Class 7 Unit 4 Topic 2 Comment 1 (L)

Myra

Thing to Remember:

Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

1 References, find resources that are 5 years or less

No errors with APA format 6 Edition

To Comment:

Instead of paying fees for services rendered, Medicaid and, Medicare now outsource healthcare delivery to managed care plans. The plans then take on any risk related to their enrollees’ healthcare costs. Managed care involves a system of care that was organized to manage costs by contracting various managed care organizations (MCO’s) to deliver Medicaid program health care services (McAuliff et al., 2014). Being that insurers may choose different markets, gives them leverage to reduce costs. In order to remain profitable, managed care plans have incentives in an effort to reduce healthcare costs. For example, Medicaid and, Medicare plans have caps on monies reimbursed to managed care plans, anything that exceeds the government limits is absorbed by the plan (Zeiger et al., 2016).

As for managed care diminishing quality, what constitutes quality health care? Healthcare is intrinsically multifaceted therefore, it is difficult to arrive at a consensus. In order to determine the point where cost and, quality is related, we must establish a required quality or accept the historical quality is an adequate point of reference. Keeping that in mind, I have found that managed care has proven to uphold the same standards of care prior to it’s inception and, in some cases proven beneficial as markets must compete for business thereby lowering prices and, driving up quality (Barnosky, 2016).

References

Barnosky, V. (2016). The Effect of Managed Care on Health Care Operations. Medical Technology, 87(6), 686-689.

McAuliff, K., Viola, J. J., Keys, C. B., Back, L. T., Williams, A. E., & Steltenpohl, C. N. (2014). Empowered and disempowered voices of low-income people with disabilities on the initiation of government-funded, managed health care. Psychosocial Intervention, 2(3), 115-123. doi: 10.1016/j.psi.2014.07.003

Zeiger, R. S., Schatz, M., Dalal, A. A., Qian, L., Chen, W., Ngor, E. W., & Kawatkar, A. A. (2016). Original Article: Utilization and Costs of Severe Uncontrolled Asthma in a Managed-Care Setting. The Journal of Allergy and Clinical Immunology: In Practice, 2(4) 120-159.e3. doi: 10.1016/j.jaip.2015.08.003