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Managed Care and Physicians, 2002.
Presenting the physician's view on managed care within the health sector of the United States.
1,145 words (approx. 4.6 pages), 6 sources, MLA, $ 39.95
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Abstract
Many physicians agree that managed care is not doing the job it was originally created to do. This paper shows that, although reform efforts have not worked in the past, many doctors believe now is the time to revisit reform to combat the lack of health care access to a growing number of Americans, escalating costs, and deteriorating quality. This paper explores the evolution of managed care, and its problems and possible solutions from the viewpoint of two organizations representing the interests of physicians.
From the Paper
"In 1993, President Clinton introduced a plan for regulated health care reform in response to escalating costs and the growing ranks of the uninsured. From 1970 until the time of the reform proposal, health care spending had increased from $74.4 billion to $752 billion annually. The Clinton proposal was met with huge opposition from the ?medical industrial complex? comprised of insurance firms, pharmaceutical companies, hospital suppliers and medical device companies and from the public who had been led to believe that the plan would give the average American less choices and higher costs. After the plan was rejected, Americans turned to managed care to control health care costs, to improve the quality of care, and to preserve their choice of provider and insurance plan. By 1999, ninety-one percent of all employees with health insurance were enrolled in managed care programs ranging from Health Maintenance Organizations (HMOs) that require enrollees to select from a network of doctors, to Preferred Provider Organizations (PPOs) that provide more flexibility in doctor selection at a higher cost than HMOs."
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Managed Care and the Patient-Physician Relationship, 1997.
This paper evaluates how managed care services are changing the dynamics of the patient-physician relationship.
3,270 words (approx. 13.1 pages), 14 sources, MLA, $ 93.95
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Abstract
This paper evaluates managed care and its negative implications on the patient-physician relationship. The author views managed health care as a serious threat to the trust embodied within the traditional patient-physician relationship. It is further argued that if this trust erodes, there cannot be any assurance about the adequacy of that health care system.
A Physician's Conflicting Loyalties
Managed Care Compromises Patient Autonomy
Ethical Problems Associated with Financial Incentives to Limit Care
Solution: Preserving the Physician's Role
From the Paper
"The foundation of the physician-patient relationship is the trust embodied within. It is based on the premise that physicians are primarily dedicated toward their patients, who can expect that physicians will honorably serve them even if it means putting the physician's own health at risk. They can rely on physicians to do everything in their power to help them. (Morreim, 23) It is this trust that enables patients to communicate private information and to place their health, and indeed their lives, in the hands of their physicians. No other individual in the health care system is in a position to assume such an important responsibility, such as the one that physicians have towards their patients. It is this trust between physicians and patients which is the backbone of any successful health care system; without it, there can be no assurance about the adequacy of that system."
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Managed Health Care Systems, 2004.
Presents a new model of model of managed health care in the U.S. using a systems approach.
7,200 words (approx. 28.8 pages), 14 sources, APA, $ 160.95
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Abstract
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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Managed Care and Changes in the Nursing Profession, 2002.
An overview of managed care in the U.S. and discussion of its impact on the nursing profession.
650 words (approx. 2.6 pages), 5 sources, $ 26.95
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Abstract
This paper gives a brief history of managed care in the US, and discusses how the practice and the profession of nursing has changed with the growth of HMOs, PPOs, and other managed care organizations. Generally, this has meant a greater involvement with insurance liability, increased patient access (for the employed population), and increased nurse involvement in decision making. The paper also discusses differences between nurse and physician "culture" that have been brought to the fore in the managed care environment.
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Understanding the Managed Care System, 2006.
This well-researched paper examines the history and current state of the managed care system which began in the 1940s with the creation of prepaid group health cooperatives.
3,110 words (approx. 12.4 pages), 7 sources, APA, $ 90.95
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Abstract
This in-depth paper explores the managed health care system in America. The writer of this paper details the evolution of the managed care system from its inception in the 1940s when health care was developed through the arrangements of an enrolled population and a group of physicians who agreed to work on salary versus on a fee-for-service basis. Also discussed is the government-led reform which resulted in the 1973 passing of the HMO Act, as well as the political and ethical issues regarding doctor-patient confidentiality.
From the Paper
"The trend is gradually changing as local officials become better educated and experienced with human service programs and supportive local interest groups. This is the result of human service personnel and advocates beginning to realize the need for understanding and working effectively with the local political officials. The matter of politics is a two way street. Human service personnel need to learn more about politics. Political officials in turn can benefit from human service personnel involvement. Citizens and policy makers both recognize that better ways are necessary to conduct politics."
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Managed Health Care, 2006.
A definition of managed health care and a discussion about the importance of educating the public about their options.
6,587 words (approx. 26.3 pages), 12 sources, MLA, $ 151.95
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Abstract
This paper defined managed care as the effort to coordinate, rationalize, and channel the use of services to achieve desired access, service and outcomes while controlling costs. It then explains that risk-based managed care are organizations which provide or contract to provide health care in broad/specified areas for a defined population for a fixed, prepaid price. Various strategies are used to control costs and this is accomplished by offering a broad range of services at least the areas of hospitalization, physician care, various types of ancillary care and/or medications. The paper explains the importance of presenting the benefits in advance, along with payments expected from the covered individual or member, so that the person can make an educated decision.
From the Paper
"Health care expenses frequently are too expensive for the average individual to pay as they go, but are suitable for health insurance coverage. Managed care provides either the service directly or contracts to provide them. This differs from conventional health insurance, where the insurer would underwrite the coverage, but not become involved the delivery of services. Managed care providers take a financial risk for part or all of the cost of service. There are three levels of risk. First, full risk whereby the provider accepts all of the financial risk for providing services, as well as all profits and losses. Secondly, partial risks where the provider accepts a portion of the risk. Third, no direct risk to the provider, but receive incentives to control cost. The last one is found in various case-managed primary care arrangements."
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Ethical Issues in Managed Health Care, 2004.
A look at the background and structure of managed care in an effort to reveal the underlying ethical issues and come up with a solution to the problem.
3,334 words (approx. 13.3 pages), 6 sources, MLA, $ 95.95
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Abstract
This paper examines how health care is a unique category of business in that every decision, whether it be clinical or economic, has an ethical component. It looks at how the ethical issues for "managed care" create four major categories of concern: professional, medical, business, and social. It also discusses how some of the most important areas for attention include the lack of professional code of ethics for physician executives, interference with the principles of informed consent and patient autonomy, violation of consumer rights, and social maleficence in obstruction to access and delivery.
Outline
Introduction
The Basics of Managed Health Care
Prioritizing Ethical Issues
Conclusion and Recommendations
From the Paper
"Medical directors and administrators in managed health care organizations today face those kinds of decisions every day (Woodstock Theological Center, 1999). For doctor like Stanley to be able to make good ethical decisions, they must understand the ethical issue involved in managed health care. Many doctors initially feel that the problems lie with the managed health care organizations, as they have seen first-hand many of the "unethical" decisions that managed care organizations make. However, recently, it has become apparent that people who are assumed to have the same perspective, such as the doctors, do not always agree on what would be the right decision. Second, doctors have begun to understand the perspectives of those with whom they disagreed."
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Managed Care and the Poor, 2000.
An examination of HMOs and their effectiveness in delivery of health care to poor and low-income communities. Includes access, capitation, Medicare, structure, physician autonomy, case management, performance analysis, care quality and more.
8,775 words (approx. 35.1 pages), 41 sources, $ 135.95
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From the Paper
"Assessing the Effectiveness of HMOs in the Delivery of Health Care to Poor and Low-Income Communities
Introduction
Managed care programs are increasing in number with the goals of controlling health care costs and continuing to provide quality care. Questions exist, however, regarding the maintenance of quality assurance.
Managed care is becoming the ?backbone of health care delivery in the United States? (Wells, Astrachan, Tischler, & Unutzer, 1995, p. 57). Managed care has two goals in particular?to control health care costs and to provide quality services that are sufficient enough to satisfy the enrollees. Several strategies based on direct control of care and indirect economic incentives are used. Payment incentives include..."
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Trust between Management and Physicians in Hospitals, 2005.
A look at the need for, yet lack of, trust between physicians in hospitals and hospital management.
882 words (approx. 3.5 pages), 2 sources, MLA, $ 31.95
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Abstract
This paper describes the conflict between the inherent objectives of hospital administrators and hospital physicians and how this conflict is the source of the erosion of trust between the two groups. The paper explains that the administrators' goals of conserving resources and containing hospital costs conflict with those of the doctors. It explains that the doctors' goal is to provide their patients with the highest quality care possible and that methods for dealing with this conflict have thus far been inadequate and may even compromise patient care. The paper then suggests that the best way to deal with the problem would be to hire high-quality trainers to conduct world-class, trust-engendering seminars for management and doctors, since none of the current methods for creating trust between doctors and management seem to be effective.
From the Paper
"As for administrators, their sense of trust with physicians, Succi asserts, boils down to one area ? ?cost/quality management.? When alluding to costs of providing services to patients, therein lies a very important factor in running a hospital, and there is little doubt that administrators are keenly interested in keeping costs from rising out of sight. And since hospital administrators are ?rewarded for conserving resources and containing hospital costs? and physicians are gaining credibility for offering ever-higher levels of care, Succi believes these two conflicting concepts create an erosion of trust."
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Financial Incentives and Physician Behavior, 2002.
A discussion on the correlation between the financial incentives that are offered to physicians by Managed Care Organizations, physician behavior and ethics.
8,662 words (approx. 34.6 pages), 15 sources, MLA, $ 182.95
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Abstract
This paper looks at the relationship between the financial incentives that are offered to physicians and their behavior and their ethics. It evaluates, through a literature review and data support, the belief that physicians are spending less time with their patients under pressure from Managed Care Organizations. It shows how because less time is being spent with the patients, the quality of care offered by the physician has gone down and how this is one of the problems with managed care.
Outline
Introduction
Background
Conflicts and Capitation
Purpose of this Research
Goals of this Research
Literature Review
Quality of Care Components
Payment Methods
Physician Behavior
Kaiser Family Study Theoretical Implications
Financial Incentives
Theoretical Implications
Ethics
Methodology
Results and Findings
Discussion
From the Paper
"There was a problem with the MCO system, however. It created a conflict of interest for many physicians. The main concern was that the quality of care was being compromised because physicians had to be careful how many tests they ordered and how many referrals they made. Because of the quota, there may have been people who needed more advanced care and didn't get it. Not all physicians minded the system, of course, because there are some people in every profession who are only out for the paycheck. The physicians that were dedicated to helping their patients, however, soon took issue with the MCO system."
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Child Center Care Vs. Care by Family, 2007.
This paper discusses child care options and looks at the development of children who attended child care centers compared with those in family care.
3,054 words (approx. 12.2 pages), 12 sources, MLA, $ 89.95
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Abstract
In this article, the writer notes that the question over who should care for children is once again being debated throughout North America, with many advocating that very young children be raised with either their mothers or a close member of the family instead of attending child care centers. The writer discusses research indicating that the poor quality of care given in existing centers throughout the United States is the reason for problems within the classroom, as children who attend these care centers are believed to have both development and social problems. The writer concludes that the important point of the debate over child care should be how to ensure quality care for children whose parents have to work, or have chosen to work, through understanding and enabling effective and positive child development and growth within center-based childcare.
Outline:
Abstract
Introduction
An Overview of Child Care in the United States
Contemporary Childcare in the United States
Towards an Effective Child Care System
Conclusion
From the Paper
"The changes in society over the past few decades have completely transformed the contemporary world, mainly through the consequences of warfare and the recent advancements in technology, which has also changed the lives of women. Accounting for almost half of the nation's workforce, a vast majority of them either are already mothers or will be, which means that something needs to be done about the childcare situation in America. Although center-based childcare is not, perhaps, the ideal situation for mothers and their children, most parents have little choice."
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Health Care and Managed Care, 2002.
Shortcomings of health care with the implementation of managed care.
4,150 words (approx. 16.6 pages), 17 sources, $ 151.95
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Abstract
This paper discusses the shortcomings of the American health care system with the implementation of managed care. The risks and future trends in the system are looked at as well as examples of what the system has faced.
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Managed Care and the Care of Suicidal Patients, 2001.
Takes a look at the managed care health system and how it affects the care of suicidal patients.
1,245 words (approx. 5.0 pages), 8 sources, $ 42.95
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Abstract
This paper discusses managed care, which is a system where health insurers closely monitor patients' treatments and restrict their insurance benefits to cover only services that the insurer judges to be "medically necessary." This system has had an important effect on the care of suicidal patients. This paper looks at these effects and evaluates their effectiveness.
From the Paper
"Managed care treatments are designed to help people move through their current crisis and restore them to their previous level of function, and the managed care companies ask that the patient's treatment focus on the objective signs of impairment that the patient presents."
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Physician Income and Physician Supply, 1999.
Examines why both income and supply have increased from 1977 to 1994. Discusses the impact of managed care, statistics, quality of care and specialists. Includes charts.
2,250 words (approx. 9.0 pages), 13 sources, $ 79.95
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From the Paper
"PHYSICIAN INCOME AND PHYSICIAN SUPPLY: AN ECONOMIC ANALYSIS
Abstract
This research examined why physician income has increased in the United States as physician supply has increased. This question was analyzed with data for the 1977-1994 period, as this period (1) reflected the substantial changes in both physician income and physician supply and (2) provided complete data for each of the variables prior to the time that managed care became the dominant force in health care delivery in the United States.
No anomaly was found between the actions of demand, prices, and supply in the physician care market for the 1977-1997 period and economic theory related to demand and supply when the data were considered on a disaggregated basis. The anomaly appeared ..."
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Health Care Managed Care and Fee-For-Service Plans, 2000.
2,790 words (approx. 11.2 pages), 11 sources, $ 83.95
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Abstract
This paper focuses on the quality of care delivered by various forms of managed care organizations and fee-for-service organizations as reported by numerous recent studies.
From the Paper
"There is a current climate of distrust and frustration with managed care which has led many people to question whether health maintenance organizations (HMOs) and other forms of managed care really are looking out for the best interests of their patients. Managed care plans have incentives in place which reward physicians and other health service providers for providing fewer services or less costly solutions. With American society?s negative feelings toward managed care medical practices, questions about the quality of care provided by various managed care institutions have been raised. The fact that managed care enrollment has been increasing while at the same time growth in total healthcare expenditures has been declining only serves to increase the frequency of questions about the quality of healthcare provided by managed care organizations. This paper will focus on the quality of care delivered by various forms of managed care organizations and fee-for-service organizations as reported by numerous recent studies."
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