Question

How does the emphasis on managed care hurt or helped the emphasis on quality of patient care and customer satisfaction?

Answer 1

Ans)Association for Ambulatory Health Care, Inc. accredits managed care organizations with emphasis on clinical records, utilization, quality of care and customer satisfaction.

- The corporatization of health care amalgamates the smaller health care operations into the larger organizations to decrease duplicate and redundant health care provisions. For example, one hospital would provide a high level of cardiac care, and another hospital would focus on oncology. Managed care does not increase community tax base because the costs are paid by the patients and their insurance. Managed care is more of an incentive for larger hospitals and corporations. The focus is to reduce duplication of services, not to use corporate economics to achieve a profit.

- First appeared in the 1920s

- Managed Care Providers refered patients to other providers and facilities within the network - outside care was not covered or covered at a lesser rate (patient pays more to see an out of network provider).
- Payments to providers based on capitation or contracted fee schedules.
- Cost containment a large factor in managed care and service coordination; utilization reviews are ongoing.