Chronic Respiratory Disorders

Paper Summary:

This paper discusses chronic respiratory disorders. The paper examines issues concerning the management of these diseases. The economic benefits for corporations and managed health care are explored. The paper contends that studies have shown time and again that a healthier workforce is a more productive workforce and companies that invest in efficient healthcare plans for their employees generally receive a large return on their investment, notwithstanding the humanitarian implications involved.

Outline
Executive Summary
Background and Overview
Managed Health Care
Incidence of Chronic Respiratory Diseases in the United States
Discussion
Potential Cost Savings from Managed Care Approach
Constraints and Considerations
Conclusions and Recommendations

From the Paper:

"Gatekeeping strategies provided under managed care programs typically include requiring preapproval for services or screening by a primary care physician prior to referral for tests or a specialist visit. In addition, gatekeeping directs patients to certain providers, usually those who have contracted to follow the company's policies and have accepted discounted payments in return for a steady flow of referrals. As the term implies, the gatekeeping function introduces issues that those who need services may be denied them, for instance, based on a strict interpretation of the criteria of "medical necessity." Another constraint is that understaffing or a lack of appropriate credentials among gatekeepers will result in delays in the provision of healthcare assistance or even to adverse decisions about employee healthcare. "Finally, the question of providers' loyalty is raised by the contractual arrangement," Strom-Gottfried ask, "can they fulfill the fiduciary responsibility to their patients while under the management of the payor?" (297)."

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