Managed Health Care Systems

Paper Summary:

Health care in the United States has a long history; from the traveling physician who provided services in private homes and charity organizations, to government programs such as Medicare and Medicaid that proceeded hospital construction, and the relatively recent trend of managed health care. Along the way, innovation and competition facilitated new health care technologies and services that offered numerous approaches to prevention, treatment, and management of diseases. In a bold new health care policy, integration and collaboration between the public and private sectors of health care is not only an option, but a necessity in providing the most efficient and sound health care services and options. This paper examines health care in the U.S. from a historical and current perspective and concludes by introducing a new model of managed health care utilizing a systems approach.

Table of Contents
Introduction
Historical Examination of Health Care
Public Sector Health Care in the USA
Private Sector Health Care in the USA
Types of Managed Care Organizations
HMO Models
The Merging of Public and Private Health Care Models
A New Universal Managed Health Care Model
Conclusions
References
Appendices

From the Paper:

"The managed health care industry did slow the growth in health care spending. Moreover, by extending coverage to services provided in an outpatient setting, it reversed the artificial preference for in-patient care that was created by indemnity insurance benefit designs. By focusing on clinical variability in physician practices, the shift to managed care forced the elimination of some unnecessary care. It also provided a stabilizing force to professional fees and institutional charges."

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