Managed Healthcare

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Managed Healthcare

A healthy care system that controls cost of services, manages the use of services and measures the performance of health care providers is called managed care. This system is both health care financing and health care delivery. There exists many types of managed care plans but the most common ones are health maintenance organizations (HMOs) and preferred provider organizations (PPOs) (Chowallur, 2008).

Managed care has tried to change the way health care is financed by changing the incentives in health care system. By so doing, managed care has affected health care negatively. Revenue resources under free-for-care service become costs under managed care. More so, managed care discouraged use of care except extremely necessary. This affects in patients hospital care and mental health care. Managed care affects health administrator’s revenue for they only make profits by providing health services which are only absolutely necessary to patients unlike, free- for -service providers which profits them when people get sick and make use of the health services (Todd, 2009). Managed care programs have affected significantly the employment of nurses since HMO has resulted in reduced number of discharges.

Managed care and prospective payments have tried to cause hospital staffing changes so as to cut the costs and expenses incurred in paying health administrator’s salaries. This reduction of medical staff has been associated with the poor quality of health care observed in hospitals (Chowallur, 2008).

Managed care denies the patient freedom o f choosing a health care provider as well it limits the healthcare provider’s ability to order diagnostic tests and therapeutic procedures. In this system, administrators rather than medical and health personnel make decisions about patient’s future health. This results into too few services being provided to patients especially for those patients who require long-term inpatient or out patient care.

The future of health care can be improved only if all the patients even those who odes not have insurance covers are allowed to access managed care services. Also quality of services offered may be improved by increasing employment of registered medical experts and by reimbursing them in time (Todd, 2009).


Chowallur Dev Chacko, M.D. (2008), Let’s reject managed care: “Managed Care: Can’t We DoBetter?” February 2008, p. 11, International Medical News Group Gale, CengageLearning.

Todd, Maria K. (2009) The managed care contracting handbook; planning and negotiating themanaged care relationship, 2nd E.d .Book News, Inc., Portland CRC / Taylor & Francis