Managed Care and Effects on Economics

[jorla9903]

hello all, i have a question here that i am having trouble putting into words, and am hoping that i came to the right forum for help. my question is this, how does managed care affect the economics of health care delivery? an example possibly?

thanks in advance for help.

[classicdame, MSN, EdD]

homework?

Well, here is how it affects my hospital. The more insurance companies that list us as a preferred provider the more patient base we have. This means more healthcare workers and other resources must be available to that patient base.

[ItsTheDude]

hello all, i have a question here that i am having trouble putting into words, and am hoping that i came to the right forum for help. my question is this, how does managed care affect the economics of health care delivery? an example possibly?

thanks in advance for help.

managed care is supposed to affect the economics of health care by lowering and controlling the cost of health care.

in a nutshell, it limits what care a person gets, based on what's defined as reasonable/necessary care by the managed care provider.

[jorla9903]

homework?

Well, here is how it affects my hospital. The more insurance companies that list us as a preferred provider the more patient base we have. This means more healthcare workers and other resources must be available to that patient base.

Not homework, just something that was thrown around in class the other day that I wasn't exactly clear on. Thanks for the reply.

[d'cm]

"managed care is supposed to affect the economics of health care by lowering and controlling the cost of health care."

Well that was the theory behind HMOs, but obviously it didn't work very well. Hence the push for reform. HMOs take money from employers and give it to the providers without the recipient of the care having to feel the cost. Providers get paid more for doing more - so they do- partially because the consumer feels it is free - they are entitled to it. The necessity of weighing cost vs benefit is eliminated and wa-la spiraling out of control healthcare cost. I believe that it is competition in the industry which has made it impossible for the HMOs to control costs because to market their product they need to offer as big a choice of providers as possible. If they deny providers payment or are considered too stringent in their rules of medical necessity the providers will drop out of the plan.