Managed Care Techniques
One of the most characteristic forms of managed care is the use of a panel or network of health care providers to provide care to enrollees. Such integrated delivery systems typically include one or more of the following:
- A set of designated doctors and health care facilities, known as a provider network, which furnish an array of health care services to enrollees
- Explicit standards for selecting providers
- Formal utilization review and quality improvement programs
- An emphasis on preventive care
- Financial incentives to encourage enrollees to use care efficiently
Provider networks can be used to reduce costs by negotiating favorable fees from providers, selecting cost effective providers, and creating financial incentives for providers to practice more efficiently. A survey issued in 2009 by America's Health Insurance Plans found that patients going to out-of-network providers are sometimes charged extremely high fees. Other managed care techniques include disease management, case management, wellness incentives, patient education, utilization management and utilization review. These techniques can be applied to both network-based benefit programs and benefit programs that are not based on a provider network. The use of managed care techniques without a provider network is sometimes described as "managed indemnity."
Read more about this topic: Managed Care
Famous quotes containing the words managed, care and/or techniques:
“Nearly all the Escapists in the long past have managed their own budget and their social relations so unsuccessfully that I wouldn’t want them for my landlords, or my bankers, or my neighbors. They were valuable, like powerful stimulants, only when they were left out of the social and industrial routine.”
—Willa Cather (1876–1947)
“A new talker will often call her caregiver “mommy,” which makes parents worry that the child is confused about who is who. She isn’t. This is a case of limited vocabulary rather than mixed-up identities. When a child has only one word for the female person who takes care of her, calling both of them “mommy” is understandable.”
—Amy Laura Dombro (20th century)
“It is easy to lose confidence in our natural ability to raise children. The true techniques for raising children are simple: Be with them, play with them, talk to them. You are not squandering their time no matter what the latest child development books say about “purposeful play” and “cognitive learning skills.””
—Neil Kurshan (20th century)