Managed Health Care

Within the past thirty to forty years, the scope and personify of wellness economic aid c everywhereage and serving has drastically changed, fixing the bearing in which wellness pull off was previously managed. There be some(prenominal) factors that collect affect the cost of wellness keeping coverage over the course of the past two to trine decades. One of these factors is the introduction and apace increasing enrollment in managed wellness flush insurance policy plans. Managed solicitude health insurance plans can, in most representatives, help to alleviate the upgrade costs of installive aesculapian coverage.Another important factor that has bear on health mission costs is the invention and implementation of radical checkup checkup exam technologies. As prominent researchers and economic analysts produce discovered, there is a trenchant and direct correlation between advancing medical technologies and rising health cope costs. Medical founding ha s been proven time and again to be an important determinant of health charge cost harvest-tide. It would appear that managed rush health insurance plans, which start to lower health rush costs, and highly expensive brand- bran-new medical innovations and procedures are at cross purposes, dis situate against one another in very different directions.Market-level comparisons take hold frame the cost growth of health take in securities industrys with greater managed electric charge penetration to be generally slower than that of non-managed anxiety health insurance markets. However, managed care is unlikely to prevent the share of gross domestic yield spent on health care from rising unless the cost-increasing nature of new medical technologies changes. Managed care health insurance plans differ greatly from regaining fee-for-service, or FFS, insurance plans.Since the early 1970s, rapidly growing enrollment in managed care health insurance plans has transformed the health insurance market in the United States. Virtually nonexistent in most markets three decades ago, managed care health plans covered 63 percent of the nations employees by 1994. Managed care incorpo pass judgment a range of features that allow the insurer greater influence in the process of care pitch.Managed care plans aggressively contract for lower footings from physicians and hospitals and attempt to constrain the use of health care serve by observe declare oneselfrs and changing provider incentives. health insurance providers that operate infra the fee-for-service ideal grant the consumer a lot more(prenominal) freedom of choice concerning doctors and treatment programs, frankincense freeing the consumer of any feelings of discontent with interfering insurance companies. Consumers of indemnity plans, however, fabricate a price for that freedom by way of drastically higher(prenominal) rate and little k like a shotledgeable input on doctors, specialists and nearby hospit als that give fit their particular needs.Many of todays health insurance consumers choose to place their trust in a managed care insurance company, relying on the expertise of the provider to support and facilitate their various medical treatments and needs. Health alimony organizations, commonly know as health maintenance organizations, have emerged as the clear draw of managed care providers. Other guinea pigs of managed care plans include preferred provider organizations, auspicate of service plans and managed indemnity plans. Most studies focus on HMOs and so do not describe variation in the type of HMO or in the purpose of the level of management in non-HMO plans. HMOs have efficaciously reduced health care expenditures (Scheid, 2003)A natural assumption would be that the spirit of care would be lowered as insurance judge go d give birth and remain reasonable and affordable. However, these cost savings have been achieved, according to most evidence, without significan t reductions in the quality of care (Bransford, 2006). This suggests that managed care health insurance plans -HMOs in particular- tend to reduce inefficiencies in the health care system.In fact, a study that psychoanalysed changes in hospital expenses in California found as much as a 44 percent slower rate of hospital care cost growth in markets with high HMO penetration relative to markets with low HMO penetration (Cooper, & Gottlieb, 2000) There are two main types of serve that managed care health insurance companies use to categorize and label their treatments and procedures. These categories are know as complementary services and substitutive services. These two price apply to new innovations in medical technology and the kernel of money spent to provide the technology to the consumer.Complementary services are those whose use increases with the use of the new technology. Complementary services are attractive to the consumer, who, understandably, desires the latest, most e ffective medical technology to treat themselves and their loved ones. For example, suppose an good were to be do in the field of diagnostic imaging. This improvement could provide clearer, higher quality images, thus hold ining to more favorable surgical operation outcomes. The likelihood of a kick downstairs surgical outcome whitethorn result in more individuals electing to receive surgical treatment. The development of this new technology in diagnostic imaging would, no doubt, have been highly expensive. Also, the costs associated with an illness in which there is an increased need for surgical process are usually sort of high.If an innovation leads to greater use of complementary services, expenditures raise more than would be predicted by simply examining the direct expenditures on the innovation. In this case, imaging and surgery are complementary technologies. This example suggests that the use of complementary services may increase the costs associated with use of new innovations by as much as fifty percent. Substitutive services, on the other hand, differ in that they are not provided because of the use of new technologies.The savings associated with the avoidance of these services counterweight the costs of the expert innovations and complementary services. If the innovation results in improved health outcomes, substitution away from services that would have been consumed later may overly occur. It is also hoped that this type of substitution would accompany most preventive services and many other innovations that yield a reduction in morbidness in the long-run. Evidence suggests that medical innovation has led to higher expenditures on health care services. It appears that if the rising cost of health care that results from technological advances remain unchecked by managed care, the effect of technological progress give tend to offset any cost savings achieved by managed care through lower prices or lower use of established services.Fact ors such(prenominal) as population increases, extended life expectancies and overall inflation have contributed to rising health care costs. However, studies have proven that important advances in specific areas of medical technology have had the most intense effect on health care costs. This finding still applies when it is considered in terms of managed care health insurance plans to a certain undeniable fulfilment (Scheid, 2003). Studies have been conducted during many periods over the course of the past several decades, focal point on substantial increases in health care costs in direct correlation to particular medical procedures and fields. Among these procedures and fields are infant birth, radiation therapy, coronary bypass surgery, and nuclear medicine and cancer treatments. For example, the innovation of cesarean sections used during problematic child deliveries has increased health care costs.The various medical personnel mustiness all be correct for their time and l abor the anesthesiologists, the surgeon, the nurses, etc. Also raising health care costs are fetal monitoring and ultrasound techniques. In the case of breast and other cancers, radiation therapy, as well as cabal therapies that include chemotherapy has contributed to rising health care costs. One field of medical practice which has become notorious for being costs-increasing is the study and treatment of emotional state oncomings.In the treatment of heart attacks, the prime cost-increasing technologies were the introduction of intra-coronary streptokinase infusion and coronary bypass surgery. A study performed by Glenn P. Mays, Gary Claxton, and Justin White (2004), using Medicare claims from 1994 to 2001, report card a four percent annual increase in the just reimbursement for treating elderly heart attack patients. They attribute the majority of this increase to the diffusion of new technologies for performing invasive revascularization procedures. Over the period of the st udy, cardiac catheterization rates rose from eleven percent to forty-one percent of heart attack patients. Bypass rates rose from five percent to thirteen percent, and angioplasty rates rose from one percent to twelve percent.The population studied by Glenn P. Mays, Gary Claxton, and Justin White (2004) was overwhelmingly enrolled in traditional FFS Medicare therefore, any finding must represent a spillover. Furthermore, they do not address the likelihood of receiving a related service, coronary bypass surgery, so we have an incomplete ascertain of how practice patterns change over the period of time studied. Different approaches are used to determine the impact of new technologies and innovations on health care costs. One approach, called the affirmative approach, focuses on individual technologies or diseases. This approach suffers from an unfitness to access the aggregate impact of technology on cost growth.The torso of evidence suggests that the impact of technology varies by disease. One study notes that in certain areas, technology clearly lowers costs, particularly when that technology facilitates complete bring round or prevention of a disease (Scheid, 2003). One example of this type of innovation is the Salk-Sabin polio vaccine, which is inexpensive to develop and manufacture and almost entirely eliminates the high costs of polio treatment. Another approach that is used to examine the effect of technology on health care costs is known as the residual approach. This approach views technological advances as being the furbish up reason for rising health care costs simply because the innovations are so expensive that there must be a manner of which to pay for the invention and further development of the technology.The differences between health care givers and the companies that provide the health care insurance have blurred substantially. A decade ago managed health care organizations was referred to as an alternative delivery systems. However, tod ay in the United States, managed health care organizations are now the leading form of health insurance coverage. Every individuals currently hold in the United States of America has a need for affordable and amicable health care coverage. Over the last thirty to forty years, the extent and cost of health care coverage have significantly changed therefore, altering the method in which health care is managed.The take for health care has expanded because of changes in the age population, increasing incomes, and improvement in medical technology. Elderly people take up more health care and health care systems must supply the expected quality if health care. The improvement of medical technology has largely increased treatments to enable people to have a good quality of life. The resource factors such as land, labor, income, capital, goods and services cause shifts in the managed care. The increase in the health care price reduces peoples income and this means that the health care p rice is more expensive in comparing to other goods and services. An increase in income leads to an increase in demand and vice versa. However, a decrease in income volition reduce the amount of health care treatments.The relationship between price and quality of health care demanded indicates the quantity of health care services that can be obtained at conceivable price. A change in price leads to a movement along the demand curve. For example if the price of eye surgery rose significantly, thus people would seek another alternative of treatment. This would lead to a fall in the demand, but when income or prices of health care services change, the demand curve will shift. If the level of cost changes then the supply curve will shift. For example if the doctors or nurses income increases, this process will increase health care cost.Managed care plans substituted the traditional fee for service system. The plans provide a number of economic incentives for health care providers, pati ents, and payers to do health care cost. The increased enrollment will reduce the health care expenditures through reduction of price and quantity. Currently, the new plans are best-selling(predicate) among public sector of health care programs such as Medicaid and Medicare. Medicaid and Medicare is a joint federal and state-run program that provides health coverage to selected low-income individuals who cannot provide their own health insurance and senior citizens over 65 years of age. brass intervention contributes to an increase of health care cost and creates inefficiencies, while wide-ranging employers are cutting benefits, demanding higher contributions from their employees and saying there is more of the same to come, smaller and medium-sized employers offering health care plans dropped in 2002. People competency demand a better Medicare of Medicaid program, but they will be affected by escalating health care costs. The private insurers will be under even more pressure, as they will have to provide policies orient to the needs and budgets of their clients.They will increasingly have to keep costs garbage down by using their bargaining power. People in this country demand health care because they want to be healthy. This trend has been fueling managed health care systems for the last forty years. Changes in health care anatomical structure are influenced in this country by macroeconomic conditions and the standard of living. organisation agencies have a tremendous impact on regulating and imperious of health care spending. Changes in age structure, increasing real incomes, and improvements in medical technology have all fueled this desire for better health care. ReferencesBransford, C.L. (2006). The Exercise of Authority by Social Workers in a Managed Mental Health Care Organization A Critical Ethnography. diary of Progressive Human Services, 17 (2), 63-85.Cooper, C. C., & Gottlieb, M. C. (2000) Ethical issues with managed care Challenges faci ng focussing psychology. The Counseling Psychologist, 28, 179-236.Glenn P. Mays, Gary Claxton, and Justin White 2004 Managed Care Rebound? Recent Changes in Health Plans Cost Containment Strategies (Health Affairs, August 11, 2004)Scheid, T.L. (2003). Managed care and the rationalization of mental health services Journal of Health and Social Behavior, 44 (2), 146-161.