Managed care is a system of delivering healthcare by organizations known as ‘HMO’s or ‘Health Maintenance Organizations’ that provide healthcare in the form of customized packages known as ‘health plans’. The cost of delivery is combined with provision of quality in the healthcare. More than half the population of the US, which has been insured, has a managed care package (Le Grand, 1998). There are several challenges that managed care hospitals could be facing in the US. These include: – 1. Many hospitals are reconfiguring the manner in which they would be adopting managed care plans.
This is especially to provide cost-effective treatment. However, certain changes are very dangerous and seem to be unsafe. Registered nurses are frequently utilized less often under the managed care plans. Hence, coordinated and hassle-free medical care may not be achievable. The services of the nurses are utilized less frequently as a cost-cutting mechanism. However, it is important that the hospital understands that nurses play a very important role in managing the patient care effectively, and should not reduce their services as a cost-cutting measure.
Many hospitals are utilizing the services of nurses and reducing the services of other personnel that may not be needed. They feel that the services of nurses could be extended (The American Nurse s Association, 2007). 2. Hospitals having managed care packages are not providing customers with greater options in treatment and diagnostic procedures. This may ultimately affect the quality of care provided. Customers are often offered very little options, and may even be forced into certain procedures. The hospitals, to keep the costs of medical care down, may specifically do this.
However, this could negatively affect the hospital. Customers should be provided with greater choices and even offered the latest diagnostic and treatment techniques. Some of the hospitals are keeping the costs down by minimizing unnecessary expenditure, simplifying administrative processes and ensuring more number of customers are brought into the health plans (by offering attractive and quality assured plans). Offering the available options in treatment is required as a part of the informed consent process (Rogoski, 2003). 3.
Managed care organizations favor admitting the patients less frequently to the hospital or lowering the period of hospitalization. Many times hospitals are confronted with removing the patient out of the hospital, although they urgently require care. In such a situation, the managed care organization should try to identify the patients that require hospitalization frequently, and provide them with specialized packages that cover their health needs. Such packages would obviously be costlier (Millenson, 1986).
References:
Millenson, M.(1986), Managing Health Care, Retrieved on July 22, 2007, from Alicia Patterson Web site: http://www. aliciapatterson. org/APF0904/Millenson/Millenson. html Rogoski, R. R. (2003), Managed Care’s Challenges, Retrieved on July 22, 2007, from HMT Online Website: http://archive. healthmgttech. com/archives/h0303cover. htm The American Nurse s Association (2007), Managed Care: Challenges & Opportunities for Nursing, Retrieved on July 24, 2007, from The American Nurse s Association Web site: http://www. nursingworld. org/readroom/fsmgdcar. htm