Question Description
Managed Care Trends/Issue Analysis
Prepare a five-page paper inwhich you research and evaluate what you believe to be the top three mostsignificant trends/ issues in managedcare today. Justify, providing explanations for your threechoices. Include three to five reference sources (excluding the course text)that have been written within the past three to five years.
[Instructor's Tips]
This assignment does ask youabout the top three most significant trends/ issues in managed caretoday (2018). Managed care should refer to a variety ofapproaches intended to reduce the cost of providing health benefits, coordinatebetter care, and improve the quality of care.
Managedcare is not interchangeable with managed care organizations such as HMOs, PPOsor POSs. Managed care is also not interchangeable with the U.S. healthcaredelivery system. I used to work for Magellan, the largest managed behavioralhealthcare organization in the US. Magellan is not an insurance company.Magellan is a managedcare organization that manages mental/behavior healthbenefits for Medicare, Medicaid, and major insurance companies that offer HMO,PPO, POS, and indemnity plans. Magellan also manages employee assistanceprograms for many Fortune 500 companies. Magellan has employed utilizationreview and case management to control the cost of mental/behavioral healthcareand ensure that quality of mental/behavioral healthcare is provided to thepatients.
Have you heardabout disease management that is one main essence of managed care? Have youheard about health wellness programs? Under the Affordable Care Act,managed care organizations have promoted health wellness programs intensively.Have you heard about utilization review? Have you heard about casemanagement? Have you ever heard about Accountable Care Organizations(ACOs) or patient-centered medical homes? ACOs and patient-centeredmedical homes are new managed care models. Are they similar to HMOs, but theyare not the same. HMOs focus on control costs, while ACOs and patient-centeredmedical homes have an emphasis on improving quality of care with evidence-basedpractices. Once improving quality of care is done correctly with evidence-basedpractices, the cost of providing healthcare will be reduced.
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