Evolution of Managed Care Essay

Evolution of Managed Care Name University of Phoenix Evolution of Managed Care Managed Care refers to a program that evaluates, coordinates and makes possible the care of individuals without the full financial risks involved. The goal of managed care was to meet the needs of select group of individuals and families by arranging their health care needs. One example would be employees or individuals paid a set fee to physicians for their services. These fees were set even before any services were rendered so the individual knew what the cost was going to be.Often times an organization would contract care for a certain physician controlling the cost of what the fee would be for their services. The evolution of managed care can be traced back to the early 19th century.Evolution of Managed Care Essay

Over the years there have been many changes to the managed care system to meet the needs and demands of the health services needed. With all the new changes that have taken affect the manage care system has rapidly grown. Through out this paper I will explain where, what and how managed care has changed to meet the needs of individuals.In 1929, Dr. Michael Shadid was considered to be the first managed care pioneer. He started a cooperative health care plan in rural Oklahoma (AMCRA, 1994). With the help from Oklahoma Farmers Union he enrolled several families who paid a predetermined amount and delivered care to these individuals.

In 1929 another organization in Los Angeles offered the same service as Dr. Shadid. The Los Angeles Department of water and power contracted two doctors to offer their services to these individuals. Dr. Ross and Dr.Loos provided care for the workers and families of said organization. After 5 years these doctors opened, owned and controlled the first group practice (AMCRA, 1994).

Around 1933 a Dr. Sidney Garfield and associates started providing medical care on a prepaid basis for workers on a construction project. Workman’s compensation insurance company paid a percentage of the premium income for these accident cases; workers contributed 5 cents from their wages for medical services. This same program was also used by Henry Kaiser in 1938.At the end of World War two, Kaiser opened his comprehensive health services to the public. Kaiser believed he could make it possible for millions of Americans to have comprehensive health services at a price they could afford (Firshein, J. 2009).Evolution of Managed Care Essay

In the late 1950’s two other types of managed care programs were introduced. The first program being individual practice association (IPA), this program was contracted with individual physicians or single specialty groups to provide care. These physicians would provide services at their offices that were enrolled in that type of program.These physicians were able to continue to see other patients that were not under the contract but were reimbursed differently. The second program was the network-model HMO and was contracted with one or more large multispecialty groups (Firshein, J. 2009). These network providers are reimbursed by capitation and receive a fixed monthly payment per person.