The down sides to this practice are: 1) physicians may cut utilization too much, causing patient care to suffer, or 2) physicians reduce utilization and may not see the financial incentives they have been expecting.(Wehrwein) .
Many privately owned practices formed groups to assist in their negations with Managed Care Organization's, allowing better financial terms and practice standards in their contracts. Some physicians began to see that so much of their time was spent negotiating contracts and ensuring that each of the rules established by the ever-growing number of Managed Care Organizations were being followed. Quite often, more office staff had to be employed to maintain patient records and to ensure the appropriate referral processes were followed. Those processes change each year as the HMO's find more ways to contain costs and increase the quality of service. In order to remain compliant with the changes, many physicians and office managers had to pick up more duties to maintain the growing administrative responsibilities of practices. Most doctors found that they could no longer do it all. They found it too difficult to effectively juggle all of the administrative and the medical sides of their business. .
Managed care has had a large impact on many issues in health care. One of the many changes has been the effect it has had on the provider system.6 Many practices have consolidated into larger group practices. They hire practice managers and/or administrators that were well educated in healthcare management to handle the day-to-day operations. The role of these managers encompassed much more than training staff to use the phones and schedule appointments, as had been much of the office managers" jobs in the past. Managers know as much if not more than physicians on Managed Care organizations, and have been essential in conforming the overall office flow, to meet the requirements placed upon them by the wide variety of insurance carriers, from governmental agencies to managed care organizations.
