Managed Care and its effect on Management at the Primary Care Level.
Managed care has made a phenomenal impact on the Health Care industry. One area in which it has deeply effective medicine is in the role managers play in a variety of health service organizations. Directors and supervisors have to alter their strategic plans and change the course they had previously planned, and physicians have had to change the way they practice medicine. The different types of managers and the individualized and constantly evolving roles they play in Health Service Organizations must meet the needs of these organizations, as well as to remain in compliance with the regulatory agencies on an ongoing basis. .
One of the main focuses behind establishing Managed Care Organizations was to provide quality health care to beneficiaries of the plan, while controlling the costs of services. Many health care providers have found that the patients are given little say in the delivery of their care, as managed care organizations are often too concerned with cost-containment than in the quality of care. Physicians often differ in their methods of treating patients, much the same as any two artists" paintings of the same subject would be different.(Kleinke1456-1457) Often these diverse methods come up with the same results, a healthier patient. When any ancillary services are ordered performed in diagnosing the patient, the treatment costs more. Thus, a main goal of an HMO and other insurance companies is to eliminate the use of any unnecessary ancillary services ordered during the course of treatment of a patient. In doing so, overall costs can be reduced. Physicians and patients contend that the forced elimination of testing will lead to a decrease in the quality of care. The differences in opinion on this issue has started the debate on which managed care organization is better for quality patient care, the capitation or the fee-for-service? The reason many managed care organizations form a Health Maintenance Organization is to offer capitated payments as incentive for providers to avoid over utilizing services.
