Module 02 Written Assignment - Outline and Annotated Bibliography

Running head: MYTH OF MANAGE CARE 1

Myth of Managed Care

Marion Allen

Rasmussen College

Foundations of Managed Care

May 24th, 2020

1

TITLE OF PAPER 2

Myth of Managed Care

One common myth I found associated with managed care is that HMOs threaten the

quality of care. Managed health care as it was developed in the USA, and the current backlash

towards it, must be viewed in the traditional context of the U.S. health care system and

conditioned both providers' and patients' expectations of unlimited resources and free choice(5).

In this essay, I will be going over why these myths are not valid and provide supporting facts.

The most comprehensive analysis of comparisons on quality found that HMOs provide care

that is generally better than or equal to fee-for-service care. However, HMOs should not be

satisfied with "equal to," since geographic variations in medical practice patterns under fee-for-

service, documented by John Wennberg, M.D., and his fellow researchers, point to significant

quality of care concerns throughout American medicine. HMOs are leading long-overdue efforts

to measure the quality of care so that they can stay up to standard. (6)

The managed care industry should be able to withstand these criticisms if it were making

huge profits, a charge leveled by providers and the public. Although controlled care use has

continued to grow steadily, the net income of most managed care organizations has plummeted.

In 1997, for a reported collective loss of almost 1 billion. As a result, health plans have

significantly raised employer premiums for the third year. They now find their previous allies,

the funders of care, frustrated and antagonistic.

Review of the statics on managed care performance since around 1980 had six studies cite

that HMO plan enrollee can receive more preventive tests, examinations, and health promotion

2

3

TITLE OF PAPER 3

services than plan enrollees (3). Managed care extends coverage to preventive visits and

screening, which is beneficial to vulnerable areas of populations. Part of the RAND Health

Insurance experiment found that youth assigned to an HMO had a 40% greater number of routine

preventive visits and 50% more office visits than a control group attached to a fee-for-service

plan (4).

So, conclusion factual data has shown there is no proven fact that if you use a HMO plan you

are risking not receiving quality care. Personally, I use an HMO plan as it is very affordable and

allows me to choose my Doctors without waiting on a referral. This type of freedom allows me

easy access to transition my care from the provider to the next, which is vital in receiving a high

quality of care. Choosing your healthcare plan should be tailored around what benefits you or

your family.

4

TITLE OF PAPER 4

References

(1) Platt BD, Stream LD. Dispelling the negative myths of managed care: an analysis of anti-managed

care legislation and the quality of care provided by Health Maintenance Organizations. Florida

State University Law Review, 1996: 23: 489–510.

(2) Miller RH, Luft HS. Does managed care lead to better or worse quality of care? Health Affairs, 1997,

16 (5): 7–25.

(3) Miller RH, Luft HS. Managed care plan performance since 1980. Journal of the American Medical

Association, 1994, 271: 1512–1516

(4) Managed Care - DocShare.tips. http://docshare.tips/managed-

care_574b1fccb6d87f5f2d8b4ee8.html

(5) Special Theme – Health Systems Managed care: the US experience.

https://www.who.int/bulletin/archives/78(6)830.pdf

(6) Six major myths of managed health care By John Kingsdale July 27, 1998

Retrieved on May 24, 2020 from

https://www.bizjournals.com/boston/stories/1998/07/27/editorial2.html?page=all

5

Comment Summary Page 1

1. Omit the words, "running head". Page 2

2. You are missing the "title" of your paper. 3. Make sure to indent five spaces.

Page 3 4. Make sure your are double-spacing only.

Page 4 5. Please refer to the APA link on the course home page. Your references should be in alphabetical order and not

numbered.