Forms of Managed Health Care

Managed care began as prepaid health care, the provision of a set package of services for a re-established fee. The originators intended to deliver affordable, accessible care to poor and middle-class farmers and labourers who wanted to eliminate unexpected medical bills. Today’s critics of managed care say it has failed in this mission. They argue that consolidation of behavioural health care has concentrated control in the hands of a few powerful financial organizations. These organizations, say critics, place profit ahead of patient welfare, deny or delay access to necessary treatments and providers, award bonuses for reducing referrals to specialists, and arbitrarily discharge providers who use too many resources. For-profit, industrialized health care has not controlled inflationary medical costs, and over 42 million Americans are without health insurance. Managed Mental Healthcare Sample

Forms of Managed Health Care

Managed health care evolved swiftly from the 1980s to the present. Forms of managed care and managed mental health care are defined according to: (1) structural characteristics, (2) relationship of provider and patients to systems, and (3) financial arrangements. Methods to reduce costs include reviewing the medical necessity of services, intensive management of high-cost cases, regulation of inpatient admissions and length of stay, incentives for selecting less costly forms of care, beneficiary cost sharing, and selective contracting with health care providers. Hybrids blend the characteristics of more than one model as a function of diverse sets of local and regional requirements, state regulations, and specific statutes. The major types of managed health care are as follows: (Barker, 2009, 25) Managed Mental Healthcare Sample