Describe what you see as the future of managed care. Base your assessment on a comparison to traditional healthcare delivery systems using cost, quality, and access to care. Include a brief section that provides a comparison with a care system in another country. Feel free to use your previous evaluation of managed care models, reimbursement methods, accreditation options, and government programs.

 

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The Future of Managed Care

The health care system is broken. This is a statement that can be heard in physician offices to the halls of Justice. Costs are soaring, while Americans’ life expectancy and infant mortality rates rank 29th and 30th in the world, respectively (Zakaria, 2012). Traditional health care focused on allowing consumers to choose health care providers and services. Managed care was developed in the United States as a way to control health care costs by controlling the delivery system. It started with organizations like Kaiser Permanente who worked on employing physicians and healthcare providers directly, to better manage costs. Managed care plans in the private health insurance industry control costs by restricting access to specialists, reducing unnecessary hospitalizations, and focusing on well care. In addition, managed care plan force providers to discount their rates, thus spurring consumers to visit particular “in plan” physicians. These restrictions on medical care and services have resulted in patients fearing a lower quality services and less access to care.

In 1984, only five percent of insured Americans were enrolled in a managed care plan, this figure jumped to 50 percent in 1993, and to 90 percent currently (National Conference of State Legislatures, 2011). Consumers were enticed to take part in managed care plans as a way to save money on health care, presumably due to more efficient delivery and better oversight. Yet, health care spending continues to rise each year. Experts suggest 20 to 30 percent of American’s health care spending is wasteful, redundant or inefficient (American Health Insurance Plans, 2012). Traditional methods failed to rein in costs, so now managed care plans are more prevalent……………..

 

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