Type: Analysis
Pages: 3 | Words: 726
Reading Time: 4 Minutes

Managed care is defined as a health care system with structures designed to reduce costs. Managed health care was once seen as an effective way of supporting and having a quality health care which could contain costs in the US. But due to the rapid growth of managed care, it has had many implications for both the patients and doctors as well as for the employers, state, insurance and medical institutions. This essay will review and evaluate the future implications of managed care for health care providers in the US.

Its implications. The development of a health care policy is by a greater margin being influenced by cost considerations. Research has indicated that in the US, the Americans are paying more for health care utilization than in Europe which has a greater capacity and a higher utilization of the services than the US. The situation has been frustrating especially for health care providers and the payers. This has given rise to the growth of private insurance but which has also suffered the effects of economic recession and its impact. The need for efficiency and improved outcome for health services gave rise managed care in the US. It later developed as a mechanism for constraining the growth of health care costs. As the size for Medicare program in the 1890s and 90s expanded rapidly, the traditional private insurance shifted drastically from indemnity insurance to managed care plans. Enrollment in Medicare managed care increased from 1 million in 1985 to 6 million in 1999. But as the use of this approach increased, “there was a decline of the annual per cent change in per capita health spending in the nation declined from 5.0-6.9 between 1991 and 1993 to 2.0 — 2.2 between 1994 and 1996”, (Fairfield G., David H., Mechanic D. & Rosleff F. 1997).

The feeling of health care providers in the US towards managed care has had mixed feelings from that of anger, denial, negation and by finally accepting the situation. This is because the clinicians are always torn between competitive packages and resistance due to suspicion of their managers’ motives. There are both positive and negative implications for the health care providers. The positive implications include; there is increased professionalism, there is provision of better and reliable information and also that there’s greater collaboration. The negative implications include reduced clinical freedom, conflict of interest, there’s increased supervision, reduced status and there is a big likelihood of altered doctor patient relationship (Fairfield G., David H., Mechanic D. & Rosleff F. 1997). This shows that health care provides are likely to experience lack of enough freedom although they may derive some satisfaction from the increased professionalism and by working with guidelines thus knowing that their practices are of high standards (Hudak R. & Barkley W. 2010).

Thus there will be need for new staff needs like a new approach to marketing because of the declining opportunities and to stem the rising costs. This means that they will up their role of new enrollments, try to reduce disenrollment, and design appropriate packages for buyers. This implies that the physicians will have to integrate all the above information to build a successful organization. The health care providers will have to ensure that they conduct accurate assessments and report appropriately. This is because the managed care industry will continue confronting several issues and thus the need to tailor unique services that will have to appeal to the market. The physicians will also have to modify the organization’s focus from the “managed care” to either “comprehensive or coordinated care” and then maintain constant feedback to their patients as this will increase patient satisfaction. Clearly, the future will automatically belong to the health care providers who can confront the declining opportunities in the ever rising costs while giving high quality Medicare and increasing customer satisfaction (Hudak R. & Barkley W. 2010).


From the information above, the successful health provider will have to be proactive and be able to change and adapt to the environment whenever need arises. Although designed to help reduce health care costs, the system has had its downfalls and now Americans are paying more to access the services. This puts the health care providers in the spot as they have to be innovative enough and offer excellent services to satisfy the customer, hence a new approach is needed to retain the patient.

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