Managed Health Care Issues Essay

3222 Words 13 Pages
When one examines managed health care and the hospitals that provide the care, a degree of variation is found in the treatment and care of their patients. This variation can be between hospitals or even between physicians within a health care network. For managed care companies the variation may be beneficial. This may provide them with opportunities to save money when it comes to paying for their policy holder’s care, however this large variation may also be detrimental to the insurance company. This would fall into the category of management of utilization, if hospitals and managed care organizations can control treatment utilization, they can control premium costs for both themselves and their customers (Rodwin 1996). If health …show more content…
The second category is preference (Kongstvedt, 2007). When the term preference is used, what it means in this sense is that there is more than one way to cure the patient. This means that the patient has a choice to make between the specific treatments. The patient’s preference to certain treatments defines how utilization management works. Patients in the same region may prefer a single treatment to another or patients of a specific age demographic may opt out of surgery when a younger crowd may see it as the only option (Kongstvedt, 2007). The third and final category of unwarranted care is supply. The term does not refer to supplies as in the usage of equipment or tools needed to perform a job. The word “supply” is referring to the treatment that is most available is the most often used in regards to a patient’s care. For instance, in a state that the majority of the population is elderly patients, who use Medicare, will have higher per capita spending for Medicare patient’s than the states that do not have a high population of elderly residence using Medicare services (Rodwin 1996). With these categories in place, managed health care organizations can group health care into these categories and establish parameters for reducing cost and create cost effective utilization of health care resource to all of their customers. Utilization management was set in place to contain costs, but one might also assume that by
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