Managed Health Care

Managed Care is a systemic health service and care delivery structure which have an organized and managed cost, quality, and utilization of health care. The evolvement of managed care plans started in Newyork with prepaid group practice plans such as Health Insurance Plan and Group Health of Puget Sound, where group physicians provided health medical services in a fixed monthly plan. In 1971, the concept of prepaid group practice enhanced the reduction of health care expenditures. It was later renamed health maintenance organizations, and the government and private sector increased funding on managed care plans in health services. In the 1980s, employers recognized indemnity insurance and traditional health care practices, which substantially expanded the health system and plan. In the 1990s, many employers and employees understood the vitality of health care plans and insurance; hence millions were enrolled in receiving health care through managed care arrangements (Barnes et al., 2016). After a century, the managed care plan has revolutionized into Health insurance plans and the Affordable Care Act or Obama Care, enabling citizens to access federal government health care services to themselves and their families.

The U.S. has implemented the Affordable care Act, which facilitates equitable health insurance cover to its citizens. The citizens make monthly or annual subscriptions and payments on Obama Care or the Affordable care act to access health medical services. The Affordable Care system is efficient to all Citizens of America because it lowers the expenses of medical expenditure and it provides a quality health care support system. In another perspective, it becomes inefficient when an insurance health care plan offsets an individual’s payment cost; therefore, it becomes hard for an insurance company to cover the costs of the patient’s when they can’t afford to clear their dues (N.Y. State of Health (2016). Also, the health care plan can exploit citizens when they register to an insurance plan with low premiums but high deductions monthly and yearly.

The legislation authorities and health care managers preview the accreditation of the health care systems and health insurance companies to realize and promote quality and standardized health care to the public. Through accreditation, fraud and exploiting insurance health cover plans can be eliminated and impeded from escalating poor health service provision to the public (H. S. Rexburg (2016). The policymakers, health managers, and law enforcement units collaborate to sue and sanction insurance companies with exploitive and inhumane health service systems, which enhance equitable, efficient, quality, and standardized health care systems to meet customization.

In conclusion, the U.S. improvised has the ISO 9000 accreditation in the health care systems to prevent inefficient health care providers and a joint partnership with federal agencies like DNV, FBI, AOA, and CIHQ to identify, investigate, and establish the gaps in health care provision in the private and public health sector. Such partnerships have increased efficiency and quality health service, health insurance cover to citizens. The ISO minimum standards have greatly improved the hospital safety, quality, and patient and family satisfaction on the health services provisions.

References

Barnes, A. J., Unruh, L. Y., Rosenau, P., & Rice, T. (2016). Health system in the USA.

Health Services Research, 1-33. https://doi.org/10.1007/978-1-4614-6419-8_18-1

H. S. Rexburg (2016, October 19). Accreditation of health care. https://www.youtube.com/watch?v=3XDs7ccTQDs

N.Y. State of Health (2016, January 12). Health Insurance Explained. https://www.youtube.com/watch?v=i9fRGwg0btk