Hope Harvey
WednesdayNov 29 at 4:05am
In the 1980s, managed care expanded across the country, which marked a watershed moment in American healthcare. Managed care aimed to efficiently organize and manage healthcare services in response to rising healthcare costs and the need for cost management. According to Scales (2021), managed care models put an emphasis on efficient and well-coordinated care, which has a major influence on healthcare delivery. He highlights the importance of cooperation across healthcare professions and the positive effect of integration on patient outcomes in his research on integrated care models. An emphasis on health preservation to avoid expensive interventions was central to this paradigm, which also placed a premium on preventative care and therapy that were cost-efficient. Capitation, gatekeeping, and network utilization were some of the tactics put into place by the new healthcare organizations that emerged: Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs). The goal of implementing these measures was to better control costs without compromising on the delivery of comprehensive healthcare.
Managed care has also had a major effect on the provision of medical treatment. Because of this change, healthcare providers are now financially motivated to put an emphasis on value-based care rather than a number of services provided, as opposed to fee-for-service approaches. To maximize care provision and ensure consistency, patients were encouraged to seek medical treatment inside specialized networks. The goal was to increase cooperation among healthcare practitioners within these networks (Himmelstein et al., 2020). Additionally, usage review procedures were established as a result of managed care’s introduction to ensure treatments were appropriate and necessary, which impacted the acquisition and utilization of healthcare services.
In addition, healthcare integration has revolutionized the delivery of medical treatment by bringing together medical, behavioral, and social services. Health outcomes are affected by numerous complex factors beyond just medical interventions, and as a result, comprehensive and patient-focused care strategies have been adopted as a result of integration (Jaušovec & Gabrovec, 2023). The result has been better patient outcomes and more effective care coordination because to the increased cooperation between various healthcare providers made possible by this change. Patients may be certain that they will receive continuous and comprehensive care from a variety of specialists thanks to integrated care models, which aim to reduce fragmentation.
Therefore, the future of healthcare delivery and patient care demand is expected to undergo further transformation. Technological progress will have a crucial impact on healthcare, facilitating the provision of care from a distance, telemedicine, and individualized treatments based on data analysis. Adopting patient-centered approaches that prioritize individual needs and preferences will continue to enhance the provision of care. Furthermore, there will be an increased focus on addressing the social determinants of health, which include factors such as educational access, socioeconomic status, and environmental circumstances. This recognition is based on the understanding that these factors have a substantial influence on health outcomes.
The concept of stewardship, as described in the Bible, holds significance in the context of healthcare delivery. According to 1 Corinthians 4:2 NIV “Now it is required that those who have been given a trust must prove faithful.” This principle advocates for the conscientious and ethical administration of resources, in accordance with the concept of effectively managing healthcare while maintaining the quality of care. Healthcare professionals have the responsibility to deliver compassionate and effective care while also being responsible stewards of limited resources, similar to how managed care aims to use resources wisely.
Ultimately, the expansion of managed care during the 1980s fundamentally transformed the provision of healthcare by emphasizing the importance of cost-efficient and well-coordinated treatment. Integration has enhanced care by promoting collaboration among providers. The future of healthcare is expected to incorporate technological innovations, individualized care, and a heightened emphasis on addressing social factors that influence health, all while maintaining responsible management in providing healthcare services.
References
1 Corinthians 4:2 NIV – – Bible Gateway. (n.d.). Www.biblegateway.com. https://www.biblegateway.com/passage/?search=1%20Corinthians%204%3A2&version=NIVLinks to an external site.
Himmelstein, D. U., Campbell, T., & Woolhandler, S. (2020). Health care administrative costs in the United States and Canada, 2017. Annals of internal medicine, 172(2), 134-142.
Jaušovec, M., & Gabrovec, B. (2023). Architectural Evaluation of Healthcare Facilities: A Comprehensive Review and Implications for Building Design. Buildings, 13(12), 2926.
Scales, K. (2021). It is time to resolve the direct care workforce crisis in long-term care. The Gerontologist, 61(4), 497-504.