26 Jun 2022

29

Legal Issues in Case Management

Format: APA

Academic level: University

Paper type: Coursework

Words: 316

Pages: 1

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Universal healthcare has not been achieved in several countries, including the United States. In this respect, there are cases where the healthcare serves needed by the patents are cost-effective o the insurance companies. In such cases, there are several strategies undertaken to facilitate care for the patents, four of which include medical care management, on or near-site clinics, direct primary care, and reference based pricing (Arrieta et al., 2017). Medical care management programs entail coordination of employee care, monitoring ongoing treatment, and suggestions of treatment options for the patients. This management seeks to explore the best medical treatment with the lowest cost making it cost-efficient for the insurance companies. 

Near or onsite clinics also play a significant role in reducing healthcare costs by boosting the quality of primary care, thereby reducing the costs of services for both the healthcare facility and the insurance companies. Other methods to reduce the cost of healthcare are adoptions of direct primary care (Maniadakis et al., 2018). This form of healthcare does not require insurance companies' involvement as the patients pay for their treatment based on the cost to the healthcare facility. Reference-based pricing involves setting up of fixed process for medical services and procedures for insurance companies to pay. 

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Patients' consent is required for them to be placed in intubation; hence the placement without their approval is a violation of their rights. It is within their legal rights to sue the hospital or the caregiver. In such a case, I will first inform the proxy caregiver of the developments and seek their approval for either removal of continuations of the treatment process (Law et al., 2015). The patient will also be informed of the developments in case they recover. It is, however, in their prerogative to either sue the healthcare facility or the healthcare practitioners. 

References 

Arrieta, A., Hong, J. C., Khera, R., Virani, S. S., Krumholz, H. M., & Nasir, K. (2017). Updated cost-effectiveness assessments of PCSK9 inhibitors from the perspectives of the health system and private payers: insights derived from the FOURIER trial.  JAMA cardiology 2 (12), 1369-1374. 

Law, J. A., Morris, I. R., Brousseau, P. A., de la Ronde, S., & Milne, A. D. (2015). The incidence, success rate, and complications of awake tracheal intubation in 1,554 patients over 12 years: an historical cohort study.  Canadian Journal of Anesthesia/Journal canadien d'anesthésie 62 (7), 736-744. 

Maniadakis, N., Holtorf, A. P., Corrêa, J. O., Gialama, F., & Wijaya, K. (2018). Shaping pharmaceutical tenders for effectiveness and sustainability in countries with expanding healthcare coverage.  Applied health economics and health policy 16 (5), 591-607. 

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StudyBounty. (2023, September 14). Legal Issues in Case Management.
https://studybounty.com/legal-issues-in-case-management-coursework

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