How Has Manage Care Affected Health Care Delivery

Robert Bu

The role of Managed Care in shaping our Health Care system has been large. It has affected us at the individual level and as a whole at the national level. It has reshaped thinking regarding the role of financial intermediaries and the patient-physician relationship. Depending on your view of health care, these changes are for the good or have hurt our overall system of delivery.
At the organization level many hospitals formed systems in order to compete in a market driven by negotiations and leverage when dealing with health plans. (Ginsburg, 2005) A significant number of hospitals bought primary care practices in an attempt to create an efficient system. This strategy rarely worked, in large part due to the decreased production on employee physicians. (Ginsburg 2005) Integrated Delivery Systems (IDS) were seen as the wave of the future, but we are now seeing many hospitals sell off their physician practices or simply not renew contracts.
The physician practice and physician-patient relationships have been altered by managed care. Once upon a time in our communities, the family doctor was viewed as a part of our family. With managed care we sometimes take a more skeptical view of our relationship. Few physicians on their own had the leverage to negotiate prime deals with insurers; therefore we saw more formal and informal groups form.
The US health system is now at battle between the need for simplicity of dealing with patients and physicians on a group financial scale in a market where the product, health care delivery, is very complex and individualized. This has created a very inefficient system of delivery with multiple conflicting motivators. (Bar-Yam, 2006) These dueling motivators have created a backlash.
Patients have regained input into there health care choices. Preferred Provider Organizations (PPO) have made gains over HMOs and many state legislatures have enacted “patients’ bills of rights”. (Ginsburg, 2005) In response to patients desire for choice many insurance companies are now shifting increased costs to patients and limiting choices less with the “sharpest changes in cost sharing” being applied to prescription drugs. (Ginsburg, 2005)
With political winds shifting every day it seems, it is a challenge for health care organizations to judge the direction they should set sail. Many hospitals continue to consolidate in an attempt to gain access to capital. Patients who wish to gain choice will need to continue paying for it. However the drive for efficiency continues. One very positive emphasis has been the focus on prevention of illness and injury in an attempt to create cost effective efficiency.

What positives have you seen occur in the past two years of health care coverage? What needs do you feel could be improved upon?

Bar-Yam, Y., (March 2006), Improving the Effectiveness of Health Care and Public Health: A Multiscale Complex Systems Analysis, American Journal of Public Health, 96, 3, 459-467.

Ginsburg, P.B., (Nov/Dec 2005), Competition In Health Care: Its Evolution Over The Past Decade, Health Affairs, 24, 6, 1512-1523.

How Has Manage Care Affected Health Care Delivery

Robert Bu

The role of Managed Care in shaping our Health Care system has been large. It has affected us at the individual level and as a whole at the national level. It has reshaped thinking regarding the role of financial intermediaries and the patient-physician relationship. Depending on your view of health care, these changes are for the good or have hurt our overall system of delivery.
At the organization level many hospitals formed systems in order to compete in a market driven by negotiations and leverage when dealing with health plans. (Ginsburg, 2005) A significant number of hospitals bought primary care practices in an attempt to create an efficient system. This strategy rarely worked, in large part due to the decreased production on employee physicians. (Ginsburg 2005) Integrated Delivery Systems (IDS) were seen as the wave of the future, but we are now seeing many hospitals sell off their physician practices or simply not renew contracts.
The physician practice and physician-patient relationships have been altered by managed care. Once upon a time in our communities, the family doctor was viewed as a part of our family. With managed care we sometimes take a more skeptical view of our relationship. Few physicians on their own had the leverage to negotiate prime deals with insurers; therefore we saw more formal and informal groups form.
The US health system is now at battle between the need for simplicity of dealing with patients and physicians on a group financial scale in a market where the product, health care delivery, is very complex and individualized. This has created a very inefficient system of delivery with multiple conflicting motivators. (Bar-Yam, 2006) These dueling motivators have created a backlash.
Patients have regained input into there health care choices. Preferred Provider Organizations (PPO) have made gains over HMOs and many state legislatures have enacted “patients’ bills of rights”. (Ginsburg, 2005) In response to patients desire for choice many insurance companies are now shifting increased costs to patients and limiting choices less with the “sharpest changes in cost sharing” being applied to prescription drugs. (Ginsburg, 2005)
With political winds shifting every day it seems, it is a challenge for health care organizations to judge the direction they should set sail. Many hospitals continue to consolidate in an attempt to gain access to capital. Patients who wish to gain choice will need to continue paying for it. However the drive for efficiency continues. One very positive emphasis has been the focus on prevention of illness and injury in an attempt to create cost effective efficiency.

What positives have you seen occur in the past two years of health care coverage? What needs do you feel could be improved upon?

Bar-Yam, Y., (March 2006), Improving the Effectiveness of Health Care and Public Health: A Multiscale Complex Systems Analysis, American Journal of Public Health, 96, 3, 459-467.

Ginsburg, P.B., (Nov/Dec 2005), Competition In Health Care: Its Evolution Over The Past Decade, Health Affairs, 24, 6, 1512-1523.

Managed Care
Robert Bu

The role of Managed Care in shaping our Health Care system has been large. It has affected us at the individual level and as a whole at the national level. It has reshaped thinking regarding the role of financial intermediaries and the patient-physician relationship. Depending on your view of health care, these changes are for the good or have hurt our overall system of delivery.
At the organization level many hospitals formed systems in order to compete in a market driven by negotiations and leverage when dealing with health plans. (Ginsburg, 2005) A significant number of hospitals bought primary care practices in an attempt to create an efficient system. This strategy rarely worked, in large part due to the decreased production on employee physicians. (Ginsburg 2005) Integrated Delivery Systems (IDS) were seen as the wave of the future, but we are now seeing many hospitals sell off their physician practices or simply not renew contracts.
The physician practice and physician-patient relationships have been altered by managed care. Once upon a time in our communities, the family doctor was viewed as a part of our family. With managed care we sometimes take a more skeptical view of our relationship. Few physicians on their own had the leverage to negotiate prime deals with insurers; therefore we saw more formal and informal groups form.
The US health system is now at battle between the need for simplicity of dealing with patients and physicians on a group financial scale in a market where the product, health care delivery, is very complex and individualized. This has created a very inefficient system of delivery with multiple conflicting motivators. (Bar-Yam, 2006) These dueling motivators have created a backlash.
Patients have regained input into there health care choices. Preferred Provider Organizations (PPO) have made gains over HMOs and many state legislatures have enacted “patients’ bills of rights”. (Ginsburg, 2005) In response to patients desire for choice many insurance companies are now shifting increased costs to patients and limiting choices less with the “sharpest changes in cost sharing” being applied to prescription drugs. (Ginsburg, 2005)
With political winds shifting every day it seems, it is a challenge for health care organizations to judge the direction they should set sail. Many hospitals continue to consolidate in an attempt to gain access to capital. Patients who wish to gain choice will need to continue paying for it. However the drive for efficiency continues. One very positive emphasis has been the focus on prevention of illness and injury in an attempt to create cost effective efficiency.

What positives have you seen occur in the past two years of health care coverage? What needs do you feel could be improved upon?

Bar-Yam, Y., (March 2006), Improving the Effectiveness of Health Care and Public Health: A Multiscale Complex Systems Analysis, American Journal of Public Health, 96, 3, 459-467.

Ginsburg, P.B., (Nov/Dec 2005), Competition In Health Care: Its Evolution Over The Past Decade, Health Affairs, 24, 6, 1512-1523.