Quality in Managed Care

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Qualityin Managed Care

22ndMarch 2017

Qualityin Managed Care

Summary

Managedcare aims at improving the access to health services by loweringtheir cost. The research study conducted by Park and Lee (2015) wasbased on the existing inconsistency on the relationship betweenmanaged care and its access. The researchers investigated howMedicaid managed care is linked to reduced rate of hospitalizationand its quality impacts to patients when compared to traditionalapproaches. The study used 254321 Medicaid patients aged between 18and 64 from sixty-seven counties of Florida in short-term treatmentsto collect data. This data was analyzed by multivariate logisticregression and then compared to Medicaid HMO. The analysis indicatedthat patients of Medicaid HMO had high chances of hospitalization byACSCs. This research also found that the competition influenced thehospitalizations. However, there was no data proving the presence ofspillover effects. It was concluded that the managed care increasedthe hospitalizations which could be prevented. They researchersargued that the increase was due to low costs of the services inFlorida. The findings also indicated that increase in competition didnot benefit the Medicaid patients.

Impactsof Managed Care

Thereare many impacts of managed care to the health system includingstandard improvement, efficiency, and quality assurance among others.It has disregarded the correlation between cost and care qualitysince the management does not allow treatment below standards.However, critics argue that managed care led to higher cost,increasing uninsured individuals, and loss of practitioners (Huffman,Brat, Chamberlain, &amp Wise, 2010). This system puts a downwardpressure on the overall quality of health care when institutions tryto balance their profits and expenditure. Finally, there have beenconcerns about the risk of insurance where some patients push theircosts to other people within the managed care system.

References

Huffman,L. C., Brat, G. A., Chamberlain, L. J., &amp Wise, P. H. (2010).Impact of managed care on publicly insured children with specialhealth care needs.&nbspAcademicPediatrics,&nbsp10(1),48-55.

Park,J., &amp Lee, K. H. (2014). The association between managed careenrollments and potentially preventable hospitalization among adultMedicaid recipients in Florida.&nbspBMChealth services research,&nbsp14(1),247.