changing physical and emotional needs.
3) Access to appropriate pediatric specialists for children with chronic or disabling illnesses.
4) Coordinated care both within the managed care network and among other child-serving organizations outside the plan.
5) Rewards and encouragement for the active participation of parents.
6) Fair reimbursement rates, particularly...
He doesn't mention Apple's iPod, iPod Touch, and iPad, but those devices also pose a challenge for traditional radio broadcasting. People can "…select music that suits their individual tastes and many have wider repositories of music in their own libraries" -- thanks to the iTunes and similar services -- than are offered on the playlists of radio broadcasters (Picard, p. 1). Moreover, Satellite and Internet radio are offering "hundreds of
Legislation Pertaining to Foreign Nurses Practicing in the United States Discuss the process that this legislation will go through, referencing the steps to the legislative and administrative process The Rural and Urban Health Care Act of 2001 (S 1259 and HR 2705) dramatically expanded the existing H-1C temporary nursing visa program established in 1999. Before, there were only three ways that foreign-educated nurses could get permission to enter the United States to
Legislation of Foreign Nurses Practicing in the United States The United States Health Care system is undergoing a major crisis of nurse-staffing shortage. A survey conducted by the American Hospital Association -- AHA of 715 hospitals performed during spring 2001 showed that a vacancy of 126,000 positions of registered nurses prevails through out the nation. The International Council of Nurses -- ICN, a federation of 125 nursing organizations indicated it to
Texas is one of the strictest states in the country for nurse practitioners who want to open their own clinics, requiring them to find a physician with the willingness and time to follow a complex set of rules. Those rules include requiring the physician to delegate prescriptive authority, review patient charts, make on-site visits or practice within a certain geographical distance of the nurse practitioner. It's a system many nurse
Many of them who have worked for 20 years as nurses have gone up the managerial or corporate ladder. More and more nurses have chosen more paper work and less patient care by becoming supervisors, administrators and nursing directors and then retire or else proceed to another career if they are not yet retiring (Benjamin). Compounding the problem of shortage were a lack of surgical educational content and clinical experiences
Future Challenges Facing U.S. Healthcare: One of the major issues that the United States has encountered in the recent years is the country's healthcare system especially in the wake of the need for healthcare reforms. However, even with the ratification of healthcare reform policies by the Obama administrations, the country's healthcare system is likely to continue facing some challenges in the future. Current Healthcare Problems in the U.S.: The current healthcare system in
Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.
Get Started Now