Abstract
This is an investigative report on the effects of managed care on the quality of health care. Managed care is a belief that a health care system should work to keep people healthy. However, when people are sick or injured, the health care plan should work to assure the right treatment in the right setting by the right person. There are various forms of managed care.

Tags: managed, care, quality

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."

Tags: Physician, Patient, Healthcare, Managed Care, Conflict, American Medical Association

Abstract
Managed care in the United States consists of Health Management Organizations (HMOs), Preferred Provider Organizations (PPOs), and Medicaid and Medicare. These organizations arose as the growing population of the United States began to demand forms of health insurance that would not only provide services to workers but also their families. This paper discusses managed care health organizations in the US, looking at the reasons these organizations came into being, their origins and their original purpose.

Tags: health, managed, care

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."

Tags: health, care, privacy, rights, doctor, patient, law, insurance, care, provider

Abstract
The American health care system has been at the center of debate for many years. One of the most pressing issues confronting the health care system involves Medicare and its beneficiaries. This discussion focuses on the ramifications of moving Medicare beneficiaries into managed care organizations (MCOs). The paper illustrates that moving the Medicare beneficiaries into MCOs is a bad idea because there will not to be any real cost savings, and many individuals are likely to be denied needed care.

From the Paper
"An article found in American Economic Review explains that Medicare is the second largest government entitlement program in the United States. The cost associated with running this program is astronomical. The article asserts that in 1999 the government spent $230 billion or 13% of its budget on Medicare and its beneficiaries. (Antos and Bilheimer) The major issue with Medicare is that it is expected to grow exponentially in the next few years due to the aging population. It is estimated that 47 million people will be enrolled in the Medicare program. (Antos and Bilheimer)"

Tags: medicare, mco, managed, care, organizations

Abstract
This paper explores the pros and cons of managed care, with special emphasis in the addictions field. The paper examines how managed care providers are now responsible for managing and providing health care coverage for much of addiction treatment. The paper further examines how many health care providers have expressed their concerns that managed care's stronghold in this area may reduce the quality of care afforded patients affected by addiction. The paper provides a synopsis of the pros and cons, with an analysis of the ethical considerations related to health care in general, as well as ethical considerations specific to the field of addictions treatment.

Outline:
Introduction
Benefits of Managed Care
Conflicts or Cons of Managed Care
Ethical Conflicts
How Does Managed Care Impact Ethical Codes
Recommendations and Conclusions
References

From the Paper
"Most of the goals associated with managed care are benevolent in nature. These include focusing on cost containment and quality improvement among health care organizations (Gervais et al. 1999). To this extend managed care agencies are interested in providing comprehensive mental health benefits, they simply aspire to do so in a cost effective manner. Initially managed care organization's primary focus included expanding access to quality health care services for those that were often uninsured or those that lacked adequate health care insurance because of their financial status (Gervais et al. 1999)."

Tags: health, coverage, financial, status, chiropractic, yoga, community

Abstract
This paper looks at the consequences for the American health care system of managed care programs, the primary goals of managed care programs as seen from the health care service providers, and the recipients of managed care programs. The paper also looks at some the inherent ethical contradictions in managed care systems and whether patients can actually be assured quality health care if the cost of that care is the primary consideration.

From the Paper
"Whether we like it or not, managed care is a reality in the United States. Its existence is causing an axiomatic restructuring at all levels of the American health care system. HMO's (Health Maintenance Organizations), PPO's (Preferred Provider Organizations), and physician-hospital organizations have become essential to our current health care delivery system. (Phoon et al., 1996) As the trend in health care continues to move away from traditional plans, it is imperative that we focus on the validity of quality in the managed care system."

Tags: health, maintenance, organization, preferred, provider, insurance, profits, hospitals

Abstract
The paper explores how managed care has affected patients, the healthcare system and the role of the nurse in the contemporary environment of cost containments and justifying expenses to the insurance company. The paper then looks at how managed care has affected the knowledge and skills needed by the nurse and the nursing education they have to receive.

Outline:
How Managed Care has Affected Patients, the Healthcare System, and the Role of the Nurse
How Managed Care has Affected the Knowledge and Skills Needed by the Nurse
The Effect of Managed Care on Nursing Education

From the Paper
"The current system of managed care was initially put into place mainly as a cost-cutting measure, to ease the financial stresses placed upon the healthcare system. However, many have argued that the impact of managed care upon patient health has been, according to most healthcare providers, largely detrimental. Before the advent of managed care, a healthcare provider's "obligations were owed almost exclusively to the patient" (Shapiro 2000). But in the era of managed care, physicians have had to become "more concerned with their obligations to the managed care organization--so much so that their clinical behavior has been altered" (Shapiro 2000). The American health care system is the most expensive healthcare system in the yet America has a higher rate of infant mortality and lower life expectancy than other industrialized nations (Copeland, 2003, p.1)"

Tags: knowledge, skills, education, insurance, providers, costs

Abstract
This paper introduces, discusses, and analyzes the use of managed care in modern health care. Specifically, it includes a brief history of managed care, and positive and negative effects of the process are outlined. The paper provides an understanding of the differences between traditional health care and managed health care.

From the Paper
"Managed care is not a new phenomenon in health care. In fact, it has existed in the United States since the 1920s. "Historians cite the 1930s as the beginning of managed care as we know it today. The launch of the Kaiser Health Plan during World War II resulted in the first clinic-based system of managed care" (Editors). Edgar Kaiser, the founder of the Kaiser Health Plan (still one of the largest and most successful managed care plans), created an American phenomenon. Managed care is strictly an American invention, and still proves most popular in the United States."

Tags: medical, aid, hmo, clinics, patients, doctors, specialists, prescriptions, nurses

Abstract
This paper addresses the ethics of managed care. This topic has come under controversy since its inception in the 1960s in the form of Medicare and Medicaid. This paper shall clearly examine the history of managed care and its evolution from a federally- funded and managed institution to a billion- dollar industry within the private sector. A case study of the current nursing shortage shall be provided in order to present many of the problems that are manifest in managed care. This paper concludes with an emphasis on the potential future of managed care.

From the Paper
"Currently, managed care is most commonly referred to as the Health Maintenance Organization, or the HMO, as this industry has single- handedly dominated the American health care arena. Yet the HMO is not the only form of managed care, but has simply been recognized foremost in the media as encouraging business practices that press the "bottom line" of the economic standing rather than the overall welfare of the patient. This is a controversial practice, especially in respect to how the HMOs maintain the power of health and human welfare. The influence of economic properties in health care has given rise to the question, "Is managed care an ethical institution for the health care industry?" The lack of ethical qualities is highly evident in the case studies of the growth and manipulation of the Medicaid and Medicare systems, where administrative preferences were placed before those of the health care profession."

Tags: ethics, managed, care

Abstract
The paper looks at the system of managed care in the US and shows how, despite the many positive outcomes of this form of healthcare, there are difficulties that have not been overcome. The paper posits that in order for managed care to endure, changes in the marketing strategies for managed care must be considered and there should be renewed efforts to manage patient care by changing the limitation of choice in health care providers.

Outline:
Strengths
Weaknesses
Effectiveness
Conclusion

From the Paper
"There are difficulties with our society's health care. Many solutions have been suggested and many program variations have been tried, but costs have continued to rise and dissatisfaction with services have continued. One of the most recent and most criticized systems is the managed care system.
"Managed care is the most common form of health insurance in the United States. Its intent was to provide a more a cost efficient coverage than traditional insurance programs or paying a per-service charge. Managed Care, however, a very complicated system and often difficult for the insured to navigate."

Tags: HMO, insurance, companies, coverage, patient, physician

Abstract
This paper explains that, with managed care systems, hospitals needed to compete for managed care contracts and gain clout with insurers for better reimbursement rates; therefore, administrators, who are usually not medically trained, save costs by downsizing the R.N. staff, resulting in less favorable patient outcomes. The author suggests that the simplest solution would be to abolish for-profit medical facilities and replace them with facilities judged on how well they spend all their income on patient care by providing the best possible medical care by doctors, nurses and nursing assistants. The paper concludes that, as long as the United States considers the right to make a handsome profit more important than the mandate to provide care for the sick, nothing will change.

Table of Contents
History of Nursing-Staff Erosion
Legal Ramifications
Possible Solutions
Conclusion

From the Paper
"Hospitals may cross-train janitors and security guards to do nursing work. "Studies report that hospital nursing staffs, which once consisted of 85-95 percent registered nurses and only 5-15 percent aides, are now only 80, 70 sometimes 50 percent registered nurses and up to 50 percent aides." This sort of understaffing leads to errors. Sometimes those errors are R.N. errors, due to lack of time to consider all the ramifications of their own and their assistants' actions. For example, in one nursing care facility, an elderly man, called Mr. D by authors Baker and Cooper, was restrained, partially because of his behavior. However, he became agitated during a time when he was not under observation because, with too few assistants, an R.N. had to reassign some staff."

Tags: managed-care, downsizing, mba, for-profit, adminstrators

Abstract
This paper discusses the advantages and disadvantages of managed care. It begins with a brief explanation of traditional health care. The author then explains that the benefits of managed care include medical treatment for the individual at reduced costs. The paper highlights the problems between managed care and doctors. It concludes with the author's personal opinion on these problems.

From the Paper
"Even though dealing with managed care seems like a very trying ordeal, medical workers in the present-day seem to be handling it remarkably well. There is no doubt that it creates a greater strain on the medical profession in general, and that there is much more in the way of paperwork and decision-making that these individuals have to deal with. Just a few years ago, most of the professional's day revolved around taking care of the patients that needed attention. Now, thanks to managed care organizations, much of the same individuals' day revolves around the paperwork necessary to make sure that the rights of those same patients are being upheld as much as humanly possible."

Tags: medical, doctor, patient, insurance

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.

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."

Tags: managed, care, organizations, patients