Managed care refers to a system of healthcare delivery whereby the cost of health insurance is limited as much as possible while maintaining high quality. The system uses a variety of mechanisms that aim to reduce unnecessary expenditures in healthcare, some of which include encouraging patients to choose less costly methods of care, providing only the most important care services, and cost-sharing between insurance companies and beneficiaries (Medicaid, 2019). Managed care organizations consist of various professionals and healthcare centers that work jointly to control the rate of patients’ access to caregivers. Systems such as capitation involve paying a constant fee to physicians for each patient they attend to, regardless of the patient’s illness. Many states are adopting policies to align payment incentives with improved care for people living with chronic conditions. Such high-cost cases are managed carefully to ensure that as the cost is minimized, the quality of care provided is not compromised.
Managed care has been criticized for encouraging compromised care. The need to minimize the cost of care can inevitably lead to the provision of substandard care. The system has made many patients lose trust with their physicians. Many patients feel that caregivers will be looking to spend as little time with them as possible so that they maximize profits and minimize the cost incurred (UOW, 2019). The need to reduce cost leads to the adoption of some strategies such as replacing highly trained caregivers who are likely to charge expensively. Follow-up services are not prioritized in the managed care system. Therefore, while the managed care system might be well-intended in most cases, it often leads to the compromise of quality healthcare services to patients.
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References
Medicaid. (2019). Managed Care. Retrieved from https://www.medicaid.gov/medicaid/managed-care/index.html
UOW. (2019). Managed Care: Ethical Topic in Medicine. Retrieved from https://depts.washington.edu/bioethx/topics/manag.html
